Hello!
I’m new to FHIR and dug through the documentation. Can anyone point me to the right place where to store/retrieve patient-ventilation data?
Thanks!
Are you interested in “number of patients on ventilators”, “# of ventilators available”, and things like that, or are you interested in capturing the specific mixture of gases being delivered to a patient at particular periods of time?
Hello @lloyd,
thank you for your response!
I’m interested in capturing and querying the specific mixture of gases being delivered to a patient at particular periods of time, including:
- Inhale & Exhale Ration
- Ventilation Mode (e.g. CPAP)
- Mesurements of ventilation parameters at a timestamp (e.g. FiO2 (%) )
The only thing I’ve found so far is the following:
https://www.hl7.org/fhir/servicerequest-example-ventilation.json.html
https://build.fhir.org/valueset-servicerequest-orderdetail.html -> for ventilation-mode?
Consider Procedure. It will need some extensions.
The HL7 Patient Care work group (that owns Procedure resource) discussed this question on Aug 20, 2020.
Generally speaking, Patient Care doesn’t recommend using Procedure for the examples provided. Instead, patient data documentation related to output/measurements/readings off a ventilator would be an Observation. Observation.device can reference the specific ventilator (Device) and/or DeviceMetric (for device settings).
Since there could be multiple use cases, please elaborate on which is of primary interest.
- What is being ordered (ServiceRequest)
- Vent settings, which can often change (DeviceMetric)
- Documentation of the vent settings for the patient (Observation) as well as patient’s physiological response (Observation)
1 Like
Hello @michellemiller,
thank you for your response. Some time passed by since your answer, sorry for me not giving feedback sooner.
Your answer helped me to realize that I mixed up two use cases.
For interested readers: I modeled it in the following way:
- Ventilation Procedure - as a FHIR Procedure for tracking the actual action of the ventilation with start- and end-date and the ventilation-mode saved in the procedure.code + a custom category to flag it as ventilation.
- Ventilation Parameters - as FHIR Observations (category=procedure, partOf=procedure) to track measurements like FiO2 at given timestamps.
Orders (ServiceRequest) or DeviceMetrics are not of interest for me for now. But good to know of these resource for future needs, thanks!
Kind regards!
I have a very similiar problem: how to I model the hours of mechnical ventilation for reimbursment purposes? From the primary system I only get the numbers and I need to make that number available at the FHIR API. So, I could create a procedure with fake dates that represent the correct length or I could create an observation since I want to communicate a “measurement” but there is no LOINC code… any thoughts on that?
Thank you very much!
For pure reimbursement purposes, you could just submit a Claim with a billing code of “mechanical ventilation” and specify a quantity of 23 hours or whatever the amount was. If you’re going to represent an actual procedure to support the claim, the presumption is that you should actually know when the procedure started and stopped.
From another group I got the hint to use an observation resource with the LOINC code “74201-5” and set the unit to “minutes” or “hours” despite the code actually requests days… not sure about it, though