CardioVascular use cases related resources with Imaging

[ghost]

I have generated a population based on Synthea using the "chf_*" modules. I am noticing that the resources that get generated in particular the ImageStudies are not linked to a DiagnosticReport resource that documents the findings. What am I missing here?

[jawalonoski]

You are not missing anything.

An ImagingStudy is conducted and recorded for every ImagingStudy State in a module.

A DiagnosticReport resource is only generated if:

• The module explicitly defines a DiagnosticReport State
• Or, if US Core is enabled (it is enabled by default), then a DiagnosticReport and DocumentReference are generated for each Encounter to capture simple template-driven clinical notes.

We currently support US Core v4 (with a PR in-progress #1103), and only use the v4/STU4 US Core DiagnosticReport Profile for Report and Note exchange for generic clinical notes (not imaging results).

US Core v5 has the US Core Observation Imaging Profile which could be used with the US Core DiagnosticReport Profile for Report and Note Exchange to document the ImagingStudy findings, but we do not currently generate these automatically, nor do we currently support US Core v5.

Even if we did support US Core v5, the issue with generating these automatically is that Synthea modules do not currently explicitly define the results. So, we would need to change all the models to do so, or figure out a way to make clinically reasonable inferences on what those findings would be in the context of the module workflow. Which, I am sure you understand, is non-trivial.

Everything in FHIR is optional. Everything in a Synthea module is optional, and unless it is defined, it doesn't happen. We're happy to take pull requests.