Stream: Death on FHIR
Topic: Birth Record Identifier
Eric Trinh (Genesis) (Aug 19 2019 at 16:22):
Hello, can someone please explain more about how to bind value into BirthState element? As I read it shall be CodeableConcept that'll be selected from CodeSystem ABC Codabar. What is ABC Codabar and where/how to get it? I also see that there's already birthPlace and birthDate elements in Patient resource that can be utilized for the same information. Should we use Birth Record Identifier or Patient for these elements?
Eric Trinh (Genesis) (Aug 19 2019 at 16:23):
i think @Adam Holmes @AbdulMalik Shakir can help me :smile:
Adam Holmes (Aug 19 2019 at 16:43):
Hey @Eric Trinh (Genesis) !
The "ABC Codabar" is definitely an issue. There was a comment made about it during balloting, so I'd expect it will be fixed (https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=20713&start=0). The UML diagram above actually lists ISO 3166-1 as the code system instead, but I think that is also incorrect, as I'd expect something more like ISO 3166-2 (3166-1 is country level, 3166-2 is state/province level). For now, the way I am using the "Birth Record Identifier" resource is by just populating the valueString as the Decedent's Birth Certificate number (if available) - I think it is acceptable to only worry about that for now, and update as the IG changes in future.
Eric Trinh (Genesis) (Aug 19 2019 at 17:14):
thanks @Adam Holmes, i also saw that 3166-2 is more accurate but just FYI there're many cases that the birth place state is a foreign country so 3166-1 is still needed. In my opinion, a valueString is good enough for country/state name, it should be up to the implementer to map it to their data element.
Adam Holmes (Aug 19 2019 at 17:35):
That's definitely a great point, but I think that case is captured correctly by having the birthPlace extension on the Decedent profile (which is a FHIR Address, not a CodableConcept - which doesn't limit you to a USA or Canada place of birth). My understanding of the "Birth Place Identifier" profile is really to try to map the record back to a state birth certificate (if the decedent even has one, so you can think of the entire resource as optional). Perhaps a bit of context may help for understanding the difference between what's already on Decedent and what is represented by Birth Place Identifier: it is essentially a FHIR version of what is captured by fields 88 (Infant Death/Birth Linking - birth certificate number), 89 (Infant Death/Birth Linking - year of birth), and 90 (Infant Death/Birth Linking - State, U.S. Territory or Canadian Province of Birth - code) in the IJE mortality format.
Eric Trinh (Genesis) (Aug 19 2019 at 19:06):
alright i see, thanks for the clarification
AbdulMalik Shakir (Aug 21 2019 at 00:24):
@Adam Holmes You are correct on all points. The terminology binding for BirthRecordIdentifier.BirthState.valueCodeableConcept will be modified to be code system ISO 3155-2. It designates any one of the 50 states, 1 district, or 6 outlying areas that comprise the United States of America. This is the jurisdiction that assigned the referenced birth record identifier. It is used for US-issued birth records only. Place of birth makes use of the birthPlace extension defined by the VRDR IG. However, consideration is being given to dropping the extension and instead slicing patient.address to include a birth address slice.
Eric Trinh (Genesis) (Aug 21 2019 at 18:55):
@Adam Holmes @AbdulMalik Shakir what do you guys think about this resource?
{
"fullUrl": "urn:uuid:c7277513-9dd7-4f9d-8ce8-4eec6da1ee46",
"resource": {
"resourceType": "Observation",
"meta": {
"profile": [
"http://www.hl7.org/fhir/us/vrdr/StructureDefinition/VRDR-Birth-Record-Identifier"
]
},
"code": {
"coding": [
{
"system": "2.16.840.1.113883.6.290",
"code": "BR",
"display": "Birth Record Identifier"
}
],
"text": "Birth Record Identifier"
},
"subject": {
"reference": "urn:uuid:1dbf74f1-6d94-4a5e-80d7-8e8eb636dbae"
},
"valueString": "1990GA000026985",
"component": [
{
"code": {
"coding": [
{
"system": "LOINC",
"code": "21112-8"
}
],
"text": "Birth date"
},
"valueDateTime": "1990-11-13T00:00:00-06:00"
},
{
"code": {
"coding": [
{
"system": "LOINC",
"code": "21842-0"
}
],
"text": "Birthplace"
}
}
]
}
}
Adam Holmes (Aug 21 2019 at 19:14):
@Eric Trinh (Genesis) Looks good to me (looking at the IG as-is right now)!
AbdulMalik Shakir (Aug 22 2019 at 06:47):
@Eric Trinh (Genesis) Your example looks structurally sound except when it comes to the birth state, which you seem to have replaced with the concept "Birthplace". It also lacks a value for the coded concept that is the birth state. The instance is correct as far as it goes but it is incomplete without the inclusion of the birth state.
Eric Trinh (Genesis) (Aug 22 2019 at 13:18):
@AbdulMalik Shakir well because according to loinc.org, code 21842-0 has name as "Birthplace". However i can change to Birth State if that's what you prefer. And for the coded concept, i can't find the list of codeableconcepts for code system ISO 3166-2. Where can i get it?
Last updated: Apr 12 2022 at 19:14 UTC
