Mapping for patient referrals to specialist, etc

[mysakjs (John_Mysak)]

Is visit_occurrence / visit_detail, discharge_to_concept_id. in the right arena for mapping patient referrals (e.g. to specialist) within the OMOP CDM? Or is this intended primarily (and/or only) for discharge when a patient leaves the hospital by check out process or deceased, AWOL, etc. ? I found some good discussion here

Definition of Visit, transfers and referrals, and distinction of ER from hospital visits

Friends: Transferring a discussion from the CDM working group here: @rimma said: Hi @zwbutt : Could you please elaborate your concerns about the current proposal? It seems to me that we are on the same page, but I may be wrong. @Christian_Reich said: I think you are on the same page. I am the one who is trying to avoid these claim-based or encounter-based approaches. I was thinking that each exposure of a patient to an organizational unit providing care is a visit. So, those units would…

re: granularity of visits, but so far haven’t come across details on where to map/store referral information, if there’s a place.

Was this excluded intentionally from an observational health/sciences perspective ? i.e. given the limited / specialist scope of the OMOP CDM ?

[Christian_Reich]

Is visit_occurrence / visit_detail, discharge_to_concept_id. in the right arena for mapping patient referrals (e.g. to specialist) within the OMOP CDM?

Should be. It’s just another way to pass a patient on from one healthcare encounter to another.

haven’t come across details on where to map/store referral information, if there’s a place.

We haven’t defined that explicitly, yet. It could go into disposition, though. Can it?

Was this excluded intentionally from an observational health/sciences perspective ?

Things are usually not excluded, but they are not included yet, because nobody made the proposal. Want to be the first one?

[mysakjs (John_Mysak)]

Got it, thank you. I’ll have a look at using the visit_* attributes and make a related proposal if needed for our use case(s).

[tomtom (Tommi)]

Resurrecting this old thread.

I work in secondary / specialized health care unit and we utilise OMOP database alongside with traditional data warehouse (both in postgres). The OMOP is up and running and we have conducted studies utilising it successfully.

I stumbled upon a research question where we would need to calculate a time to an event, specifically we need to calculate the waiting time from a received referral to a certain unit in our hospital to a certain procedure performed to the patient. This it the first time we would like to utilise data of referrals in OMOP database and I just hadn’t think of it earlier do we even have that data in OMOP. We do not.

I cannot find any documentation nor discussions regarding where to map the referral data and how. At first, I was thinking maybe we can populate admitting_source_concept_id and preceding_visit_occurrence_id in visit_occurrence table somehow, but after I read the description/definition of those columns in that table I think it’s a wrong path.

I discussed this issue with a colleague of mine from another organization and she brought up an idea to populate observation_concept_id and value_as_concept_id in observation table to build up the direction and target of the referral (‘Referral for’ concept in observation_concept_id and desired hospital unit in value_as_concept_id).

I have no clue which of these two propositions would work if neither? Or maybe we are trying to use OMOP database to something that the CDM model is not ment for?