Hi All,

What is the difference between issued and Effective[x] field of an observation.
If we get multiple observations for a particular patient which fields should be used as filter to extract the latest observation.


It depends on the observation. An observation like blood pressure will almost always have issued = effective, since the number is recorded immediately. On the other hand, lab results can take a long time to become available, so the effectice[x] << issued. And then some observations are time averaged things, so effective[x] is a period.

If only this were simple, but it’s not. Nor is your question, either. Generally, the clinically significant result would be the most recent effective[x] (by date/time or the end of the period). But in some cases, the most recently received lab result would be the most important, if it was the one that drove the decision making; this needs good business analysis with clinical users

Hello, I’d like to piggyback on this, regarding how we report issued date in smoking status. It is a ‘must support’ field.

In our patient record, there is no specific issued date for smoking status. Rather, it is a date when the patient record was last updated for hundreds of fields, including smoking status. Would it make sense to interpret that smoking status was not clinically significant, the latest update date is permissible to be reported as ‘issued’ date?
Thank you for your help!

The date, in this case, is the date of the observing. If the patient’s smoking status was updated, or reviewed and found to be unchanged, the date should be the same as all of the other reviewed records.

If the patient’s smoking status has not been reviewed, it is not a new observation.