Jan 2015 Ballot Comment #17

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    • Type: Change Request
    • Resolution: Persuasive with Modification
    • Priority: Medium
    • FHIR Core (FHIR)
    • DSTU1 [deprecated]
    • Structured Documents
    • Composition
    • 6.9.2.2
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      Current Disposition: 3/5/2015
      3/5/2015 - Motion to reopen Rick G/Brett M - passed unanimously.

      Revised Disposition: We will go forward with the existing model that went to ballot in January, with the change that the reference to ANY resource is constrained to List.
      Update the description of List.text to make it consistent with its use as section narrative as well as List narrative (i.e. not just a summary of the list content).
      When list is included as a section, that text of the list is the authenticated content.
      When the section content is naturally narrative only, the reference would still be to a List (not Basic) with an appropriate emptyReason code.

      Motion: Rgeimer/Bmarquard

      Vote: For unanimous

      =======================

      Previous Disposition: 1/22/2015

      Motion: Adopt the modeling of section as presented by Calvin. See SDWG minutes, Q3, Thursday, Jan 22nd.

      Motion: CBeebe/KConan

      Vote: For 8, Abstain 9, Against 2

      Show
      Current Disposition: 3/5/2015 3/5/2015 - Motion to reopen Rick G/Brett M - passed unanimously. Revised Disposition: We will go forward with the existing model that went to ballot in January, with the change that the reference to ANY resource is constrained to List. Update the description of List.text to make it consistent with its use as section narrative as well as List narrative (i.e. not just a summary of the list content). When list is included as a section, that text of the list is the authenticated content. When the section content is naturally narrative only, the reference would still be to a List (not Basic) with an appropriate emptyReason code. Motion: Rgeimer/Bmarquard Vote: For unanimous ======================= Previous Disposition: 1/22/2015 Motion: Adopt the modeling of section as presented by Calvin. See SDWG minutes, Q3, Thursday, Jan 22nd. Motion: CBeebe/KConan Vote: For 8, Abstain 9, Against 2
    • Enhancement
    • Non-compatible
    • DSTU1 [deprecated]

      Existing Wording
      The composition section defines a section (or sub-section) of the document, but unlike in CDA, the section content is actually a reference to another resource that actually holds both the narrative and data content for the section. This design means that the narrative and data can be reused in many other ways. Note that the most common resource to use for the content of a section is the List resource.

      Proposed Wording
      The composition section defines a section (or sub-section) of the document. Like CDA, the section contains the human readable narrative (text). It will also contain a set of references to the underlying resources that were used to construct the text. This design supports the reuse of resources while enabling the construction of authenticated text within documents.

      A composition can be authenticated as needed and when dealing with a narrative document, the composition as a whole needs to be reviewed.

      Comments
      A clinical document needs to exhibit a high degree of consistency with the view of the information that the legal authenticator reviewed when they signed the document. In CDA the section/text element was identified as the location for the authenticated narrative content. In FHIR narrative can be found in any domain resource, inclusive of the List resource. There is no clear statement as to where the authenticated narrative content can be found.

      Grahame's Comments
      I think the statement is pretty clear - the target resource holds the narrative. Yes, this is more complex than CDA, but it allows for more reuse. I do not think that duplicating the narrative will reduce complexity

      Disposition Comment
      FHIR defines the specific algorithm for rendering a document, including what narratives are rendered in what order and requires that this view be what is displayed to authenticators

            Assignee:
            Unassigned
            Reporter:
            Calvin E. Beebe
            Calvin E. Beebe
            Watchers:
            2 Start watching this issue

              Created:
              Updated:
              Resolved: