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  1. FHIR Specification Feedback
  2. FHIR-37574

How can we support hierarchy within activities in a care plan?

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive
    • Icon: Medium Medium
    • FHIR Core (FHIR)
    • R5
    • Patient Care
    • STU
    • CarePlan
    • Hide

      Hierarchy is already supported via

      • Nested CarePlan
        •  CarePlan.partOf supports a reference to a larger care plan of which this particular care plan is a component or step
      • RequestOrchestrations can contain hierarchical groups of actions, where each specific action references the action to be performed (in terms of a Request resource), and each group describes additional behavior, relationships, and applicable conditions between the actions in the overall group
        • CarePlan.activity.plannedActivityReference supports a reference to RequestOrchestration{}

      For the specific example around Chemotherapy Protocols, use PlanDefinition, since the protocol is not patient-specific

      • PlanDefinition - The resource is general enough to support the description of a broad range of clinical and non-clinical artifacts such as clinical decision support rules, order sets, protocols, and drug quality specifications.
        • Chemotherapy Protocols (PlanDefinition for non-patient specific) results in a CarePlan (patient-specific)
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      Hierarchy is already supported via Nested CarePlan  CarePlan.partOf supports a reference to a larger care plan of which this particular care plan is a component or step RequestOrchestrations can contain hierarchical groups of actions, where each specific action references the action to be performed (in terms of a  Request  resource), and each group describes additional behavior, relationships, and applicable conditions between the actions in the overall group CarePlan.activity.plannedActivityReference supports a reference to RequestOrchestration { } For the specific example around Chemotherapy Protocols, use PlanDefinition, since the protocol is not patient-specific PlanDefinition - The resource is general enough to support the description of a broad range of clinical and non-clinical artifacts such as clinical decision support rules, order sets, protocols , and drug quality specifications. Chemotherapy Protocols (PlanDefinition for non-patient specific) results in a CarePlan (patient-specific)
    • Jay Lyle / Rob Hausam : 5-0-0

    Description

      We need to support hierarchy within activities in a CarePlan to allow nesting of activities.

      For example, we need to record Chemotherapy Protocols that are composed of a set of courses (cycles) and each course has a set of activities (medications) to be done.

      Another example is the Colonoscopy.

      Parent Activity: ServiceRequest: Colonoscopy, Friday June 10th in am.

      Children Actions:

      1. NutritionOrder: Clear liquids starting 24 hours prior to scheduled procedure, nothing purple or red.
      2. NutritionOrder: NPO after midnight the night before procedure except heart, blood pressure, or breathing medication (if ordered) may be taken with a small sip of water.
      3. MedicationRequest: At 2 p.m. the day before, give Dulcolax, 10 mg p.o.
      4. MedicationRequest: Starting at 5 p.m. the day before, patient is to drink 8 oz. Go-Lytely every 10 minutes until entire gallon is given.
      5. ServiceRequest: If, upon completion of the gallon of Go-Lytely, the stool is not yellow-mucus to clear, give tap water enemas until clear.
      6. MedicationRequest: Start IV normal saline @ KVO in a.m. in the am of the procedure if no IV access in place

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            Unassigned Unassigned
            rquintano Ricardo Quintano
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              Updated:
              Resolved: