Finnish Base Profiles
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Many systems have a need to answer the question: "How to find patients/encounters that are at ward X at moment T?".
There are key points to consider when forming the search criteria:
IMP
(inpatient encounter) encounters, so we should filter
by class
.in-progress
encounters, so we need to filter by status
.Organizational ward should be communicated using the serviceProvider
property.
FHIR request parameters:
GET /Encounter
IMP
in-progress
gt
and le
filters as per target momentHistorically some systems keep the ward encounter active when the patient is sent to ICU. Leaving
the encounter in an in-progress
state would cause a gotcha: encounter says that it's active but
patient is not really there. Using encounter´s location
elements could be used to express that
the patient has no active location in the ward, but this might be difficult to process for client
systems and depend heavily on the organizational and location structures of a facility. Because of
these problems, the encounter SHOULD not be kept in-progress
when the patient is in an ICU period
(if there is a need for "recycling" the ward period encounter, it should be set to finished
and
then back to in-progress
upon return from the ICU).
Encounter
s location
field is a reference to Location
that has a field managingOrganization
.
Use of this to find the organization responsible for the patient is problematic.
Location.managingOrganization
might change for different reasons (a room is assigned to another
organization) and this would have an unexpected effect on the responsibility-concern.
Location.managingOrganization
is "too far" from the encounter to be useful in this context.
Querying by location is also an option. Here the focus is on the physical location and not the organizational responsibility towards the patient. This blog post will describe the process.
Generated Narrative: Encounter id-for-ward-encounter
identifier: id-for-ward-encounter (use: usual, )
status: In Progress
class: ActCode IMP: inpatient encounter
subject: Testi Henkilö Male, DoB: 1990-01-01 ( National Identifier for Finland (use: official, ))
period: 2022-02-27 01:03:00+0200 --> (ongoing)
Location | Status | Period |
Location Vuode 3 | Active | 2022-02-27 01:03:00+0200 --> (ongoing) |
serviceProvider: Organization Kirurgian vuodeosasto 4B, Länsi-Pohjan keskussairaala, LPSHP