CHEMEDDocumentMedicationList entry slicing is ambiguous

[dvribeira]

The slicing rules of https://github.com/hl7ch/ch-emed/blob/master/input/fsh/profiles/CHEMEDDocumentMedicationList.fsh make it so that actual validation of PML documents containing changed entries will never be successful (tested with matchbox 3.5.3 with CH EMED 4.0.1, but I believe the problem still applies):

• changed resources distinguish themselves from not changed resources by having the partOf element/slice set as mandatory, while it is optional for original resources
• when a resource does not have a partOf element (in our case, any original resource), validation it is not ambiguous as it cannot be a changed resource (which requires this element) -> validation passes
• when a resource does have a partOf, the validator will not know against with resource profile it should be matched, since both do, and validation will fail.

* entry contains
    MedicationStatement 0..* and
    MedicationRequest 0..* and
    MedicationDispense 0..* and
    MedicationAdministration 0..* and
    Observation 0..* and
    MedicationStatementChanged 0..* and
    MedicationRequestChanged 0..*
* entry[MedicationStatement].resource 1..
* entry[MedicationStatement].resource only CHEMEDMedicationStatementList
* entry[MedicationRequest].resource 1..
* entry[MedicationRequest].resource only CHEMEDMedicationRequestList
* entry[MedicationDispense].resource 1..
* entry[MedicationDispense].resource only CHEMEDMedicationDispenseList 
* entry[MedicationAdministration].resource 1..
* entry[MedicationAdministration].resource only CHEMEDMedicationAdministration
* entry[Observation].resource 1..
* entry[Observation].resource only CHEMEDObservationList
* entry[MedicationStatementChanged].resource 1..
* entry[MedicationStatementChanged].resource only CHEMEDMedicationStatementChangedList
* entry[MedicationRequestChanged].resource 1..
* entry[MedicationRequestChanged].resource only CHEMEDMedicationRequestChangedList

The proposal would be to remove the distinction between original and changed resources at the document entry level, since they are anyway discriminated at the composition/references level and to use the CH EMED parent profiles. It should be enough to use CHEMEDMedicationStatement and CHEMEDMedicationRequest at this level instead:

* entry contains
    MedicationStatement 0..* and
    MedicationRequest 0..* and
    MedicationDispense 0..* and
    MedicationAdministration 0..* and
    Observation 0..*
* entry[MedicationStatement].resource 1..
* entry[MedicationStatement].resource only CHEMEDMedicationStatement
* entry[MedicationRequest].resource 1..
* entry[MedicationRequest].resource only CHEMEDMedicationRequest
* entry[MedicationDispense].resource 1..
* entry[MedicationDispense].resource only CHEMEDMedicationDispenseList 
* entry[MedicationAdministration].resource 1..
* entry[MedicationAdministration].resource only CHEMEDMedicationAdministration
* entry[Observation].resource 1..
* entry[Observation].resource only CHEMEDObservationList

Optionally, but not required to solve the issue, would be to also downgrade the dispense and observation slices to the parent resources out of consistency. No strong opinion there on my side.

[ziegm]

(tested with matchbox 3.5.3 with CH EMED 4.0.1, but I believe the problem still applies)

Yes, I have also encountered this problem in a similar project

[ziegm]

@dvribeira @pjolo please review the changes:

• profile CH EMED Medication List Document
• changelog

[dvribeira]

The changes are good for me.

Thanks a lot!

[pjolo]

The changes are also good for me.