Canadian FHIR Baseline Profiles - Profiling Stream Meeting - Feb 12th Notes

A big thanks as always to Sheridan for the incredibly precise and detailed notes!

Feb 12th: Due Diligence Review, comparing CA Baseline to eReferral iGuide

AllergyIntollerance

Possible candidates for relaxation:

- verificationStatus.coding slice is currently closed (meaning no other slices other than StatusCode or default) can exist
o Doesn’t present an issue with eReferral because eReferral doesn’t include slices of it’s own (align to default)
o Need to keep an eye on it and determine if other IGuides will slice this element other ways (would cause an issue with inheriting the closed slice structure)

- code.coding:NotAsked slice & code.coding:NoAllergy slice
o Small terminology differences between the valueSet that eReferral uses – though intent is the same
 eReferral has a required binding to build.fhir.org/ig/HL7/fhir-ips/ValueSet-allergy-intolerance-substance-condition-uv-ips.html which is made up of Snomed CT codes
 CA Baseline slices fix to hl7.org/fhir/v3/NullFlavor and 716186003 from SNOMED CT respectively.
o More follow up needed to understand how eReferral accounts for Not Asked

- onsetDateTime
o Baseline considers onsetDateTime to be MS, eReferral does not (both allow other data types)
o If onsetDateTime is more clinically desirable – need to follow-up with eReferral to see if the impact of them flagging onsetDateTime as must support

- Reaction.Substance.coding
o Coding is 1..* in CA Baseline, 0..* in eReferral
o Likely to relax after confirming reason that eReferral did not tighten cardinality to require a code be provided if reaction substance is known

Condition

Relaxation decision:
- Relax cardinality of HealthConcernCode to 0..1 (is currently 1..1)

Possible candidates for relaxation:
- Code.coding
o 1..* in CA Baseline, 0..* in eReferral
o May relax in CA Baseline but need to confirm reason that eReferral did not tighten cardinality to require a coding be provided if code is populated (some might only be able to populate code.text)

Next time (Feb 26th): Will continue DDR with eReferral iGuide, will follow-up on the action items from above and also will look at the Patient, Practitioner, and Location profiles as profiled in the eReferral iGuide