FHIR Chat · Linking EOB with clinical note · CARIN IG for Blue Button®

Stream: CARIN IG for Blue Button®

Topic: Linking EOB with clinical note

Hannah Sennik (Mar 18 2021 at 17:37):

Is it possible to link an explanation of benefit (EOB) resource with the associated clinical note from the visit? I see that both the EOB resource and DocumentReference (or DiagnosticReport) resource have a reference to an encounter, but is this a reliable way to link them?

Michele Mottini (Mar 18 2021 at 17:51):

I think that's the only way to do it. ExplanationOfBenefit.encounter is not must support, so most server (and probably client) would not populate / ignore it though

Corey Spears (Mar 19 2021 at 17:01):

In general (with a big caveat below), the encounter would be one of the most likely resource to serve as a link between an ExplanationOfBenefit and a clinical note. Alternatively an implementer could possibly add such documentation to the ExplanationOfBenefit.supportingInfo.valueReference or valueAttachment where the ExplanationofBenefit.category would classify the type of information provided.

Now, for the caveat: There are several ways this sort of information may be provided or retrieved. The ExplanationOfBenefit supportingInfo can be used for many classes of data. Without further definition by a supported IG or by a server explicitly, it might not be possible to find or discern the meaning or purpose of such information.

In short: This sort of clinical information is not within the scope of the CARIN BB IG. While the IG does not disallow linking or otherwise providing such information, I would not expect a server supporting CARIN BB alone to make that information available.

That being said, I would be interested in hearing about the use case.