3.Gram Stain Profile - Healthedata1/OO-on-FHIR-Micro-Profile GitHub Wiki
This Profile on Observation defines the gram stain observations for a culture.
There are two potential patterns for reporting a Gram Stain results: 1) a single observation on the cytologic description -e.g. 'Gram Positive Bacilli' 2) a pair of observations describing the relative number as well as the cytologic descripion - e.g. 'Many Gram Positive Bacilli'. This profile describes the structure for the second case.
Based on DAF-Core/US-Core plus additional USlab (LRI) and US-Core Micro Report constraints (in italics):
Each Gram stain Observation must include:
- a status
- a category code of ‘laboratory’
- micro category code as translation
- a LOINC code, if available, which tells you what is being measured
- performing organization
- a patient
- a pair of result components with: - LOINC code and a component result code for the relative number and - LOINC code and a component result code for the cytologic description
Each Gram stain Observation must include: must support:
(stuff from LRI OBX and OBR)
- an identifier (Filler/Placer) - Discuss whether this is a must support - not an LRI requirement
- a time indicating when the specimen was collected
- a time indicating when the measurement was reported
- the specimen
- a specimen rejection reason This is really a data absent reason and should go there instead of an extension on Obs - consider a DAR profile
(note: the LRI requirement for AOE vs results category is not needed for this profile since is implicitly a result profile)
Terminology considerations ( note need help from community to work these out)
For Observation.code
& Observation.component.code
- extensible binding to LOINC with METHOD_TYP
= 'Gram stain`
For Observation.component.valueCodeableConcept
- extensible binding to SNOMED CT qualifier codes for Rare, Few, Moderate and Many.
For Observation.component.valueCodeableConcept
- extensible binding to SNOMED CT concept codes for: ( This is too big a Valueset right now- need to identify the relevent 20 or so terms.)
-
Gram-positive bacteria
-
Gram-negative bacteria
-
Gram variable & Gram-indeterminate bacteria