Fix Version/s: 2020.01 - Zomerrelease 2020
Informatiestandaard:BgZ, Laboratoriumresultaten, Zelfmetingen, Huisartsgegevens, Basisgegevens GGZ, BgLZ
Impact:Backwards incompatible. Implementing systems will have to include both the FHIR and zib value set.
Voorgestelde oplossing:* Add slices to Observation.interpretation.coding to support both FHIR core binding and HCIM binding (not backward compatible)
** FHIR slice with cardinality 1..1
** HCIM slice with cardinality 0..1
In zib-LaboratoryTestResult-Observation, Observation.interpretation.coding is sliced to support both the FHIR core ValueSet and the (partially overlapping) HCIM ValueSet.
The FHIR Resource Observation has an extensible binding to Value Set ObservationInterpretation.
The HCIM LaboratoryResult 2017 has a binding to InterpretatieVlaggenCodelijst
The HCIM profile zib-LaboratoryResult-Observation binds to the HCIM InterpretatieVlaggenCodelijst only. This is not consistent with the intent of an extensible binding.
However the InterpretatieVlaggenCodelijst contents could and probably should have been mapped to the FHIR ObservationInterpretation.
The mapping could be as follows:
|HCIM SNOMED code||FHIR code|
|Above reference range (281302008)||High (H)|
|Below reference range (281300000)||Low (L)|
|Intermediate (11896004)||Intermediate (I)|
|Resistant (30714006)||Resistant (R)|
|Susceptible (131196009)||Susceptible (S)|
- Several issues exist that seek to extend the rather limited set in the HCIM (ZIB-1024,
ZIB-1017, ZIB-814, ZIB-683)
- It is debatable what relation Above/Below reference range and H/L have. Above/below do not state how high/low. In the FHIR set there are also Critically High/Low and Very High/Low, which suggest that High/Low are also somehow more than just a relative statement
- The ConceptMap establishes a relationship between the HCIM/FHIR values, but does not change the profile yet. Once the relationship is established though, it makes sense to revert to the FHIR set as defined in the base resource. Because the binding is extensible it is expected to be used before reverting to alternatives. The HCIM codes could/should be added in a second coding