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  1. FHIR Specification Feedback
  2. FHIR-43538

Confusing use of Observation.code values

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Core (FHIR)
    • 7.0.0-ballot
    • Cross-Group Projects
    • US Core Average Blood Pressure Profile
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      Background

      See FHIR-43960

       

      Decision

      • We will derive Average Blood Pressure directly from Observation
        • The resulting StructureDefinition and conformance expectations will be unchanged except for removing the need to include the LOINCs. 85354-9, 8480-6, and 8462-4.
        • Edit the Profile introductions to reflect these changes where appropriate
        • Will not be grouped under vitals in the Profile and Extensions page
      • Add an implementation note in the Average Blood Pressure Profile:

      The category "vital-signs" aligns with the USCDI Data Class and Elements and provides a convenient and consistent grouping of the clinical concepts.  Implementers can group them differently based on their clinical needs.

       

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      Background See FHIR-43960   Decision We will derive Average Blood Pressure directly from Observation The resulting StructureDefinition and conformance expectations will be unchanged except for removing the need to include the LOINCs. 85354-9, 8480-6, and 8462-4. Edit the Profile introductions to reflect these changes where appropriate Will not be grouped under vitals in the Profile and Extensions page Add an implementation note in the Average Blood Pressure Profile: The category "vital-signs" aligns with the USCDI Data Class and Elements and provides a convenient and consistent grouping of the clinical concepts.  Implementers can group them differently based on their clinical needs.  
    • Eric Haas/Gay Dolin: 17-0-0
    • Clarification
    • Non-compatible

    Description

      The tables provides a slice for uscore-avg-bp to state the average BP panel code (96607-7).  However, it still requires the use of 85354-9 as well which is creating some challenges:

      • These two codes are not equivalent, so should not be used within the same instance of Observation.code
      • Arguing that 85354-9 includes 8478-0 does not work either as then uscore-avg-bp should have be set to that, not 96607-7
      • Since they need to be equivalent, the consumer of this resource may just read 85354-9 and think they know what they have, but they don't and it totally different.

      There is the challenge that this profile is a profile on the Blood Pressure Profile that requires the use of 85354-9.  As that would at least be confusing, if not actually incorrect, suggest to base Average Blood Pressure Profile directly on the Vital Signs Profile thus removing the need to include 85354-9 altogether and avoid the contradiction and potential for misinterpretation.

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            Unassigned Unassigned
            hbuitendijk Hans Buitendijk
            Hans Buitendijk
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              Created:
              Updated:
              Resolved: