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fhir-fi / finnish-base-profiles

Finnish FHIR Base Profiles
https://hl7.fi/fhir/finnish-base-profiles/
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Condition.isNotAuthoredByMedicalDoctor #81

Closed jpriebe-epic closed 1 year ago

jpriebe-epic commented 1 year ago

Is Not Authored by a medical doctor

Is not authored by a medical doctor (Käyntisyy) Some conditions are very much like diagnosis but the asserter is not a medical doctor. THL specification identifies these as käyntisyy.

Couldn't this be covered by the standard element Condition.Asserter with a simple rights check?

It's not a core requirement but it is standard and I think fits the needs of what you're trying to do here.

mrinnetmaki commented 1 year ago

I've understood that the meaning of the field is to indicate something like

Sure, we understand that you have this kind of a condition, but we cannot fully trust it or act upon it before it has been asserted by a medical doctor.

A potential problem with Condition.asserter is that we may not even know the asserter. It might be a symptom checker app, for instance, not an individual.

jpriebe-epic commented 1 year ago

The app is an interesting example! And I don't think core FHIR profile supports this well.

I think a proper way to extend conditions to be enterable by devices as you suggest would be to extend attester to include non-person links:

image

Somewhat like with the provenance resource defines agents as devices:

image

Do you have the route to get this to the overall FHIR group? I can help go the Epic routes if it would be helpful.

mrinnetmaki commented 1 year ago

Let's at least discuss with THL next week.

mrinnetmaki commented 1 year ago

Epic uses a coding for "reason to visit" (https://fhir.epic.com/Specifications?api=10187) but category for "problem list item" (https://fhir.epic.com/Specifications?api=950).

Open to checking out whether also reason for visit could be expressed as a category. @jpriebe-epic to check internally.

mikajylha commented 1 year ago

I made a draft PR that tries to better line this up with THL specification and make the solution cleaner at the same time.

See https://github.com/fhir-fi/finnish-base-profiles/pull/90