Uploaded image for project: 'FHIR Specification Feedback'
  1. FHIR Specification Feedback
  2. FHIR-41129

Problem ClinicalStatus Mapping

    XMLWordPrintableJSON

Details

    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Highest Highest
    • US C-CDA on FHIR (FHIR)
    • 1.2.0-ballot
    • Cross-Group Projects
    • STU
    • CF-problem
    • C-CDA to FHIR Problems
    • Hide

      Proposed Disposition to solve this simply:

      • Add note in @statusCode row: "To be used only if the C-CDA Problem Status Observation is missing." (Additionally create a ConceptMap for ActStatus -> ClinicalStatus)
      • Add note in abatementDate row: "If present (or C-CDA effectiveTime/high/@nullFlavor=UNK), the .clinicalStatus must be inactive, remission, or resolved. If C-CDA status fields map to .clinicalStatus of active, relapse, or recurrence, suggest setting .clinicalStatus to inactive for FHIR conformance."
      • Add a mapping for observation/effectiveTime/high/@nullFlavor=UNK to ._abatementDateTime.extension[DAR] since in C-CDA, the "UNK" high effectiveTime has been the recommended way to indicate "resolved problem but unknown resolution date."
      Show
      Proposed Disposition to solve this simply: Add note in @statusCode row: "To be used only if the C-CDA Problem Status Observation is missing." (Additionally create a ConceptMap for ActStatus -> ClinicalStatus) Add note in abatementDate row: "If present (or C-CDA effectiveTime/high/@nullFlavor=UNK), the .clinicalStatus must be inactive, remission, or resolved. If C-CDA status fields map to .clinicalStatus of active, relapse, or recurrence, suggest setting .clinicalStatus to inactive for FHIR conformance." Add a mapping for observation/effectiveTime/high/@nullFlavor=UNK to ._abatementDateTime.extension [DAR]  since in C-CDA, the "UNK" high effectiveTime has been the recommended way to indicate "resolved problem but unknown resolution date."
    • Jay Lyle/John D'Amore: 18-0-6
    • Enhancement
    • Non-substantive

    Description

      The status of the Problem Concern Act is separate from the clinical status of the problem itself. So the row in the table about using the @statusCode is incorrect.

      The table doesn't actually clarify the difference between this row and the latter row that does map the Problem Status Observation, though removing this (@statusCode-based) row entirely will help.

      Additionally - status is determined by the presence & value of an abatementDate; so a note could be added to the row on Problem Status that - if the Problem Status observation is not present, then clinicalStatus can be inferred by the presence or absence of /effectiveTime/high (either @value or @nullFlavor).

      Attachments

        Activity

          People

            benjamin Benjamin Flessner
            benjamin Benjamin Flessner
            Benjamin Flessner
            Watchers:
            3 Start watching this issue

            Dates

              Created:
              Updated:
              Resolved: