Merge pull request #16 from RemeCare/wip

TOTeM and NEWS symptoms added + corrections
hl7-be · Jan 29, 2025 · 7e67b40 · 7e67b40
2 parents 44d47e5 + 55ce2b9
commit 7e67b40
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diff --git a/input/fsh/examples/other-qualitative/example-distended-abdomen.fsh b/input/fsh/examples/other-qualitative/example-distended-abdomen.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "INCOMPLETE: Distended abdomen example"
 Description: "NEEDS ATTENTION: Current answer options are no / a little / fierce. These cannot be found in LOINC or SNOMEDCT currently. Change answer options or request new LOINC codes."
 * status = #final
-* code = $snomed#60728008 "Swollen abdomen" 
+* code = $snomed#60728008 
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueCodeableConcept = $loinc#LA10138-8 //TODO: Needs correct value

diff --git a/input/fsh/examples/other-qualitative/example-level-of-responsiveness.fsh b/input/fsh/examples/other-qualitative/example-level-of-responsiveness.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "Level of responsiveness example"
 Description: "Level of responsiveness (ACVPU scale)"
 * status = #final
-* code = $loinc#67775-7 "Level of responsiveness"
+* code = $loinc#67775-7 
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueCodeableConcept = $loinc#LA17108-4

diff --git a/input/fsh/examples/other-qualitative/example-reduced-appetite.fsh b/input/fsh/examples/other-qualitative/example-reduced-appetite.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "Reduced appetite example"
 Description: "Answer options are absent / mild / moderate / severe."
 * status = #final
-* code = $snomed#64379006 "Reduced appetite" 
+* code = $snomed#64379006  
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueCodeableConcept = $snomed#255604002

diff --git a/input/fsh/examples/other-qualitative/example-shortness-of-breath.fsh b/input/fsh/examples/other-qualitative/example-shortness-of-breath.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "Shortness of breath example"
 Description: "Possible answers are yes and no"
 * status = #final
-* code = $snomed#267036007 "Shortness of breath"
+* code = $snomed#267036007 
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueCodeableConcept = $snomed#373066001

diff --git a/input/fsh/examples/other-quantitative/example-national-early-warning-score.fsh b/input/fsh/examples/other-quantitative/example-national-early-warning-score.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "National Early Warning Score example"
 Description: "National Early Warning Score (NEWS)"
 * status = #final
-* code = $snomed#1287358002 "National Early Warning Score"
+* code = $snomed#1287358002 
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueQuantity.value = 6

diff --git a/input/fsh/examples/pain/example-abdominal-pain.fsh b/input/fsh/examples/pain/example-abdominal-pain.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "Abdominal pain example"
 Description: "Pain scale is used as answer"
 * status = #final
-* code = $snomed#21522001 "Abdominal pain"
+* code = $snomed#21522001 
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueCodeableConcept = $loinc#LA10138-8

diff --git a/input/fsh/examples/pain/example-pain-during-urination.fsh b/input/fsh/examples/pain/example-pain-during-urination.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "Pain during urination example"
 Description: "Possible answers are yes and no"
 * status = #final
-* code = $snomed#49650001 "Urination painful"
+* code = $snomed#49650001 
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueCodeableConcept = $snomed#373066001

diff --git a/input/fsh/examples/pain/example-pain-in-calves.fsh b/input/fsh/examples/pain/example-pain-in-calves.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "Pain in calves example"
 Description: "Possible answers are yes and no"
 * status = #final
-* code = $snomed#1264028004 "Pain in muscle of lower leg"
+* code = $snomed#1264028004 
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueCodeableConcept = $snomed#373066001

diff --git a/input/fsh/examples/pain/example-pain-medication-taken.fsh b/input/fsh/examples/pain/example-pain-medication-taken.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "INCOMPLETE: Pain medication taken example"
 Description: "NEEDS ATTENTION: No LOINC or SNOMEDCT code currently exists for Pain medication taken.  Change answer options or request new LOINC codes."
 * status = #final
-* code = $loinc#72514-3 "Pain severity - 0-10 verbal numeric rating [Score] - Reported" //TODO: Needs correct code
+* code = $loinc#72514-3  //TODO: Needs correct code
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueCodeableConcept = $loinc#LA10138-8 //TODO: Find out which valueset to use

diff --git a/input/fsh/examples/pain/example-pain-surgical-wounds.fsh b/input/fsh/examples/pain/example-pain-surgical-wounds.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "Pain surgical wounds example"
 Description: "Pain surgical wounds example description" //TODO: Needs description
 * status = #final
-* code = $loinc#72514-3 "Pain severity - 0-10 verbal numeric rating [Score] - Reported" //TODO: Needs correct code
+* code = $loinc#72514-3 //TODO: Needs correct code
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueCodeableConcept = $loinc#LA10138-8 //TODO: Needs correct value

