Details
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Change Request
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Resolution: Not Persuasive with Modification
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Medium
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US Core (FHIR)
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current
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Cross-Group Projects
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STU
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CBC Example
Metabolic Panel Example
Urinalysis Example [deprecated] -
FHIR-34910 Lab Result and Specimen Information for RBC Observation is Missing
Description
The Metabolic Panel example is not viable in real life.
The glucose code indicates it was performed on blood. Yet the rest of the panel has codes indicating it was performed on serum/plasma. The specimen upon which this panel is performed and thus where the results/observations originate is missing too. Furthermore the lab results (names) to which codes are mapped are missing for each result/observation. CLIA requirements are not met with this example either.
Codes names/terms should not be used for the lab result as they are dynamic and noncompliant with several best practices/regulations.
All lab panels like this (and CBC, Urinalysis) are orders by their nature and should be represented by FHIR Service Request which is referenced by Diagnostic Report with the reported results and their values. Again specimen info should also be linked between the two with the order reflecting what is collected which may be different than what is analyzed (upon which results/observations are generated).
Kindly perform a complete review of all FHIR lab examples (US Core and non core) so they can be corrected to represent actual results that might be performed. Also every profile, IG to which they are referenced should have the updated and clinically accurate examples to avoid patient safety issues in implementations.
Lastly, CLIA indicates requirements for updating lab results that may impact the write/correction aspects mentioned for US core. Certain lab results are not allowed to be modified per CLIA, so FHIR implementations will need to be compliant. I don't see anything mentioned in HL7 FHIR about these requirements (unless I missed them)?
Attachments
Issue Links
- duplicates
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FHIR-34910 Lab Result and Specimen Information for RBC Observation is Missing
- Published
- is duplicated by
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FHIR-34908 Discordant/missing info in US Core lab examples
- Duplicate
- is voted on by
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BALLOT-26962 Negative - Andrea Pitkus : 2022-Jan-FHIR US CORE R4.1 STU
- Closed