Representing PCP/GP History in FHIR

2
votes

Background:

I have been digging into the FHIR DSTU2 specification to try and determine what is the most appropriate resource(s) to represent a particular patient's historical list of GPs/PCPs. I am struggling to find an ideal resource to house this information.

The primary criteria I have been using is to identify the proper resource is that it must provide values to associate a patient to a practitioner for a period of time.

Question: What is the proper resource to represent historical pcp/gp information that can be tied back to a patient resource?

What I have explored:

Here is a list of my possible picks thus far. I paired the resource types with my thought process on why I'm not confident about using it:

  • Episode of Care - This seems to have the most potential. It has the associations between a patient and a set of doctors for a given time period. However, when I read its description and use-case scenarios, it seems like I would be bastardizing its usage to fit my needs, since it embodies a period of time where a group of related health care activities were performed.

  • Group - Very generic structure that could fit based on its definition. However, I want to rule out other options before taking this approach.

  • Care Plan - Similar to Episode of Care rational. It seems like a bastardization to just use this to house PCP/GP history information. The scope of this is much bigger and patient/condition-centric.

I understand that there may not be a clear answer and thus, the question might run the risk of becoming subjective and I apologize in advance if this is the case. Just wondering if anyone can provide concrete evidence of where this information should be stored.

Thanks!

1
hl7-fhirdstu2-fhir
pcp = "primary care provider"? "presenting complaint, primary"? "primary care problem"? - ErichBSchulz

1 Answers

3
votes

That's not a use-case we've really encountered before. The best possibility is to use the new CareTeam resource (we're splitting out CareTeam from EpisodeOfCare and CarePlan) - take a look at the continuous integration build for a draft.

If you need to use DSTU 2, you could just look at Patient.careProvider and rely on "history" to see changes over time. Or use Basic to look like the new CareTeam resource.