Minutes - Referral WG 2021-12-14

Attendees

• Dr Alain Derom
• Bart Decuypere
• Frederik Lenaerts
• Hans De Keersmaecker
• Jean-Michel Polfiet
• Jos Bellen
• Karlien Erauw
• Kristof Jaubin
• Olivier Lothaire
• Philippe Cauchie (let at 4.30PM)
• Thibault Mahieu
• Tom Tollenaere
• Richard Francken
• Stefan Waegemans
• Werner De Mulder

Excused/Not present

• Alexis Van Zeveren
• Benny Verhamme
• Frédéric Istace
• Frederik De Kegel
• Joost Van Averbeke
• José Costa Teixeira
• Mieke Buckinx
• Nico Vannieuwenhuyze
• Nick Hermans
• Paul Neyens
• Peter Laridon
• Robert Nicolas
• Theo Schumacher
• Tom Fiers
• Toon Schiemsky

Agenda

• Rework on issues resulted from the pilot phase, issues #48 and #50 having priority

Minutes

• Up-to-date list of issues can be consulted here
• Issue 33 : DiagnosticReport.code : coding same as composition type

• Set both to "laboratory report"?
• In examples we find e.g. Hematology studies, but our reports are typically more extensive than only hematology
• subject of lab report will be in the subject f.e. hematology will appear as chapter in lab report
• proposal: not to put the type at this level in the lab report, just call it laboratory studies
• Bart looked at LOINC codes (11502-2, not coded as RETAM yet at federal level)
• Philippe proposes to test this first (later today), be careful that an hematology study comes from another service
• let's allow it for now and await the tests

• Issue 23: How to encode comments

• We need to specify how to deal with different kinds of comments. Here an inventory and suggestion of process:

• a. Comment on a result of analysis - may be done .note to the result? But there are different cases possible:

• a.i. result field itself maybe comment or text (e.g. "Positive" or "No longer performed by lab; replaced by analyses XXX"
• a.ii. Comment in commentfield may be combined with number (or comment0 in result field)

• b. Comment regd. reference values (e.g. age-specifics) – in .text to the reference values?
• c. We often created dummy test codes to contain comments. E.g. serum aspect. Is this allowed? There are no LOINC codes for these dummies - will we allow every lab to use their own. Can we use this system? If not, how do we encode such comment?
• d. Comments regarding the laboratory (not the results). E.g. status of accreditation. We currently use dummy tests for that. Acceptable? If not, then how?
• e. Comments regarding tests performed by 3rd parties. We currently do that by means of flags (codes) next to results, and use a dummy test to explain the legend. Allowed? If not then how?
• f. Comments regarding administrative issue, e.g. missing information like gender, DOB. Today we use dummy test codes. Allowed? If not, then how?
• g. There is also a .conclusionCode - to use instead of dummy analyses? Or a combination? Dummy analysis have the advantage they can be linked to a sample (useful e.g. for serum aspect) - .conclusionCodes cannot do this.
• Do we want/need to agree on standards for the above? Or allwo every lab to do their own way?

• there are 3 LOINC codes availabel 55752-0, 94330-8 and 86468-6
• there is also a note field available for comments
• on analysis level there are also comments
• Issue can be moved to "for implementation" status

• Issue 31 given name (patient & practitioner)

• when a person has more than one given namen
• do it in one field in the FHIR resource or do it in seperate fields ?
• proposal to put it in one field as in the EID

• Issue 30: patient status during specimen collection

• Medina never fills this in so field should be optional
• on specimen resource there is a note field of type annotation where you can put any text

• Issue 25: same issue as 33 but on different level (at diagnostic report level while issue 33 is on level)

• move to "done"

• Issue 47 : RequestCode

• where to put the RequestCode : don't put it in the lab result
• the protocol will not always match the request
• the analysis order codes cannot be mapped 1-to-1 to lab codes

• Issue:

Next Meeting: on Tuesday Dec 21 4PM