Consultations
Consultations - data model
Note - Draft Consultations are not considered clinically safe to share with patients/citizens via PFS. They are intended just as drafts, not all of the information captured is ready to be shared.
The GP clinical system is required to withhold Consultations in a draft state. We require consumers to not display draft Consultations.
Patient Facing Services incorporates the GP Connect data model. This contains guidelines on how providers need to populate each of the FHIR resources. It is advised to read the data model first, to understand how this is being populated by GP clinical systems.
The information conveyed in the Consultations is about the structure and not about the overall content for Consultations. For more information on representing the different clinical areas, click on the link provided.
The relevant profiles in the data model are as follows:
List - CareConnect-GPC-List-1
Encounter - CareConnect-GPC-Encounter-1
However, not all clinical information stored on GP systems may be safe to display for the end user (patients/citizens). This guide is intended to help consumers understand what is clinically safe and useful to display via PFS from the GP Connect data model. Please see the PFS recommendations below.
A consultation is the structure within which source systems group one or more clinical record entries which occurred at the same time and for the same or similar purpose attributed to or asserted by the same actor.
PFS Recommendation
Safe to display to patient / citizen - With a safety rating of 'High', 'Medium' or 'Low'.
Useful to display to patient / citizen - With a recommendation of 'Recommended' or 'Not recommended'.
For example, the element 'Id’ has a safety rating of ‘High’, meaning it can be shown via Patient Facing Services (PFS). However, we believe it may not be useful to display 'Not Recommended' for the patient / citizen. It’s worth noting, there are elements that will have no meaning or have any merit in being displayed such as ‘Id’. For example, some elements are just entities that link data together.
For further information on the labelling please visit Data model labels used within this guidance.
Encounter
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| id | ||
| meta.profile | ||
| identifier | ||
| status | ||
| type | ||
| subject | ||
| participant | ||
| period | ||
| length | ||
| location | ||
| serviceProvider |
List (Common)
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| id | ||
| meta.profile | ||
| status | ||
| mode | ||
| subject | ||
| encounter | ||
| date | ||
| orderedBy |
List (Consultation)
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| title | ||
| code | ||
| entry |
List (Topic)
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| extension(relatedProblemHeader) | ||
| title | ||
| code | ||
| entry |
List (Heading)
| Element | Safe to display to patient / citizen | Useful to display to patient / citizen |
|---|---|---|
| title | ||
| code | ||
| entry |
Further Information
Note - Not every element will have further information. Further information is to simply give additional context and perspective to the element.
Encounter
status
Not advised for PFS
Further information
A Consultation is either 'unknown' (draft) or 'finished' (complete). Only consultations of type 'finished' should be included. However, we require Consumers to ensure Consultations with status 'unknown', (if they are received) to be excluded from the user interface.
type
Further information
This element is a CodeableConcept. The element may include more than one code for the medication and/or more than one text description. Consumers are strongly advised to use the original term text as the primary text displayed to the end user (patient / citizen). For more information on 'Processing data from a CodeableConcept', specifically section 'Original term text' then please visit -
period
Use with caution for PFS
Further information
This element is the date and time the consultation started.
Please note, a Consultation will have a date / time of when it is recorded and a date / time that it is referring to. For example, if an individual were to visit a patient on Friday and record it on the Monday. The date advised to be displayed is the Friday date (when the Consultation took place) not the Monday date when it was recorded.
This is the preferred element date. It is also strongly advised to display only the start date. The end (length) is not always accurate.
length
Not advised for PFS
Further information
The 'length' element is not advised as safe to display, since it is not always accurate. The automated timer starts at the beginning of the Consultation. A clinician may walk away from the screen for x amount of time, giving an inaccurate length of the Consultation. In some cases this is manually recorded and is not expected to provide significant useful information
List (Common)
date
Use with caution for PFS
Further information
It is advised using the ‘period’ start element for the date. If supplementary information is needed for the audit date use the ‘date’ element. The ‘date’ element may be useful to state when the date of the Consultation was last modified on the GP clinical system.
List (Consultation), (Topic) and (Heading)
title
Further information
The ‘title’ is considered a useful element for Consultations, it’s contextualised information that is recorded against history, action or plan. For example, if an individual adds a procedure with no context of whether it's history or a plan, they could have completely different connotations.
code
Use with caution for PFS
Further information
It’s worth nothing that the ‘code’ element will allow Consumers to recognise whether the list is representing a header for the whole consultation, a topic of the consultation or a heading for clinical content. The Consumer could use the ‘code’ to identify the purpose and the meaning of each list.
entry
Further information
The order of entries received is what should be maintained in presenting the information. This may have some impact on the context of information displayed to the patient / citizen if the order is not maintained.