Additions to the FHIR Health API

[WilliamStewart9]

VA Lighthouse API Feature Request

⚠️ Please read before submitting: As this is a public forum, please do not include any sensitive information (such as your VA API OAuth Client ID, VA API OAuth Client Secret, VA API key, Name, Address, Phone Number, Social Security Number, Medical Record Number, etc).

APIs affected (if applicable)

Veterans Health API (FHIR)

Explanation

I am providing these comments in support of the Girls Computing League who are current customers of this API and are continuing their research efforts.

1. Please add Cancer registry data - the cancer registry data in CDW likely has a number of different kinds of data, such as specific tumor staging info, and specific history of cancer treatment. Thus, the FHIR resources involved include Condition, Procedure, DiagnosticReport, and Medication. All of these resources are already implemented in the Health API, so it would be a matter of mapping the CDW registry as an additional data source and labeling the data accordingly so we can query for the registry data specifically. Please add the CDW cancer registry data to these resources.

2. Please add Clinic Encounter Diagnoses - we are probably already getting these in the current Condition resource, the additional request is to be able to determine specifically whether the conditions came from a clinic encounter and whether they were primary or secondary. Can Primary vs. secondary be found in Condition.category? If not, where would it be found?

3. Please add Stop Codes where the patients have visited - this would be in an Encounter resource, particularly the Encounter.serviceType field

4. Please add metadata that shows whether medication is given as outpatient or inpatient - the resource MedicationRequest would have this information, in particular the MedicationRequest.category field

5. Please add Radiation Therapy Data - this is covered in a profile extension of the Procedure resource called CancerRelatedRadiationProcedure - details in https://mcodeinitiative.github.io/StructureDefinition-onco-core-CancerRelatedRadiationProcedure.html.

6. Oncology Note Health factors - these are used in VistA for a wide variety of things, but I would guess Observation is probably the best resource for this. The health factor tags in question come from oncology note templates, so we would have to take a look at the specific health factors from those templates to determine all the adequate resources.

Value provided by feature

Supports more detailed oncology AI trend predictions

Acceptance criteria

The descriptions above should suffice, though since the actual data values are not yet known, a complete acceptance criteria set is not feasible at this time. if there are any questions, please respond and I will coordinate with the team.

[ryanlink]

Hi William, thanks for your feature requests. I have passed them along to the Health API product team for prioritization.

1. is already a request from GCL in our backlog.

2. We don't yet support the Encounter resources, so if there is a reference to that in the Condition we do not have it exposed.

3. We do not support the encounter resource at this time.

4. This was also previously requested by GCL and has not yet been prioritized on the product owner's roadmap.

5. Therapy data based on STU-3 is not yet supported - we are looking into this.

6. As for what the best resource is, we will need to have the KBS terminology team and our DataSources weigh in on the mappings.

I've recorded these requests with the previous ones and will let you know as soon as we have any updates.

Cheers,

Ryan Link
Customer Success Manager
API Support Lead, Lighthouse | VA API Program
developer.va.gov

[ryanlink]

@WilliamStewart9 For #1, we do not have that data available at the moment. We have done a search in CDW and do not see that registry. Do you know the table or where that data lives in CDW? If we can get access to that database, we can provide that data.

[WilliamStewart9]

Ryan, I don’t have a question with regards to the link in #1 below, are you referring to another email, post, or issue? Thanks, Will Stewart National Artificial Intelligence Institute | NAII<https://www.research.va.gov/naii/> Senior Solution Architect | EA, SA Demand Management | Intake and Analysis<https://dvagov.sharepoint.com/sites/OITEPMOIAS/dmdocsite/Pages/Intake%20%26%20Analysis%20Service.aspx> IAS Enablement Team Lead | Veteran Experience Services DevOps Transformation | Product Line Architecture Change Team Enterprise Program Management Office (EPMO) Office of Information Technology (OIT) Department of Veterans Affairs Phone: 202.794.0703 Email: [email protected]<mailto:[email protected]> From: Ryan Link <[email protected]> Sent: Wednesday, August 26, 2020 6:19 PM To: department-of-veterans-affairs/vets-api-clients <[email protected]> Cc: Stewart, William R. <[email protected]>; Mention <[email protected]> Subject: [EXTERNAL] Re: [department-of-veterans-affairs/vets-api-clients] Additions to the FHIR Health API (#174) @WilliamStewart9<https://github.com/WilliamStewart9> For #1<#1>, we do not have that data available at the moment. We have done a search in CDW and do not see that registry. Do you know the table or where that data lives in CDW? If we can get access to that database, we can provide that data. — You are receiving this because you were mentioned. Reply to this email directly, view it on GitHub<#174 (comment)>, or unsubscribe<https://github.com/notifications/unsubscribe-auth/ALIP4MPA4TPHXDDRRW3PEXDSCWC6JANCNFSM4PCKG24A>.