diff --git a/input/fsh/examples/pain/example-shoulder-pain.fsh b/input/fsh/examples/pain/example-shoulder-pain.fsh
@@ -4,7 +4,7 @@ Usage: #example
 Title: "INCOMPLETE: Shoulder pain example"
 Description: "NEEDS ATTENTION: No LOINC or SNOMEDCT code currently exists for shoulder pain. Pain scale is used as answer."
 * status = #final
-* code = $loinc#72514-3 "Pain severity - 0-10 verbal numeric rating [Score] - Reported" //TODO: Needs correct code
+* code = $loinc#72514-3 //TODO: Needs correct code
 * subject.identifier.system = $fhir
 * subject.identifier.value = "D358D4B4-6007-4C3E-A33B-056773F45DC9"
 * valueCodeableConcept = $loinc#LA10138-8

diff --git a/input/pagecontent/ews.md b/input/pagecontent/ews.md
@@ -76,16 +76,16 @@ This FHIR implementation content is currently under development and may be subje
 
   | Description                          | Code(s)                    | Possible answers |
   | ------------------------------------ | -------------------------- | ---------------- |
-  | Heart rate (HR) measurement          | LOINC 8867-4               |                  |
-  | Blood pressure (BP) measurement      | LOINC 8480-6 / 8463-4      |                  |
-  | Body weight (BW) measurement         | LOINC 29463-7              |                  |
-  | Respiratory (RESP) measurement       | LOINC 9279-1               |                  |
-  | Temperature (TEMP) measurement       | LOINC 8310-5               |                  |
-  | Oxygen Saturation (SPO2) measurement | LOINC 2708-6 (sub 59408-5) |                  |
-  | Patient on oxygen                    | SNOMED 371825009           |                  |
-  | Inhaled oxygen flow rate             | LOINC 3151-8               | SNOMED <br> - 373066001 (yes) <br> - 373067005 (no) |    
+  | Heart rate (HR) measurement          | LOINC 8867-4               | Not applicable   |
+  | Blood pressure (BP) measurement      | LOINC 8480-6 / 8462-4      | Not applicable   |
+  | Body weight (BW) measurement         | LOINC 29463-7              | Not applicable   |
+  | Respiratory (RESP) measurement       | LOINC 9279-1               | Not applicable   |
+  | Temperature (TEMP) measurement       | LOINC 8310-5               | Not applicable   |
+  | Oxygen Saturation (SPO2) measurement | LOINC 2708-6 (sub 59408-5) | Not applicable   |
+  | Patient on oxygen                    | SNOMED 371825009           | SNOMED <br> - 373066001 (yes) <br> - 373067005 (no)  |
+  | Inhaled oxygen flow rate             | LOINC 3151-8               | Not applicable   |    
   | Level of responsiveness (ACVPU scale) | LOINC 67775-7             | LOINC <br> - LA9340-6 (Alert) <br> - LA6560-2 (Confused) <br> - LA17108-4 (Verbal) <br> - LA17107-6 (Painful) <br> - LA9343-0 (Unresponsive) |
-  | National Early Warning Score (NEWS)  | SNOMED 1287358002          |                  |
+  | National Early Warning Score (NEWS)  | SNOMED 1287358002          | Not applicable   |
 
 These FHIR modules ensure standardized data exchange between systems and guarantee consistency of the vital parameters.
 

diff --git a/input/pagecontent/totem.md b/input/pagecontent/totem.md
@@ -46,6 +46,10 @@ With support from the FPS Public Health, some TOTeM projects are being rolled ou
   - Pression on chest
   - Shortness of breath
   - Shoulder pain
+  - Color of urine
+  - Hematoma
+  - Volume of 24-hour Urine
+  - Skin surrounding stoma red
 
 - **Frequency**: 3 times a day, 7 days a week.
 
@@ -69,19 +73,21 @@ With support from the FPS Public Health, some TOTeM projects are being rolled ou
 
