Questions on edit/delete possibilities for AllergyIntolerance

[hansdekeersmaecker]

As discussed during the fhiraton with @annenerenhausen , I'm creating an issue here to have some business rules in place for edit/'delete'.

For the create, it is quite clear. Everybody of KB78 can create an allergyIntolerance with with verification status 'unconfirmed'. Only physicians may use the other possibilities of verificationStatus (confirmed, refuted).

But who may edit an allergyIntolerance in which case? Again clear if a physician will confirm or refute an AllergyIntolerance. I also suppose you may always edit if you are the recorder and adding notes is also no problem as there is a separate author in the Annotation. But if a GP added a confirmed AllergyIntolerance, may for example a Nurse edit it and in which case? Example if the nurse has seen a new reaction? Or in other cases? Or should always a note be added and it's up to the physicians to make other changes for confirmed AllergyIntolerances?

Same question for delete. I suppose you can always 'delete' your own AllergyIntolerance by putting it in verificationstatus 'entered-in-error', but are there cases that you can put an AllergyIntolerance in 'entered-in-error'? For example if a colleague Nurse added something incorrectly?

I'm missing some clear business rules for these cases.

[costateixeira]

This is a very good point. We have focused on content until now. I would like to look at transactions like these (Update, remove...) Agree the rules should be there, and I think the first step is to identify the different transactions, so that we can decouple the business rules from the data exchange (which should support all the rules).

[mlambot]

Such rules, at least some of them, were discussed at the time of creation of the Care Set with our clinicians. Some were even published on the CSCT website when we started to record allergies in our EHRs with the future AllergyBE data model, however it seems to me that work got "lost in the way" between the Word document which was done inside the business rule WG and the publication of the data structure/FHIR profil in IG guide guide format. I can dig up those rules we had proposed/used at CSCT EHR level if it helps start de discussion again.

[bdc-ehealth]

@hansdekeersmaecker this is a broader architectural question. This can be a part of the access matrix, or business rules.

[KarlienHL7Belgium]

Hans will list a couple a uses cases. We, call to everyone to suggest use cases. RIZIV will take it up with the business .Afterwards the business rules will be updated and the WG will reach out again if they are not sufficiently clear

[hansdekeersmaecker]

For follow-up, I sent a mail in these Use Cases to @annenerenhausen on 25/04, but haven't seen any updates on it.

[bdc-ehealth]

@hansdekeersmaecker Thanks, Hans, for your update. I hope we get an answer from @annenerenhausen 's team soon.