FHIR Chat · Fasting Patient... · Orders and Observation WG

Stream: Orders and Observation WG

Topic: Fasting Patient...

Eric Haas (Apr 26 2018 at 14:52):

Picking up his stream here for OO discussion
Where we left off: See this http://lists.hl7.org/read/messages?id=327700

Eric Haas (Apr 26 2018 at 15:36):

• OPTION 1 : based on the LRI Guide ( V2) is OBR-13. This would correspond to either a new extension or element DiagnosticReport.fastingStatus.

• OPTION 2: a stand alone Observation that is referenced in ServiceRequest.supportingInfo when the diagnostic is requested on already existing specimens. If the request is entered first with an unknown specimen, The Specimen resource references to the ServiceRequest. Create a new supportingInfo element on Specimen where the patient fasting status Observation could be represented. Other stuff like specimen condition could go here as well ( or in notes like is commonly done today :-)). (note there is a pending tracker on DiagnosticReport to add a supportingInfo element which could also reference the Observation on the reporting end)

Created a Logical FHIR Model on ClinFhir to demonstrate: http://clinfhir.com/logicalModeller.html#ge21z

• OPTION 3: A fastingStatus and condition elements on Specimen.

Created a Logical FHIR Model on ClinFhir to demonstrate: http://clinfhir.com/logicalModeller.html#96vh7

• OPTION 4: to split Specimen (i.e., the tube of blood) from the collection (e.g., Procedure) not sure how the fasting status would be represented here??? but specimen condition would still be an element on Specimen as in OPTION 3,

Grahame Grieve (Apr 26 2018 at 20:52):

option #1 seems too specific. also, it's for reporting (which is needed) and not requesting (which is also needed) nor for 'here's the speciment' - which is also needed

Grahame Grieve (Apr 26 2018 at 20:53):

how does options 2-4 support both 'be fasting when collecting' and 'was fasting when collected'?

Rob Hausam (Apr 26 2018 at 21:08):

yes, we need both, as we discussed on the OO call today

Eric Haas (Apr 26 2018 at 21:29):

'be fasting when collecting' is a patient instruction on the ServiceRequest.patientInstructions

we are talking about 'was fasting when collected'

Eric Haas (Apr 26 2018 at 21:33):

We will be discussing some more and at Koln with BRRR. To be frank, I prefer option 3, but we may need to do a dry run at a connectathon if we can corral some users but I don't think many labs are giving up on V2 anytime soon.

Grahame Grieve (Apr 26 2018 at 21:36):

... on that side note... it's disappointing that labs are sitting FHIR out. of course, they'll continue to report in v2, but they're ceding control of the space to the consumers... there'll be a price to pay for that later for everyone

Last updated: Apr 12 2022 at 19:14 UTC