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  1. FHIR Specification Feedback
  2. FHIR-43587

Clarify location extension to use when not in Encounter

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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 Encounter Profile
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      Background:

       
      from the change log:
       

       

      ~~~

      as part of this change added this Profile Specific Implementation Guidance bullet to the Encounter resource:

      ~~~

        1. The following US Core Profiles indirectly reference the location/facility through references to US Core Encounter:

       ~~~

       
      Decision For Discussion !

      Regarding the comment

       
      We suggest to not just point to the general registry allowing any, but rather event-location should, if not, must use and identify the specific resources where that is the case:

       

       

      update the text to provide this additional detail as informal guidance:

       

        1. The following US Core Profiles indirectly reference the location/facility through references to US Core Encounter:
        • Systems SHALL use the `location` element for all resources where the element is available.
        • Systems MAY use the standard [Event Location Extension] for US Core DiagnosticReport Profile for Laboratory Results Reporting and US Core Observation Clinical Result Profile.(http://hl7.org/fhir/StructureDefinition/event-location) when no `location` element is available.

       

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      Background:   from the change log:   For the USCDI Facility Information data class and elements, the  US Core Location Profile  already supports Facility Name and has been updated to support Facility Identifier and Type. The  US Core Immunization Profile  has been updated to reference the US Core Location resource directly as a Must Support element, and the following US Core Profiles have been updated to indirectly reference the location/facility via  US Core Encounter Profile  as a Must Support element: US Core DiagnosticReport Profile for Laboratory Results Reporting US Core Immunization Profile US Core MedicationDispense Profile US Core Observation Clinical Result Profile US Core Procedure Profile US Core ServiceRequest Profile     ~~~ as part of this change added this Profile Specific Implementation Guidance bullet to the Encounter resource: ~~~ The following US Core Profiles indirectly reference the location/facility through references to US Core Encounter: US Core DiagnosticReport Profile for Laboratory Results Reporting US Core Immunization Profile US Core MedicationDispense Profile US Core Observation Clinical Result Profile US Core Procedure Profile US Core ServiceRequest Profile If the event facility/location differs from (and isn’t contained/within) the Encounter.location, systems  SHOULD  reference it directly using the resource’s  .location  element if present, or a standard  FHIR Extension .  ~~~   Decision For Discussion ! Regarding the comment   We suggest to not just point to the general registry allowing any, but rather event-location should, if not, must use and identify the specific resources where that is the case:     update the text to provide this additional detail as informal guidance:   The following US Core Profiles indirectly reference the location/facility through references to US Core Encounter: US Core DiagnosticReport Profile for Laboratory Results Reporting US Core Immunization Profile US Core MedicationDispense Profile US Core Observation Clinical Result Profile US Core Procedure Profile US Core ServiceRequest Profile If the event facility/location differs from `Encounter.location`, systems  SHOULD  reference it directly: Systems  SHALL  use the `location` element for all resources where the element is available. Systems  MAY use the standard [Event Location Extension] for US Core DiagnosticReport Profile for Laboratory Results Reporting and US Core Observation Clinical Result Profile.( http://hl7.org/fhir/StructureDefinition/event-location ) when no `location` element is available.  
    • Brett Marquard/Isaac Vetter: 22-0-0
    • Clarification
    • Non-substantive

    Description

      As part of the guidance on use of location in support of USCDI Facility Information it states "If the event facility/location differs from (and isn’t contained/within) the Encounter.location, systems SHOULD reference it directly using the resource’s .location element if present, or a standard FHIR Extension."  We suggest to not just point to the general registry allowing any, but rather indicate that event-location should, if not, must use and identify the specific resources where that is the case as Immunization, MedicationDispense, Procedure already have a suitable location for this purpose, Observation and DiagnosticReport should consistently then use event-location, while we can argue whether the ServiceRequest.location is appropriate for this purpose as it indicates where you want the requested service to be performed without an actual location being relevant as that is captured elsewhere.  It would actually not appropriate to assume that if not available the Encounter.location is the appropriate location to consider and would suggest that ServiceRequest be removed from this list. 

      If the interest is where the ServiceRequest was documented (of for that matter any of the other of the referenced resources are documented), the Provenance resource would be the more appropriate one to include the location of the author, etc.  However, that does not seem to be the intent of USCDI at this point and should be addressed as provenance is being advanced to be consistent across all resources that need that.

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            Unassigned Unassigned
            hbuitendijk Hans Buitendijk
            Eric Haas, Hans Buitendijk
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