Minutes

patient identification: checked with eHealth platform
art 8 from eHealth platform law and mapped with the BCSS law: all info passing the eHealth platform must use the NISS info from patient, the NISS is identifier at the nat'l security, can be RN number if this exists ; if not existing in RN then BIS number is created. See more here
no need to create a new Naming System as NISS can be RN or BIS number
BIS can be created by Fedasil or nat'l scty or GP
will there be FHIR messages without a NIS number ? There are now data in labs without NIS number. If there is no NIS then data are not shared

patient data are sent not by eHealth infrastructure if there is not a NIS number
Can we send a FHIR message without NISS number ? It is possible if sent the eHealthBox to the GP. Lab will use own identification from his system.

issue 59 can be closed as not necessary: the foreseen namingsystem https://www.ehealth.fgov.be/standards/fhir/NamingSystem/ssin can be used as well

New issue : how to deal with comments - new issue encountered, not in github yet

protocol 49: series of tests that are not accredited, some of them having comments. the only way to encode this is
text "analyse gedekt door accreditatie" comes with every analysis
some tests have biological relevance, some have not, they are mixed. Visualisation tool only shows 1st comment currently.
does it make sense to mix info like this ?
Belac requires to put info somewhere in a readable way. Currently there is no other way to put the comments but report becomes unreadable
make distinction b/w technically/clinically relevant & administrative/non-clinical comment

if we make extension it is at observation level not at observation interpretation level - seems that we need an extension, José will check with int'l FHIR lab group and will come up with a solution

Additional new issue with comments: comments having referenced values/referenced range/interval and alpha numeric values

see protocol 52
visualisation tool does not show these comments yet
comment that goes with referenced range f.e. normal values for diabetics/normal values for non-diabetics

issue 65 is newly created in github
see complex example here
clinical biologists feel that several tests are necessary to see how it will look like
José to come up with a proposal to put this info, we might need an extension
check with Netherlands: https://zibs.nl/wiki/LaboratoryTestResult-v5.0(2021EN)

reports not only indicate physician who ordered the lab tests, but may list other physicians in cc of lab results. We cannot find who to encode those in the FHIR message (i.e. we do not know where to put those). Do we not indicate this? Or if we do, where and how?
POC group proposes to put comment on service request/order level (plain text: copy result to GP...)
order is not digitised yet so is more for the future, there is no BeServiceRequest yet, note field at FHIR R4 service request profile

it is a non-issue: labs will results in the units in which they have pinned the result
it can be closed
receiver can receive different loinc codes

Next Meeting: on Tuesday Jan 18 4PM

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