 | Description              | Code(s)                    | Possible answers                                                                                                       |
 | ------------------------ | -------------------------- | ---------------------------------------------------------------------------------------------------------------------- |
-| Heart rate               | LOINC 8867-4               |  Not applicable                                                                                                        |
-| Blood pressure           | LOINC 8480-6 / 8463-4      |  Not applicable                                                                                                        |
-| Body weight              | LOINC 29463-7              |  Not applicable                                                                                                        |
-| Respiratory rate         | LOINC 9279-1               |  Not applicable                                                                                                        |
-| Oxygen Saturation (SPO2) | LOINC 2708-6 (sub 59408-5) |  Not applicable                                                                                                        |
-| Body temperature         | LOINC 8310-5               |  Not applicable                                                                                                        |
+| Heart rate               | LOINC 8867-4               | Not applicable                                                                                                        |
+| Blood pressure           | LOINC 8480-6 / 8462-4      | Not applicable                                                                                                        |
+| Body weight              | LOINC 29463-7              | Not applicable                                                                                                        |
+| Respiratory rate         | LOINC 9279-1               | Not applicable                                                                                                        |
+| Oxygen Saturation (SPO2) | LOINC 2708-6 (sub 59408-5) | Not applicable                                                                                                        |
+| Patient on oxygen        | SNOMED 371825009           | SNOMED <br> - 373066001 (yes) <br> - 373067005 (no)  |
+| Inhaled oxygen flow rate | LOINC 3151-8               | Not applicable   |  
+| Body temperature         | LOINC 8310-5               | Not applicable                                                                                                        |
 | Abdominal pain           | SNOMED 21522001            | LOINC 72514-3 (pain scale 0-10)                                                                                        |
 | Pain puncture wounds     | <span class="warning">??</span> | LOINC 72514-3 (pain scale 0-10)                                                                                   |
 | Pain during urination    | SNOMED 49650001            | SNOMED <br> - 373066001 (yes) <br> - 373067005 (no)                                                                    |
 | Renal pain               | SNOMED 274279008           | SNOMED <br> - 373066001 (yes) <br> - 373067005 (no)                                                                    |
 | Pain in calves           | SNOMED 1264028004          | SNOMED <br> - 373066001 (yes) <br> - 373067005 (no)                                                                    |
 | Pain provoked by eating  | SNOMED 426277009           | LOINC 72514-3 (pain scale 0-10)                                                                                        |
-| Well-being               | SNOMED 73595000            | SNOMED <br> - 268910001 (unchanged) <br> - 27762005 (improved) <br> - 230993007                                        |
+| Well-being               | SNOMED 365275006           | SNOMED <br> - 260388006 (No status change) <br> - 268910001 (Patient's condition improved) <br> - 230993007 (Worsening)|
 | Flatulence               | SNOMED 249504006           | SNOMED <br> - 373066001 (yes) <br> - 373067005 (no)                                                                    |
 | Bowel movement           | SNOMED 39211005            | SNOMED <br> - 373067005 (no) <br> - 264312008 (liquid) <br> - 300585004 (solid)                                        |
 | Nausea                   | SNOMED 422587007           | LOINC  <br> - LA137-2 (None) <br> - LA6752-5 (Mild) <br> - LA6751-7 (Moderate) <br> - LA6750-9 (Severe)                |
@@ -104,9 +110,27 @@ With support from the FPS Public Health, some TOTeM projects are being rolled ou
 
 <div class="table-md"></div>
 
-| Description   | Code(s) | Possible answers                                                                                                    |
-| ------------- | ------- | ------------------------------------------------------------------------------------------------------------------- |
-| Shoulder pain | <span class="warning">??</span> | SNOMED  <br> - 24028007 (right) <br> - 7771000 (left) <br> - 51440002 (right and left) <br> - 373067005 (no)        |
+| Description   | Code(s) | Possible answers                                                                                                                     |
+| ------------- | ------- | -------------------------------------------------------------------------------------------------------------------------------------|
+| Shoulder pain | <span class="warning">??</span> | SNOMED  <br> - 24028007 (right) <br> - 7771000 (left) <br> - 51440002 (right and left) <br> - 373067005 (no) |
+
+###### Nefrectomy specific
+
+<div class="table-md"></div>
+
+| Description    | Code(s)          | Possible answers                                                                                                                                               |
+| -------------- | ---------------- | -------------------------------------------------------------------------------------------------------------------------------------------------------------- |
+| Color of urine | SNOMED 430327009 | SNOMED <br> - 167236000 (Urine looks clear) <br> - 720001001 (Dark yellow urine) <br> - 720003003 (Reddish color urine) <br> - 167235001 (Urine: red – blood)  |
+| Hematoma       | SNOMED 385494008 | SNOMED <br> - 2667000 (Absent) <br> - 19776001 (Decreased size) <br> - 260388006 (No status change) <br> - 15454001 (Inscreased size)                          |
+
+###### Cystectomy specific
+
+<div class="table-md"></div>
+
+| Description                      | Code(s)          | Possible answers                                                                                                    |
+| ---------------------------------| ---------------- | ------------------------------------------------------------------------------------------------------------------- |
+| Volume of 24-hour Urine          | LOINC 3167-4     | Not applicable                                                                                                      |
+| Skin surrounding stoma red       | SNOMED 407549000 | SNOMED <br> - 2667000 (Absent) <br> - 255604002 (Mild) <br> - 6736007 (Moderate severity) <br> - 24484000 (Severe)  |
 
 These FHIR modules ensure standardized data exchange between systems and guarantee consistency of the vital parameters.