Stream: Patient Care WG
Topic: Condition category & CCDA
Jay Lyle (Feb 22 2022 at 21:30):
We are mapping FHIR Conditions into CDA Problem Observations.
Condition.category has no obvious target, but it's pretty close to the granularity of ConditionObservation.code. But the values are different. Both specifications allow other codes (extensible in FHIR, Should in CDA). Our base assumption is that we can simply use the source code in the target element. However, the "extensible" definition suggests we should try to find synonymy. Is there any synonymy here?
Would synonymy be achievable if we added document section context to the equation?
| CDA Problem type | FHIR category | match |
|---|---|---|
| Finding of functional performance and activity (finding) | no match | |
| Diagnosis interpretation (observable entity) | encounter-diagnosis | inexact |
| Cognitive function finding (finding) | no match | |
| Clinical finding (finding) | no match | |
| Complaint (finding) | no match | |
| Finding reported by subject or history provider (finding) | no match | |
| Problem (finding) | problem-list-item | inexact |
| Disease (disorder) | no match | |
| health-concern | no match | |
| Death diagnosis | no match |
Michelle (Moseman) Miller (Mar 24 2022 at 21:34):
Due to extensible binding in FHIR, it's ok to use the CDA codes that don't have a relative map to FHIR's value set. Additionally, per FHIR spec,
If there is at least one applicable concept in the extensibly-bound value set with a meaning which includes but is more general than the meaning that is intended to be represented by the element in the resource instance, then the code that is used in the instance SHALL be taken from the value set and should be the closest available match for the intended element instance meaning (i.e. neither more general or more specific). However, a more specific code that more completely represents the intended meaning may also be included in the instance as an additional Coding if the data type is CodeableConcept, but it cannot be used instead of the code from the value set
@Jay Lyle will speak to Structured Doc to understand their definition of diagnosis interpretation to assess similarity with encounter-diagnosis (in FHIR).
Last updated: Apr 12 2022 at 19:14 UTC
