Where can I read why a particular pattern is declared unacceptable? Should I look at the comments in
PCP-224
-
Getting issue details...STATUS
? From 2021:
Notes from internal ticket on why this type of content is not accepted. There are a number of possible interpretations: 1. It is an administrative status that indicates the procedure has been completed. 2. It represents a procedure that has been successfully completed. 3. It represents a past history of a procedure having been performed.
In the first case, if "done" is part of the life cycle of a procedure, it should be recorded similarly to other states of a procedure (e.g. planned, ordered, in progress, completed, etc.). If it represents that a procedure has been done in the past, then it should be modeled as a "history of X (situation)" (subtype of 416940007 |Past history of procedure (situation)|).
Does this mean that all situation concepts for procedures that are planned, in progress, completed etc. will also be retired? Or does it mean that if we use a concept to record a procedure has been completed, we should replace it with a 'procedure completed (situation)' instead?
I am unsure how many of these concepts are used in the Netherlands, but I see we have created 13 concepts with this pattern in the Dutch extension. I do agree they are ambiguous: most indicate that a particular procedure has been completed, but 5 of them look like patient history.
In general, we are reviewing procedure concepts that pre-coordinate a "state" of the procedure to determine whether they should be inactivated. As there is not a universal state diagram for procedures and some are quite complex, it is not feasible for SNOMED to create pre-coordinated state concepts for every procedure. We encourage users to rely on the information model or use post-coordination to specify the state of a procedure in their environment. However, there is a long history of use of some of these pre-coordinated concepts so we need to take a measured approach to their inactivation.
You are correct that some of the concepts may be interpreted as "history of" procedures, but these are also problematic as any procedure could have an analogous past history, so we would not pre-emptively create them without a sufficient use case.
We currently have not stated a lack of support for procedure states explicitly in our editorial guidance as there are administrative exceptions that are of value in the medical record (e.g. Procedure refused, procedure not done). At this point we are reviewing these one state at a time.
2 Comments
Feikje Hielkema-Raadsveld
Where can I read why a particular pattern is declared unacceptable? Should I look at the comments in PCP-224 - Getting issue details... STATUS ? From 2021:
Notes from internal ticket on why this type of content is not accepted.
There are a number of possible interpretations:
1. It is an administrative status that indicates the procedure has been completed.
2. It represents a procedure that has been successfully completed.
3. It represents a past history of a procedure having been performed.
In the first case, if "done" is part of the life cycle of a procedure, it should be recorded similarly to other states of a procedure (e.g. planned, ordered, in progress, completed, etc.).
If it represents that a procedure has been done in the past, then it should be modeled as a "history of X (situation)" (subtype of 416940007 |Past history of procedure (situation)|).
Does this mean that all situation concepts for procedures that are planned, in progress, completed etc. will also be retired? Or does it mean that if we use a concept to record a procedure has been completed, we should replace it with a 'procedure completed (situation)' instead?
I am unsure how many of these concepts are used in the Netherlands, but I see we have created 13 concepts with this pattern in the Dutch extension. I do agree they are ambiguous: most indicate that a particular procedure has been completed, but 5 of them look like patient history.
Jim Case
Feikje Hielkema-Raadsveld
In general, we are reviewing procedure concepts that pre-coordinate a "state" of the procedure to determine whether they should be inactivated. As there is not a universal state diagram for procedures and some are quite complex, it is not feasible for SNOMED to create pre-coordinated state concepts for every procedure. We encourage users to rely on the information model or use post-coordination to specify the state of a procedure in their environment. However, there is a long history of use of some of these pre-coordinated concepts so we need to take a measured approach to their inactivation.
You are correct that some of the concepts may be interpreted as "history of" procedures, but these are also problematic as any procedure could have an analogous past history, so we would not pre-emptively create them without a sufficient use case.
We currently have not stated a lack of support for procedure states explicitly in our editorial guidance as there are administrative exceptions that are of value in the medical record (e.g. Procedure refused, procedure not done). At this point we are reviewing these one state at a time.
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