FHIR003

Human readable narrative text might not match the structured or unstructured data

Hazard Description

Data could be sent as coded data rather than text. If coded information is carried without associated text it may not be comprehensible in the Transfer of Care discharge summaries.

Potential Clinical Impact

Patients may receive incorrect diagnosis or treatment.

Possible Causes

Sending system or receiving systems transform of FHIR message is not correct.

Existing Controls

The FHIR standards implementation assumes that narrative text should match the structured and unstructured data.

Design

1. Include associated text with any coded field.
2. SNOMED CT is the only coded data that can be carried in outpatient letter communications (e.g. not READ, OPCS, etc).

Test

This is tested in solution assurance by development of a renderer and messages are clinically assured. This is tested at each implementation site before going live.

Training

Implementers to provide guidance on any issue/risk might arise in use or misuse of their products.

Business Process Change

n/a