Stream: CARIN IG for Blue Button®
Topic: C4BBOrganization (contained)
Melissa Benzie (Apr 14 2021 at 19:54):
We output a contained Organization resource within our Coverage resource. Per the Fhir specification we do not output meta.lastUpdated. See https://www.hl7.org/fhir/references.html#contained
Contained resources SHALL NOT contain meta.versionId, meta.lastUpdated, or meta.security.
The Carin Stu1 IG for Organization resource requires meta.lastUpdated http://hl7.org/fhir/us/carin-bb/STU1/StructureDefinition-C4BB-Organization-definitions.html#Organization.meta.lastUpdated
What is expected here in the case of a contained Organization resource, do we follow the Fhir spec or the Carin IG?
(Asking for guidance for test validation, currently this is a test failure in Touchstone @Wendy Gereke @ryan moehrke )
thanks for the help!
Michele Mottini (Apr 14 2021 at 20:07):
Would seems very strange that a profile can break basic FHIR rules - eg you have a resource that matches the profile and fails FHIR basic rules. Seems a mistake in either the profile or the tests. @Corey Spears
Paul Church (Apr 14 2021 at 20:08):
Sounds like a test issue. A contained resource is inseparable from its container so the meta in the container is what matters.
Corey Spears (Apr 14 2021 at 20:40):
The CARIN BB IG does not specify any constraints on contained resources for any of the profiles. There are constraints on the references to organizations needing to match the C4BB Organization profile requirements. Since the Organization profile has a requirement for meta.lastUpdated, the expectation here is that an Organization would be an addressable resource rather than a contained one. I am not sure if the team has directly discussed contained resources previously. I can raise the concern with the CARIN team.
@Mark Roberts , Can we add this to the list to discuss?
Pat Taylor (Apr 21 2021 at 12:11):
@Melissa Benzie For what purpose are you using the contained resource? Are you trying to code the secondary payer? @Amol Vyas @Corey Spears @Mark Roberts
Melissa Benzie (Apr 21 2021 at 14:26):
It's contained for reasons stated here in the fhir spec: https://www.hl7.org/fhir/references.html#contained
In some circumstances, the content referred to in the resource reference does not have an independent existence apart from the resource that contains it - it cannot be identified independently,...
We use a contained resource because although we have the coverage.payor information such as name and address, we do not have it as an independent entity in our data model.
Amol Vyas (Apr 24 2021 at 02:21):
Hi @Melissa Benzie
Generally, the CARIN IG approach is to use Logical References to represent entities that may not independently exist on or may not be Literally Referenced (relative or absolute) from, your server. For example, see Notes on Fields for base CARIN EOB profile:
.insurance.coverage: When focal = true, Coverage.payer--> Organization.identifier. When focal = false, EOB.insurance.coverage.display = [name of other carrier]
where EOB.insurance.coverage.display, which we will fix to really be EOB.insurance.Reference(coverage).display, uses a logical reference.
Hope this helps. @Pat Taylor @Mark Roberts @Corey Spears
Regards,
-Amol Vyas
Melissa Benzie (Apr 27 2021 at 15:10):
thanks for your response @Amol Vyas . We are unable to provide a logical reference in this case as we do not have an identifier for the organization and we do have an address that we would then be unable to map. Contained allows us to map the name and address too.
Last updated: Apr 12 2022 at 19:14 UTC
