Working drafts of HL7™ FHIR® Release 4 (R4) artefacts authored and maintained by the Informatics Architecture team at the Australian Digital Health Agency.
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The issue
Change description
The 'other diagnostic' profiles intend to support all 'other' diagnostic reports which is broad. We are considering whether category is better supported as a value set including a set of diagnostic report types, or whether it has to be fixed to be a catch-all code and with the referencing diagnostic report provides the finer grain.
This applies to DiagnosticReport.category, ServiceRequest.category, and Observation.category. At this time a fixed code has been set in each profile though the codes chosen need to be re-examined as to their usefulness.
Both Pathology report and Diagnostic Imaging Report have a fixed value for category, "LAB" and "imaging" respectively, to enable system processing and differentiation between the reports.
For the element category in DiagnosticReport, Observation, and ServiceRequest the base binding available in the FHIR standard uses a different code system - so potentially we would be indicating that this is 'diagnostic imaging' in three different code systems.
ServiceRequest.category: https://snomed.info/sct.
Suggest rationalisation of the codes used for categorisation.
What it actually enables people to do
Understanding the DiagnosticReport.category requirements for other diagnostic reports would give clarity to implementers and other diagnostic report providers on whether a fixed category could be used to differentiate other diagnostic reports.
Rationalisation of codes used in category will enable better goruping of data in systems if there is no need to resolve multiple codes for the one concept.
Mockups
n/a
How awesome would it be?
It would be useful for implementers and system operators to know if other diagnostic reports could be categorised using a fixed value in DiagnosticReport.category or if another mechanism is required.
Workarounds
If there isn't a suitable fixed code in category to differentiate other diagnostic reports from pathology and diagnostic imaging reports, then system operators will need to devise another method to separate out these reports.
Each diagnostic provider could use their own set of categories, but this will impede interoperability between systems and make it more difficult for clinicians to find content.
Additional context
With respect to rationalisation of codes:
Pathology:
Prerequisites
The issue
Change description
The 'other diagnostic' profiles intend to support all 'other' diagnostic reports which is broad. We are considering whether category is better supported as a value set including a set of diagnostic report types, or whether it has to be fixed to be a catch-all code and with the referencing diagnostic report provides the finer grain.
This applies to DiagnosticReport.category, ServiceRequest.category, and Observation.category. At this time a fixed code has been set in each profile though the codes chosen need to be re-examined as to their usefulness.
Both Pathology report and Diagnostic Imaging Report have a fixed value for category, "LAB" and "imaging" respectively, to enable system processing and differentiation between the reports.
For the element category in DiagnosticReport, Observation, and ServiceRequest the base binding available in the FHIR standard uses a different code system - so potentially we would be indicating that this is 'diagnostic imaging' in three different code systems.
What it actually enables people to do
Understanding the DiagnosticReport.category requirements for other diagnostic reports would give clarity to implementers and other diagnostic report providers on whether a fixed category could be used to differentiate other diagnostic reports.
Rationalisation of codes used in category will enable better goruping of data in systems if there is no need to resolve multiple codes for the one concept.
Mockups
n/a
How awesome would it be?
It would be useful for implementers and system operators to know if other diagnostic reports could be categorised using a fixed value in DiagnosticReport.category or if another mechanism is required.
Workarounds
If there isn't a suitable fixed code in category to differentiate other diagnostic reports from pathology and diagnostic imaging reports, then system operators will need to devise another method to separate out these reports.
Each diagnostic provider could use their own set of categories, but this will impede interoperability between systems and make it more difficult for clinicians to find content.
Additional context
With respect to rationalisation of codes: Pathology:
Daignostic Imaging:
Other Diagnostics: