Correct link in operation rendering, targetDisease should be bound to SNOMED CT, ImmunizationEvaluation reason codes don't make sense - ImmDS #14

XMLWordPrintableJSON

    • Type: Change Request
    • Resolution: Persuasive with Modification
    • Priority: Medium
    • Immunization Forecast CDS (FHIR)
    • STU3
    • Public Health
    • (NA)
    • Hide

      Suggestion #1: Persuasive, we will correct the broken link

      Suggestion #2: Considered for Future Use, immunity is out of scope for this phase of the project. We will include immunity in a future iteration of the IG that includes the exchange of other clinical data on the patient that may affect the patient's forecast

      Suggestion #3: For things like storage conditions and recall, that information will typically be supplied by the caller as part of Immunization.subpotentReason. Expired or Outside of Scheduled can be determined by the CDS engine based on the patient history and other data. CDS engines may want to be more specific about the schedule issues (eg. given too soon, patient too young) which may be a problem if we provide a generic "out of schedule" code in an extensible value set. On 10/31/2019, the Public Health WG reviewed the value sets for Immunization.subpotentReason and ImmunizationEvaluation.doseStatusReason. We will come up with an extended set of values for the value set, drawing on experience from CDS engines and CDSi. We think we'll want to expand the "out of schedule" to be more specific.

      Overall: Persuasive with Mod

      Show
      Suggestion #1: Persuasive, we will correct the broken link Suggestion #2: Considered for Future Use, immunity is out of scope for this phase of the project. We will include immunity in a future iteration of the IG that includes the exchange of other clinical data on the patient that may affect the patient's forecast Suggestion #3: For things like storage conditions and recall, that information will typically be supplied by the caller as part of Immunization.subpotentReason. Expired or Outside of Scheduled can be determined by the CDS engine based on the patient history and other data. CDS engines may want to be more specific about the schedule issues (eg. given too soon, patient too young) which may be a problem if we provide a generic "out of schedule" code in an extensible value set. On 10/31/2019, the Public Health WG reviewed the value sets for Immunization.subpotentReason and ImmunizationEvaluation.doseStatusReason. We will come up with an extended set of values for the value set, drawing on experience from CDS engines and CDSi. We think we'll want to expand the "out of schedule" to be more specific. Overall: Persuasive with Mod
    • Craig Newman/Danny Wise: 20-0-0
    • Enhancement
    • Compatible, substantive

      Comment:

      1) In http://hl7.org/fhir/uv/immds/2019SEP/OperationDefinition-immds-forecast-operation.html, the ImmunizationRecommendation link points to the Immunization resource, not the ImmunizationRecommendation resource

      2) From the caller's perspective, it appears that specifying immunity would be specified in the Immunization resource by using a "fake" CVX code for a vaccine and say, "this is the vaccine that targets the disease that the patient is immune to". There are SNOMED CT and ICD-10-CM codes which could be used to specify immunity and keep these elements conceptually different.

      3) The reason codes (http://hl7.org/fhir/R4/valueset-immunization-evaluation-dose-status-reason.html) are: adverse storage condition, cold chain break, expired lot, administered outside schedule, product recall. All of these (except administered outside schedule) aren't things that a CDS engine would return to the caller; it's something the caller would pass up to the CDS engine. So having this as a part of ImmunizationEvaluation does not make sense.

      Summary:

      Correct link in operation rendering, targetDisease should be bound to SNOMED CT, ImmunizationEvaluation reason codes don't make sense

            Assignee:
            Unassigned
            Reporter:
            Daryl Chertcoff
            Watchers:
            3 Start watching this issue

              Created:
              Updated:
              Resolved: