Encounter Resource

1

Hello Everyone,

I’m a master student in Politecnico di Milano , and as a master thesis I’m working on designing and implementing a PHR which is HL7 FHIR compatible running on Android devices.
The main concern of this PHR , which actually I’m done with the implementation is to get Blood Pressure and Glucose.
Obviously I need to use Patient, and Observation Resources, But I’m in doubt if I need Encounter resource or not, based on the following scenario:

RHCP (Regular Home Care Plan):
A clinic has announced a plan which is created for increasing quality of individuals lives. This program aims to discover potential existence risk of strokes or diabetes , and prevent those phenomena by on time reactions. Attending this program cause a person goes through and starts the care process with consciousness. So the target of this program are not only elderly or patients but also a person who has a normal life and just wants to control his or her health parameters.
A doctor visits the applicant and prescribe (plan) a personal instruction to send the health parameters. Each plan has a cycle. During this cycle the applicants has to collaborate; meaning measures and sends the health parameters based on instruction. At the end of the plan, the persons needs to visit the doctor and the doctor will decide to end the plan or create new plan.
The requirements of joining to this program is having an android device.
However, this Regular Care Plan is also ran for the persons who do not have an android device, they might come directly to the clinic and measures their parameters, this case is not considered in our context.
Web portal functionalities:
As an assumption , this web portal is designed for a special clinic which cares about the persons who are suspected of strokes and diabetes.
There are two different roles defined in this web portal which has different access level to the web portal; nurses and doctors.
The nurses are responsible to create a record for the applicants who are interested in joining the RHCP (Regular Home Care Plan). (create patient/person) and assign a doctor to the person.
The doctor after visiting the applicants prescribes a personal plan. (create prescription for a particular persons)
A doctor can see only the patients records who are subscribed to.
A doctor can see the observations send by the patients/persons via MOBILE APP.
A doctor may end the cycle or create new one.
A doctor can see a diagram of measurements sent by a person. (data visualization)

The exchanging data between Mobile App and Web portal shall follow the FHIR rules.
Based on this scenario , do I have to consider the Encounter Resource ?

I do appreciates your answers and please pardon me if this is a bit long to read.

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Well, there are a whole lot of potential resources here - CarePlan, MedicationOrder, EpisodeOfCare, ConditionPractitioner, CareTeam - in addition to the ones you’d mentioned. Which ones you need depends on what data you want to capture and share. And that’s not completely clear from the scenario you’ve described. If all the Android app is doing is submitting pre-defined observations, then it might manage with just Observation. If it does more than that, then you might need more resources.

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Thank you @lloyd
what Android app is shared with the web portal are:
- pre-measured observations at home. Then the doctor using web portal will be notified that something new has been shared.

what web portal shared with the Android app are:
_- some personal information (demographics) , and the Android app user might change them or not. In addition the RHCP( The plan which I have defined in problem statement) can be downloaded to the Android app as a free text. Finally the practitioner after evaluating the observations might end the plan and notify patient or end the plan and ask to make contact with the clinic _

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I’m also interested in which version of FHIR you are planning to implement this with, DSTU2?
Sounds like you’ve already identified the CarePlan resource (and its referenced Patient) as the central resource for your proposed implementation.

You could consider the EpisodeOfCare resource to link the CarePlan resource to all the observations relevant to this program.
This way when content is exchanged with other systems you can know which are related to this specific scenario, and not other observations for other activities.

We have an existing implementation very similar to your solution in production that uses FHIR as the transport mechanism (but proprietary internally).

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