HL7AU - FHIR WG : HealthcareService Discussion Topics - 13-09-2018

This page is in relation to the HealthcareService discussion at working group as per Agenda Drafting

Topic :: HealthcareService.type

The following Taxonomy (in DRAFT) has been prepared by the NHSD for the classification of HealthcareService.type - it shall be converted into a CodeSystem following review by the TWG.

• It should be noted that many Service Types have been "stiked out" - as to not be included in the final version. Please review these concepts and provide feedback if there are existing use cases which will require these.

Topic :: HealthcareService.serviceProvisionCode

This CodeSystem is noted as EXAMPLE - and the concepts therein does not align to the Australian Health terminologies or options available.

We recommend the following to be used as a CodeSystem eg. 

 http://hl7.org.au/fhir/CodeSystem/au-service-provision-conditions

Topic :: HealthcareService.characteristic representation 

This is considered as the catchAll bucket for adhoc characteristics of a service, which do not fit within the core resource model. 

Recommendation is to use this for any specific use-cases that may be relevant to a vendor, not bound by BASE or PD specification. It may also include specific slices as defined by the Technical Working Groups to offer interorability (searching, display) for key items.

See Implementation Guide at https://build.fhir.demo.nhsd.com.au/StructureDefinition-nhsd-healthcareservice.html 

 the characteristics currently noted therein is slightly outdated, and should be represented as below:

Three extensions are noted under the CodeableConcept:

• a grouping (which represents the slice - eg. the type of characteristic)
• a value (used for display purposed only)
• an extended list of values (used for display purposed only)

{
    "characteristic": [{
        "extension": [{
            "url": "http://fhir.nhsd.com.au/StructureDefinition/characteristic-group",
            "valueString": "referralInformation"
        },
        {
            "url": "http://fhir.nhsd.com.au/StructureDefinition/characteristic-value",
            "valueString": "yes"
        },
        {
            "url": "http://fhir.nhsd.com.au/StructureDefinition/characteristic-extendedValues",
            "extension": [{
                "url": "note",
                "valueString": "Please call James on 023434345 prior to leaving your home to ensure he is available."
            }]
        }],
        "coding": [{
            "system": "http://fhir.nhsd.com.au/CodeSystem/rc-referralInformation",
            "code": "forPublicUse",
            "display": "For Public Use"
        }]
    }
}

Topic :: HealthcareService.characteristic AU-BASE slices

It is recommended that there are key slices offered as part of the AU-BASE profile to ensure some key attributes/concepts are widely adopted or supported - it is recommended to include at least the following as AU-BASE slices.

• Facilities
  • sample valueset: https://build.fhir.demo.nhsd.com.au/ValueSet-valueset-au-nhsd-facility.html
• Miscellaneous Characteristics NEC
  • sample valueset: https://build.fhir.demo.nhsd.com.au/ValueSet-valueset-au-nhsd-providerLocationServiceCharacteristic.html
• Appointments
  • sample valueset: https://build.fhir.demo.nhsd.com.au/ValueSet-valueset-au-nhsd-appointment.html
  • ** OR extend the appointmentRequired attribute as a CodeSystem ( purely Bool value is not sufficient )
• Availability
  • sample valueset: https://build.fhir.demo.nhsd.com.au/ValueSet-valueset-au-nhsd-availability.html

Topic :: HealthcareService.coverageArea & Home Visit Services

This use case does not pertain to all vendors, however there are healthcare services which operate by visiting your home - commonly known as their Location Service Delivery Method. These types of services do not normally provide any "physical" address information, but detail only the areas (eg. suburbs they operate in - willing to drive to)

Recommended to use FHIR-definition HealthcareService.coverageArea and make use of Location Resource Type... as per definition (HealthcareService.coverageArea:Location) 

{
	"coverageArea": [{
		"reference": "#d48afc59-9a25-3e03-a954-100b5cfbe360"
	}],
	"contained": [{
		"resourceType": "Location",
		"id": "d48afc59-9a25-3e03-a954-100b5cfbe360",
		"address": {
			"state": "VIC"
		},
		"physicalType": {
			"coding": [{
				"system": "http://hl7.org/fhir/location-physical-type",
				"code": "AREA"
			}]
		}
	}]
}

With Search Support:

GET [base]/HealthcareService?coverageArea.address-postalcode=2000


Noting the Type of Delivery Method (Location Delivery) may be relevant
GET [base]/HealthcareService?coverageArea.address-postalcode=2000&location.physicalType=home

Search: Location Delivery Method

- SITE VISIT    => [base]/HealthcareService?location.physicalType=si
- PHONE/VIRTUAL => [base]/HealthcareService?location.physicalType=virtual
- HOME          => [base]/HealthcareService?location.physicalType=home

General Items and Notes

• Languages List for use: LanguageCodeSystem.csv