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  1. FHIR Specification Feedback
  2. FHIR-40138

Clarify applicability of DiagnosticReport in USCDI Mapping

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Highest Highest
    • US Core (FHIR)
    • 5.0.1
    • Cross-Group Projects
    • USCDI
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      Clarify text:

      replace

      To enable consistent access to scanned narrative-only clinical reports, the Clinical Note Server SHALL expose these reports through both DiagnosticReport and DocumentReference by representing the same attachment URL using the corresponding elements listed below.2 Exposing the content in this manner guarantees the client will receive all the clinical information available for a patient and can easily identify duplicate data.

      with:

      To enable consistent access to scanned narrative-only clinical reports, the Clinical Note Server SHALL expose these overlapping scanned or narrative-only reports through both DiagnosticReport and DocumentReference by representing the same attachment URL using the corresponding elements listed below.  Exposing the content in this manner guarantees the client will receive all the clinical information available for a patient and can easily identify duplicate data.

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      Clarify text: replace To enable consistent access to scanned narrative-only clinical reports, the Clinical Note Server  SHALL  expose these reports through  both  DiagnosticReport and DocumentReference by representing the same attachment URL using the corresponding elements listed below. 2  Exposing the content in this manner guarantees the client will receive all the clinical information available for a patient and can easily identify duplicate data. with: To enable consistent access to scanned narrative-only clinical reports, the Clinical Note Server SHALL expose these overlapping scanned or narrative-only reports through both DiagnosticReport and DocumentReference by representing the same attachment URL using the corresponding elements listed below.  Exposing the content in this manner guarantees the client will receive all the clinical information available for a patient and can easily identify duplicate data.
    • Eric Haas / Jason Vogt : 13-0-0
    • Clarification
    • Non-substantive

    Description

      The DiagnosticReport is seemingly used for all clinical notes types. While o.k. for notes limited to observations, it would not work to include diagnosis, problems, etc. that would be present in other notes, e.g., Discharge Summary Note. DiagnosticReport should be limited to Lab, Imaging, Pathology, and Imaging as indicated on http://hl7.org/fhir/us/core/2023Jan/clinical-notes.html.

      (Comment 3 - imported by: Hans Buitendijk)

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            Brett.Marquard Brett Marquard
            hbuitendijk Hans Buitendijk
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