Stream: fhir/documents
Topic: Clinical Notes
Sathish Tiptur (Aug 16 2019 at 13:45):
We are planning on implementing Clinical Notes feature in our product and we are thinking of leveraging FHIR. There is a FHIR Resource Proposal for "Clinical Notes". The link is https://wiki.hl7.org/index.php?title=ClinicalNote_FHIR_Resource_Proposal. It appears to be in zombie state. Any comments on this? Any suggestions on as to how I can leverage FHIR for implementing Clinical Notes feature? Thanks!
Grahame Grieve (Aug 16 2019 at 13:46):
@Brett Marquard
Rob Hausam (Aug 16 2019 at 13:59):
There has been fairly recent discussion in Patient Care WG and otherwise on this and we should have documentation. @Michelle (Moseman) Miller might also be able to suggest where to look for the latest on it.
Michelle (Moseman) Miller (Aug 19 2019 at 13:46):
DocumentReference scope has been updated in R4 to explicitly say clinical notes are in scope, per http://hl7.org/fhir/R4/documentreference.html#scope
Michelle (Moseman) Miller (Aug 19 2019 at 13:58):
GF#14720 is still in Patient Care backlog. You can monitor it if you'd like, but I don't expect Patient Care will pursue a new resource proposal now that DocumentReference scope is explicit about supporting clinical notes.
Sathish Tiptur (Aug 20 2019 at 13:51):
Thanks @Michelle (Moseman) Miller
Richard Townley-O'Neill (Aug 26 2019 at 04:57):
Does this mean that an endorsed way to exchange a clinical note in FHIR is to use a DocumentReference resource with the content of the note as base 64 binary in DocumentReference.content.attachment.data ?
Lloyd McKenzie (Aug 27 2019 at 03:27):
Yes
Kenneth Myhra (Jan 29 2020 at 12:48):
I was referred here because it is said that the endorsed way to exchange a clinical note in FHIR is to put the note as base64 encoded content in DocumentReference.content.attachment.data.
- Would appreciate if someone could refer me to this endorsement
- Also, what is the definition of a note, is this the Consult note in plain text or could note also be defined as PDF documents or other large binary documents?
John Moehrke (Jan 29 2020 at 14:33):
That is found in US-Core https://build.fhir.org/ig/HL7/US-Core-R4/clinical-notes-guidance.html
Kenneth Myhra (Jan 29 2020 at 15:00):
I read through it, but only find a reference to DocumentReference.content.attachment.url. Might be that I miss it, or that I misunderstood the above conversation. Also, I could understand that a plain text note could be better to transfer in content.attachment.data. For larger documents I understand the guidance in such a way that they should be referred to through content.attachment.url, is that a correct interpretation?
John Moehrke (Jan 29 2020 at 15:22):
ah, I am a fan of Binary as a retrieval (GET) of the Binary has the advantage of following the http negotiate and thus can be retrieved in native (non base64) form. I don't know of a recommendation to use .data over Binary
Kenneth Myhra (Jan 29 2020 at 16:31):
Thanks John, my thoughts exactly
Last updated: Apr 12 2022 at 19:14 UTC
