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  1. FHIR Specification Feedback
  2. FHIR-36910

persistent, pre-existing findings across systems ?



    • Change Request
    • Resolution: Unresolved
    • Medium
    • FHIRCast (FHIR)
    • 2.0.0
    • Infrastructure & Messaging
    • STU
    • Content Sharing
      DiagnosticsReport open event
      DiagnosticsReport update event
      Get Current Context


      Comment from: Brian Swinkels

      What's the process for establishing shared content with pre-existing findings across systems?


      A patient is receiving a diagnostic mammogram. They may have previously had a record in the RIS, and the RIS is aware that they have pre-existing findings:

      • Lesion A: a mass at 2:00 from the nipple on the left breast:
        • Length: X
        • Width: Y
        • Margins: Z
        • Tissue Composition...
      • Lesion B:
        • ...


      A technologist (or an AI) then records in the PACS that a patient has three findings:

      • Finding 1 (real world - the same as Lesion A in the RIS)
      • Finding 2
      • Finding 3

      How is that mapping / reconciliation first accomplished? Should there be a getCurrentContext upon the DiagnosticReport being opened? A getCurrentContext on each system? 

      Which system is responsible for de-duplicating / reconciling historical data disparately known across the different systems? If a lesion is new to the PACS being worked out of by the clinician, but known by the CIS and dictation system, should the clinician manually delete the historical lesion for the patient in the other two+ systems to deduplicate?





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              Isaac.Vetter Isaac Vetter
              Isaac.Vetter Isaac Vetter
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