I’m looking at how to model a theatre visit. So, a patient is admitted for a knee replacement. I create an encounter for the admission and they have multiple locations as they go from ward to theatre and then back to ward. But how should I model the time in theatre itself? I can use the procedure resource to map out the knee replacement - but I need to record the various in-theatre times - Into Theatre, Anaesthetic Start, Anaesthetic Stop, Surgery Start, Surgery Stop, Into Recovery, Out of theatre, etc. Each of the times is important. Has anyone modelled something like this before, and how did you do it? I could use extensions - but that doesn’t feel right.
There are a few options. The theatre visit itself could be a sub-encounter if you wanted, but even so, that wouldn’t give you all the timestamps you’re looking for. The best we have at the moment would be to represent things like Anaesthethic start/stop as Procedure, and surgery as the same. Transfers between different locations (prep, surgical suite, recovery, ward) would all be managed through the location transfer mechanism on Encounter. I realize that’s not the ‘neat’ package you might have been hoping for.
In practice, we haven’t done a lot of work with detailed modeling of surgical encounters - most of the focus has been on summary rather than step-by-step execution. You might want to discuss further on the Patient Care stream on chat.fhir.org.
Thanks Lloyd. I will investigate using procedures and sub-encounters.