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  1. FHIR Specification Feedback
  2. FHIR-40088

Add guidance to the Procedure profile to express sdoh category

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Core (FHIR)
    • 6.0.0-ballot [deprecated]
    • Cross-Group Projects
    • STU
    • US Core Procedure Profile
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      Proposal

      Will provide guidance on the Screening and Assessments guidance page to indicate Implementers can choose to categorize procedures as an SDOH procedure or, indirectly by inspecting referenced ServiceRequest.

      Background

      The Procedure category element is optional and not considered "core".  Also, as the commenter points out, the max =1 cardinality on this element limits US Core's ability to constrain it since it may have multiple interpretations and meanings in different clinical domains. Constraining it to a specific definition may not accurately reflect the intended use.

       

      The US Core Procedure Profile may be used to "record a completed service or intervention"  and is part of the related activities illustrated on the Screenings and Assessments page. Implementers can choose to categorize procedures as an SDOH procedure or , as the commenter suggests, indirectly through the referenced ServiceRequest.

       

       

       

       

       

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      Proposal Will provide guidance on the  Screening and Assessments guidance page to indicate Implementers can choose to categorize procedures as an SDOH procedure or, indirectly by inspecting referenced ServiceRequest. Background The Procedure category element is optional and not considered "core".  Also, as the commenter points out, the max =1 cardinality on this element limits US Core's ability to constrain it since it may have multiple interpretations and meanings in different clinical domains. Constraining it to a specific definition may not accurately reflect the intended use.   The  US Core Procedure Profile may be used to "record a completed service or intervention"  and is part of the related activities illustrated on the Screenings and Assessments page. Implementers can choose to categorize procedures as an SDOH procedure or , as the commenter suggests, indirectly through the referenced ServiceRequest.          
    • Eric Haas / Brett Marquard : 18-0-0
    • Clarification
    • Non-substantive

    Description

      The other USCDI SDOH related profiles (Observations, Condition, and ServiceRequest) have a category to express the sdoh domain, but the US Core Procedure Profile (which is needed for USDCI SDOH Interventions) does not. Without this there will not be a consistent way to capture sdoh categorized procedures.

      Please add the sdoh category to the Procedure profile.

       

      The base FHIR R4 standard Procedure resource category has a maximum cardinality of 1, so this will have to be done carefully. Consider adding a slice on Procedure.category.coding with a pattern of [http://hl7.org/fhir/us/core/CodeSystem/us-core-category|sdoh|http://hl7.org/fhir/us/core/CodeSystem/us-core-category%7Csdoh] and as consider it as possibly Must Support (although it may be determined that ServiceRequest is sufficient, and if so, please make that clear on the Screening and Assessments guidance page).

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            corey_spears Corey Spears
            Corey Spears
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              Created:
              Updated:
              Resolved: