Details
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Change Request
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Resolution: Unresolved
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Medium
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FHIR Core (FHIR)
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R5
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Orders & Observations
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DiagnosticReport
Description
The DiagnosticReport resource page includes a micro-biology and susceptibility report example with two examples on how those could be expressed. Work is in progress towards a core profile where a specific approach would be recommended to avoid variant representations where essentially many systems will be required to support multiple variants.
- Rely on FHIR versioning (https://www.hl7.org/fhir/resource.html#Meta using versionId; https://www.hl7.org/fhir/http.html#history; https://www.hl7.org/fhir/http.html#vread)
- The resource.id remains the same, while versioning enables tracking updates to the resource
- Use the "replaces" extension where a new DiagnosticReport (or Observation) instance is created and the new one references the old one.
- The resource.id changes, while the resource.identifier (if used) could remain the same.
The first requires full versioning support, which not all FHIR servers do, while the second requires a different approach on how to determine when/how to display/manage the multiple resource instances in the correct context.
As the update to the organism name does not really represent a different observation being performed, and references to that isolate identification observation should not have to be changes as other observations and tests are being performed in context of that isolate, the proposed direction is to utilize FHIR versioning as the profiled approach.
The request is for OO to finalize either alternative after further review and input from the implementer community. Note that both methods could satisfy known regulatory requirements, e.g., CLIA in the US.