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hl7-be / patientwill

Profiles related to patient will, consent,... (Patient Dossier)
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Performer VS Organization #10

Open JensPenny opened 11 months ago

JensPenny commented 11 months ago

I'm posting this issue after validating the patientwill with a colleague in Nexuzhealth.

Most of the model looks fine. The only part where we had some doubts is with the difference between the performer and the organization. For example: in a dnr request for a patient with a custodian there are three main actors.

We are unsure where the doctor and custodian fit in this example. Could this be clarified?

bdc-ehealth commented 10 months ago

WG: custodian is the representative. Where do we get the NISS number of the notary/judge? Do we need another type of representative -> trusted person/patient himself? Anne Nerenhausen will verify... In any case the custodian cannot be the same person as the physician/performer.

annenerenhausen commented 10 months ago

to do : explain each flux for each PatientWill code in the Business rules document and define, for each patientwill code, the responsibility of the physician. (e.g. : commune for euthanasia). for each will code specify if the record info is a legal info or just an notification, ...

AlexisVZ-MDS commented 10 months ago

My current understanding and thoughts:

  1. The "Representative" of the logical model wil be mapped to "Organization" in fhir (since "custodian = representative" and the description for Organizations is "Custodian of the consent" (this is not documented in the business rules, so it took me some time to find this out ;-).

  2. I note the cardinality for Organisation is 0-*, so we could have more then 1 custodian/representative (for 1 patientWill(code)), is that what we want > new issue ?

  3. If found no BeOrganization, so I had a look at http://hl7.org/fhir/R4/organization.html, where I found an identifier where we could store the NISS of the representative/custodian that can agree with the DNR request of the patient. But this is probably an individual person (so not an Organization), and the valueset for Organization-Type should probably be extended cf. http://hl7.org/fhir/R4/valueset-organization-type.html, e.g. with "Person" or "Individual". And while at it we could add "Notary", "Commune", "University", ... > new issue ?

  4. But Organization has no elements for Representative.Role or Representative.Relationship. Do we really need this data ? Why ? Do we make a BeOrganization for this ? Or could we map Representative (logical) to Consent.Provision.Actor (fhir), that has a (security)Role with a valueset (indirectly) including ConsentWitness, Notary (public), LegalAuthenticator ,.. and store the NISS in the identifier of the Referenced RelatedPerson or Organization ?

bdc-ehealth commented 9 months ago

@AlexisVZ-MDS provision.actor would be better place to store the information about the representative