Stream: Orders and Observation WG
Topic: Observation for Panel (like a CBC)
Gay Dolin (Jul 06 2020 at 17:43):
(deleted)
Gay Dolin (Jul 06 2020 at 17:46):
HI. I'd like to confirm that for my 2 use cases for querying for or sending a lab panel - like a CBC that I would be using observation correctly. My two use cases are really not diagnostic reports, but rather representing within a single observation (or panel observation in this case) for/to.
1) Query to bring in to the MCC eCare Plan
2) Within a C-CDA on FHIR doc or to be sent around as a single observation. Initially, I was thinking it logical to be component observation, but then I noted that what seems to be actually recommended in the base ObservationResource is to use "hasMember" and reference the individual observation.
https://www.hl7.org/fhir/observation-definitions.html#Observation.hasMember
Example: https://www.hl7.org/fhir/observation-example-bgpanel.json.html
So. I'd like to confirm that hasMember indeed the correct way to represent a panel if not sending within a DiagnosticReport?
Rob Hausam (Jul 07 2020 at 04:21):
I think you are correct, Gay, that using hasMember for this (at least in the case of a panel like CBC) is probably the best practice. There is quite a bit of discussion in the spec under Observation Grouping [here[(http://build.fhir.org/observation.html#obsgrouping) that I think seems reasonably clear (although, there are still some wiggle room and choices that can be made). The most important point for using Observation.component, I think, is that it "is used for any supporting result that cannot reasonably be interpreted and used outside the scope of the Observation it is a component of". I think that's clearly not true in the case of a panel like a CBC, where many of the individual observations (like hemoglobin and hematocrit, for example) could also quite reasonably be used separately (can stand alone). I think there might be other cases of a lab panel, though, where the observations are more tightly bound together and would fit reasonably well with using Observation.component (that is definitely true in for some non-lab observations, like blood pressure and Apgar scores). So it's not entirely black and white, but I think that hasMember is going to be the best choice in most cases for lab.
Gay Dolin (Jul 07 2020 at 14:30):
Thanks Rob
Last updated: Apr 12 2022 at 19:14 UTC
