Add condition extension(s) to represent a role in context of Condition.encounter (e.g. Primary/Sequence, Admit, Discharge etc.)

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    • Type: Change Request
    • Resolution: Persuasive with Modification
    • Priority: Medium
    • FHIR Core (FHIR)
    • DSTU2
    • Patient Administration
    • STU
    • Condition
    • Hide

      The encounter will be update to include the following new backbone element diagnosis replacing the indication property.

      Encounter.diagnosis 0..* backbone element

      Encounter.diagnosis.condition 1..1 reference(condition)

      Encounter.diagnosis.role 0..1 codeableconcept

      (new valueset with:

      _ admission diagnosis, discharge diagnosis, _

      chief complaint, comorbidity, pre-op, post-op, billing)

      Encounter.diagnosis.rank 0..1 positiveInt (this is to be sequential per role type)

      The hospitalization.dischargeDiagnosis and hospitalization.admissionDiagnosis will also be removed.

      The description on the reason property will be updated to indicate that its purpose as a more patient
      centric valueset/concept.

      The encounter-primaryDiagnosis and encounter-relatedCondition extensions will be removed, as they are now redundant, and represented in the core resource.

      PA Call 15 Nov 2016
      Also need to consider the search parameter updates as per tracker 10578

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      The encounter will be update to include the following new backbone element diagnosis replacing the indication property. Encounter.diagnosis 0..* backbone element Encounter.diagnosis.condition 1..1 reference(condition) Encounter.diagnosis.role 0..1 codeableconcept (new valueset with: _ admission diagnosis, discharge diagnosis, _ chief complaint, comorbidity, pre-op, post-op, billing) Encounter.diagnosis.rank 0..1 positiveInt (this is to be sequential per role type) The hospitalization.dischargeDiagnosis and hospitalization.admissionDiagnosis will also be removed. The description on the reason property will be updated to indicate that its purpose as a more patient centric valueset/concept. The encounter-primaryDiagnosis and encounter-relatedCondition extensions will be removed, as they are now redundant, and represented in the core resource. PA Call 15 Nov 2016 Also need to consider the search parameter updates as per tracker 10578
    • Alexander Henkett/Alex de Leon: 11-0-0
    • Enhancement
    • Non-compatible
    • DSTU2

      Add condition extension(s) to represent a role in context of Condition.encounter (e.g. Primary/Sequence, Admit, Discharge etc.)

      Note: the extensions do exist on the Encounter:

      http://hl7-fhir.github.io/extension-encounter-primarydiagnosis.html

      http://hl7-fhir.github.io/extension-encounter-relatedcondition.html

      While I agree that these classifications are in context of an encounter, there is a condition.encounter element that specifies the encounter-specific context for that specific condition. Additionally, in our EHR, these attributes are on the diagnosis – not the encounter - which makes it more challenging to know when to update the encounter resource version when an attribute of the diagnosis/condition changes.

      This has been discussed on Zulip a couple times:

      https://chat.fhir.org/#narrow/stream/implementers/topic/I.20have.20a.20problem.20to.20using.20.20condition.20resource.20for.20.20diagnosis

      https://chat.fhir.org/#narrow/stream/implementers/subject/Condition%27s.20Priority

            Assignee:
            Unassigned
            Reporter:
            Michelle Miller
            Watchers:
            1 Start watching this issue

              Created:
              Updated:
              Resolved: