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  1. Other Specification Feedback
  2. OTHER-2427

Use of Nullflavor vs Data absent reason value set

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive with Modification
    • Icon: Medium Medium
    • Cross Paradigm Gender Harmony - Sex and Gender Representation (OTHER)
    • 1.0.0-ballot
    • Terminology Infrastructure
    • Terminology
    • 13.3
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      Discussed on GHP 2023-02-20

      Also discussed in Zulip (Using FHIR Data Absent Reason Code system) 

      Agreed that GHP will align with use of FHIR DAR. This means:

      • FHIR-39238 to add an "asked but declined" code to the Gender Identity value set. This seems like a straightforward use of 'asked-declined' from the DAR code system.
      • FHIR-39231 to consider which "unknown" code to use for Sex Parameters for Clinical Use. This is the one I think needs discussion about whether the unknown code from DAR or NullFlavor is more appropriate.
      • Add a code to table 396 to represent FHIR DAR code system
      • Update all other tickets and IG content as appropriate.
      • And support a long term activity to harmonize DAR/Null across product families.

      For easy reference, these are the two codes (and associated systems) we're looking at:

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      Discussed on GHP 2023-02-20 Also discussed in Zulip ( Using FHIR Data Absent Reason Code system )  Agreed that GHP will align with use of FHIR DAR. This means: FHIR-39238  to add an "asked but declined" code to the Gender Identity value set. This seems like a straightforward use of 'asked-declined' from the DAR code system. FHIR-39231  to consider which "unknown" code to use for Sex Parameters for Clinical Use. This is the one I think needs discussion about whether the unknown code from DAR or NullFlavor is more appropriate. Add a code to table 396 to represent FHIR DAR code system Update all other tickets and IG content as appropriate. And support a long term activity to harmonize DAR/Null across product families. For easy reference, these are the two codes (and associated systems) we're looking at: "UNK" from  https://terminology.hl7.org/CodeSystem-v3-NullFlavor.html "unknown" from  https://terminology.hl7.org/CodeSystem-data-absent-reason.html
    • Riki M / MaryKay M : 6-0-4
    • Enhancement
    • Compatible, substantive
    • 1.0.0-ballot

    Description

      I prefer the use of Nullflavor over FHIR Data absent reason value set for these reasons:

      #1 better alignment with CDA use of the additonal nullflavor element

      #2 better alignment with V2 (where the FHIR value set is not used)

      #3 the FHIR value set was created for a specific data element = data absent reason and provides additional content; IF there is a desire to include these codes in value sets bound to other data elements, THEN there must be an effort to harmonize ACROSS ALL product families and provide guidaince on mapping to the nullflavor value set, where appropriate to support translation between systems using different HL7 products

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            seanmuir Sean Muir
            RikiM Ulrike Merrick
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              Updated:
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