[ryanlink]

Sorry @WilliamStewart9 - that was not meant to be a link to issue number 1 in this repo but a reference to your 1st request above about cancer registry:

1. Please add Cancer registry data - the cancer registry data in CDW likely has a number of different kinds of data, such as specific tumor staging info, and specific history of cancer treatment. Thus, the FHIR resources involved include Condition, Procedure, DiagnosticReport, and Medication. All of these resources are already implemented in the Health API, so it would be a matter of mapping the CDW registry as an additional data source and labeling the data accordingly so we can query for the registry data specifically. Please add the CDW cancer registry data to these resources.

We do not have that data available at the moment. We have done a search in CDW and do not see that registry. Do you know the table or where that data lives in CDW? If we can get access to that database, we can provide that data.

[WilliamStewart9]

Ethan, Do you have any input specifics to share in the context of Ryan’s reply below? Thanks, Will Stewart National Artificial Intelligence Institute | NAII<https://www.research.va.gov/naii/> Senior Solution Architect | EA, SA Demand Management | Intake and Analysis<https://dvagov.sharepoint.com/sites/OITEPMOIAS/dmdocsite/Pages/Intake%20%26%20Analysis%20Service.aspx> IAS Enablement Team Lead | Veteran Experience Services DevOps Transformation | Product Line Architecture Change Team Enterprise Program Management Office (EPMO) Office of Information Technology (OIT) Department of Veterans Affairs Phone: 202.794.0703 Email: [email protected]<mailto:[email protected]> From: Ryan Link <[email protected]> Sent: Thursday, August 27, 2020 10:05 AM To: department-of-veterans-affairs/vets-api-clients <[email protected]> Cc: Stewart, William R. <[email protected]>; Mention <[email protected]> Subject: [EXTERNAL] Re: [department-of-veterans-affairs/vets-api-clients] Additions to the FHIR Health API (#174) Sorry @WilliamStewart9<https://github.com/WilliamStewart9> - that was not meant to be a link to issue number 1 in this repo but a reference to your 1st request above about cancer registry: 1. Please add Cancer registry data - the cancer registry data in CDW likely has a number of different kinds of data, such as specific tumor staging info, and specific history of cancer treatment. Thus, the FHIR resources involved include Condition, Procedure, DiagnosticReport, and Medication. All of these resources are already implemented in the Health API, so it would be a matter of mapping the CDW registry as an additional data source and labeling the data accordingly so we can query for the registry data specifically. Please add the CDW cancer registry data to these resources. We do not have that data available at the moment. We have done a search in CDW and do not see that registry. Do you know the table or where that data lives in CDW? If we can get access to that database, we can provide that data. — You are receiving this because you were mentioned. Reply to this email directly, view it on GitHub<#174 (comment)>, or unsubscribe<https://github.com/notifications/unsubscribe-auth/ALIP4MIEKUMMDBSOHTH7ZPLSCZR2RANCNFSM4PCKG24A>.

[WilliamStewart9]

Dr. Kelley from Durham VAMC told us this was in the CDW ONC raw domain. I am not familiar enough with CDW to know whether that helps you. If you still can't find it, perhaps we can ask him. Ethan

…

On Thu, Aug 27, 2020 at 10:38 AM Stewart, William R. < ***@***.***> wrote: Ethan, Do you have any input specifics to share in the context of Ryan’s reply below? Thanks, Will Stewart National Artificial Intelligence Institute | NAII <https://www.research.va.gov/naii/> Senior Solution Architect | EA, SA Demand Management | Intake and Analysis <https://dvagov.sharepoint.com/sites/OITEPMOIAS/dmdocsite/Pages/Intake%20%26%20Analysis%20Service.aspx> IAS Enablement Team Lead | Veteran Experience Services DevOps Transformation | Product Line Architecture Change Team Enterprise Program Management Office (EPMO) Office of Information Technology (OIT) Department of Veterans Affairs Phone: 202.794.0703 Email: ***@***.*** *From:* Ryan Link ***@***.***> *Sent:* Thursday, August 27, 2020 10:05 AM *To:* department-of-veterans-affairs/vets-api-clients < ***@***.***> *Cc:* Stewart, William R. ***@***.***>; Mention < ***@***.***> *Subject:* [EXTERNAL] Re: [department-of-veterans-affairs/vets-api-clients] Additions to the FHIR Health API (#174) Sorry @WilliamStewart9 <https://github.com/WilliamStewart9> - that was not meant to be a link to issue number 1 in this repo but a reference to your 1st request above about cancer registry: 1. Please add Cancer registry data - the cancer registry data in CDW likely has a number of different kinds of data, such as specific tumor staging info, and specific history of cancer treatment. Thus, the FHIR resources involved include Condition, Procedure, DiagnosticReport, and Medication. All of these resources are already implemented in the Health API, so it would be a matter of mapping the CDW registry as an additional data source and labeling the data accordingly so we can query for the registry data specifically. Please add the CDW cancer registry data to these resources. We do not have that data available at the moment. We have done a search in CDW and do not see that registry. Do you know the table or where that data lives in CDW? If we can get access to that database, we can provide that data. — You are receiving this because you were mentioned. Reply to this email directly, view it on GitHub <#174 (comment)>, or unsubscribe <https://github.com/notifications/unsubscribe-auth/ALIP4MIEKUMMDBSOHTH7ZPLSCZR2RANCNFSM4PCKG24A> .