FHIR Chat · QI Core Issues · IG creation

Stream: IG creation

Topic: QI Core Issues

Grahame Grieve (Jan 14 2022 at 01:52):

@Bryn Rhodes I've just said that QI Core is a go, but I'm not really thrilled with this:

 <vaccineCode>
    <extension
               url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet">
      <valueCanonical
                      value="http://cts.nlm.nih.gov/fhir-r3/ValueSet/2.16.840.1.113883.3.464.1003.196.11.1220"/>
    </extension>
    <text value="Influenza, seasonal, injectable, preservative free"/>
  </vaccineCode>

Grahame Grieve (Jan 14 2022 at 01:52):

the problem is that the text doesn't match the extension both structurally and detail

Grahame Grieve (Jan 14 2022 at 01:55):

the text is the concept, but the concept is not a concept, it's a value set. And the text is for the first concept in the value set, not the set of things the value set describes.

Grahame Grieve (Jan 14 2022 at 01:56):

and so the rendering of the concept in the IG publisher, and any other system, isn't a correct statement of what's going on, and I don't think it's clinically safe

Grahame Grieve (Jan 14 2022 at 01:57):

and nor did the IG explain to me in any meaningfully way how I would use that extension to say something clinically meaningful, and nor did I find resolving the value set reference in the example at all straight forward

Grahame Grieve (Jan 14 2022 at 01:58):

but we need to get this thing done. Can the committee take this up as a future work item and make sure that's clearly implementable in a safe way in the future?

Bryn Rhodes (Jan 14 2022 at 02:56):

I've logged a tracker for this, happy to take it up: https://jira.hl7.org/browse/FHIR-35802

Bryn Rhodes (Feb 25 2022 at 17:26):

CQI has been working on improving these examples and have some proposed updates, starting with the description of the examples in the negation profile: https://build.fhir.org/ig/HL7/fhir-qi-core/branches/master/StructureDefinition-qicore-immunizationnotdone.html#examples

Bryn Rhodes (Feb 25 2022 at 17:29):

We're proposing that when the notDoneValueSet extension is used, the text of the concept must include "Not done value set: " and then the name of the value set referenced by the extension:

<vaccineCode>
    <extension url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet">
      <valueCanonical value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1254"/>
    </extension>
    <text value="Not Done Value Set: Influenza vaccine"/>
  </vaccineCode>

Bryn Rhodes (Feb 25 2022 at 17:31):

The link to the value set doesn't render in the narrative though, so it's still not possible to browse to the value set from the narrative.

Bryn Rhodes (Feb 25 2022 at 17:33):

In addition, we added a link from each negation profile back to the "negation in QI Core" topic on the home page, and extended guidance for authors and implementers using these profiles: https://build.fhir.org/ig/HL7/fhir-qi-core/branches/master/index.html#negation-in-qi-core

Bryn Rhodes (Feb 25 2022 at 17:34):

@Grahame Grieve , do these changes address your concerns?

Grahame Grieve (Feb 25 2022 at 19:47):

mostly, yes. I'm thinking about this bit though:

The link to the value set doesn't render in the narrative though

Grahame Grieve (Feb 25 2022 at 20:05):

@Bryn Rhodes if the Extension definition adds a display label, then we can display it

Bryn Rhodes (Feb 25 2022 at 21:13):

So using the display extension in R4:

  <vaccineCode>
    <extension url="http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-notDoneValueSet">
      <valueCanonical value="http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.1254">
        <extension url="http://hl7.org/fhir/StructureDefinition/display">
          <valueString value="Influenza vaccine"/>
        </extension>
      </valueCanonical>
    </extension>
    <text value="Not Done Value Set: Influenza vaccine"/>
  </vaccineCode>

Grahame Grieve (Feb 25 2022 at 21:19):

no the label should be on the ElementDefinition in the extension definition itself

Bryn Rhodes (Feb 25 2022 at 22:19):

Ah, I see, so I put it here: https://github.com/HL7/fhir-qi-core/blob/master/input/resources/structuredefinition-qicore-notDoneValueSet.xml#L65

Grahame Grieve (Mar 01 2022 at 01:51):

next release:

Grahame Grieve (Mar 01 2022 at 01:51):

image.png

Bryn Rhodes (Mar 02 2022 at 16:24):

Fantastic, thanks Grahame!

Bryn Rhodes (Mar 02 2022 at 16:25):

Minor issue, but the US Core comparison isn't version-specific:

Bryn Rhodes (Mar 02 2022 at 16:25):

https://build.fhir.org/ig/HL7/fhir-qi-core/branches/master/qa.html#QICoreRelatedPerson

Bryn Rhodes (Mar 02 2022 at 16:25):

We're getting warnings that we're not deriving from USCoreRelatedPerson and USCoreServiceRequest, but those profiles don't exist in the version of USCore we're targeting (3.1.1).

Grahame Grieve (Mar 02 2022 at 20:29):

well, I'm not sure when I'll get to that, but it won't be a problem for FMG

Grahame Grieve (Mar 03 2022 at 00:31):

no, in fact, that's deliberate. We deliberately compare to the latest for that test, since that's about policy and direction. If it turns out that the profile in question didn't exist in your dependency, then you review the differences, and US realm can ask to review the diferences.

Bryn Rhodes (Mar 05 2022 at 21:37):

That makes sense and when we update to the next version we will be deriving from the new profiles.

Last updated: Apr 12 2022 at 19:14 UTC