FHIR Chat · Specimen Type · smart/health-cards

For lab testing, @Max Masnick , we're talking in the Australian connectathon about reporting what kind of test specimen the Covid PCR was performed on. And it matters for some authorities, because not all testing is the same. e.g. IATA require this field.

So we considered these approaches:

{
 "contained" : [{
   "id " : "sp1",
   "resourceType" : "Specimen",
   "type" : { "text" : "Nasopharyngeal Swab"}
 }],
 "specimen" : { "reference" : "#sp1" }
}

{
  "bodySite" : {
    "coding" : [{
      "system" : "http://snomed.info/sct",
      "code" : "2175005",
      "display" : "Pharyngeal cavity
    }]
  }
}

{
  "bodySite" : { "text" : "Nasopharyngeal Swab" }
}

Grahame Grieve (Nov 23 2021 at 03:00):

the first is correct from a FHIR pov, and I think that that DM profile should allow specimen because this use case will keep mattering again and again as we go forward

Grahame Grieve (Nov 23 2021 at 03:01):

also this is related to the specimen collection question from @Issac (https://chat.fhir.org/#narrow/stream/284830-smart.2Fhealth-cards/topic/Self.20performed.20RAT/near/261708131)

Josh Mandel (Nov 23 2021 at 03:02):

(Makes sense re DM -- though I think coded body site is more straightforward and concise here.)

Grahame Grieve (Nov 23 2021 at 03:11):

right it's more straight forward, but you're testing on a sample, not a body site, and the relationship between the two isn't straightforward

Josh Mandel (Nov 23 2021 at 03:21):

I agree with the semantics you mention; just opining body site is pretty close.

Grahame Grieve (Nov 23 2021 at 03:23):

indeed but it doesn't allow for other uses of specimen (like the referenced link)

Max Masnick (Nov 23 2021 at 22:06):

@Grahame Grieve thanks! I agree this is important to model.

I think it's important to use a code for this vs. free text for interoperability. Can we get away with option #2 from a FHIR perspective?

Grahame Grieve (Nov 23 2021 at 22:09):

I'm not sure. That's really a question for OO, but I would expect not. It's obviously less characters but it would most likely be inconsistent with what's happening anywhere else. I'll ask OO.

I agree that coding is good, but the implementer who actually asked had only free text