Add 'report' to Composition Category to support report Compositions
Description
Activity
Sebastian Iancu June 26, 2023 at 8:54 PM
Approved during March-April 2023 SEC meetings
Thomas Beale March 5, 2023 at 5:35 PMEdited
Agree with @Joost Holslag that AQL querying has to match any original content in reports (e.g. discharge summaries) but not cited material. The addition of this code certainly doesn’t mandate any particular kind of AQL processing; that must be determined elsewhere.
I had not noticed earlier the statement in the Description that a Discharge summary cannot include new information. That is not in general true, and should not be a restriction we impose. There will almost certainly be new content in a discharge summary, e.g. statements about patient management going forward.
Sebastian Iancu February 23, 2023 at 9:44 AM
I don’t think that is very problematic or relevant - I still think it is about a type of a composition, even though might be within other contexts.
Joost Holslag February 22, 2023 at 6:58 PM
@Sebastian Iancu to me it’s fine to add the term code now and decide later on all implications.
How do you feel about the relevancy(event, episodic) vs content type(report, message) mixing in category?
Sebastian Iancu February 22, 2023 at 8:37 AM
@Joost Holslag, I have the impression that you have same concerns on the impact on AQL, if/when we going to specify that behaviour in AQL specs. In the meanwhile, this is the TERM component, so in theory we could already introduce the term and deal a bit later (and separately) with AQL (and RM).
Why would we do it now? - because is going to be a major release soon, and I’m hoping this term-set will be soon in highly used by implementation. But is important do decide firmly now about the name and semantic of this code.
The use-case is discharge summaries. These are Compositions which only (“mostly”) contains links to existing entries. We will be using links but since the Composition should be transferred to another health provider it must be serialized and validated against an template.
Technically this Compostions contains a lot of entries which is “link to self”.
The most important thing is to precisely define the semantic meaning of the content in a composition. In this specific use-case the content of the composition is always a copy of the primary source. This means that the Discharge letter only bring one new thing into the EHR - that is the fact that there is an approved discharge letter. But the entries in the composition is link and copies of entries in other primary sources.
The requirements to the system is quite small:
Content of "report" documents MUST not be in the resultset when doing normal AQL queries.
It MUST be possible to query for "report" compositions with specific content.
The solution to this problem is simple and I can give an example with an AQL query. Below is a standard query for body weight. Look at the WHERE condition. Here I am looking for all body weights which are NOT part of a report composition. This WHERE condition will be the default filter on all queries. If the client would like to query for all body weights in report document, then just change from NOT EQUALS 434 to EQUALS 434.
SELECT o/data[at0002]/events[at0003]/data[at0001]/items[at0004]/value/magnitude
FROM COMPOSITION c
CONTAINS OBSERVATION o[openEHR-EHR-OBSERVATION.body_weight.v1]
WHERE c/category/defining_code/terminology_id/value = 'openehr'AND c/category/defining_code/code_string != '434'
Given that we agree that there is a class of compositions which belongs to the "report" group. Then we should add such semantic into the RM to make it precise and consistent.
The proposed solution is to add a new code for composition category:
<group name="composition category">
<concept id="431" rubric="persistent"/>
<concept id="433" rubric="event"/>
<concept id="434" rubric="report"/>
</group>