I see where are you going.
All the concepts from the abovementioned hierarchy of Snomeds are Conditions (might not be the worst decision to put them there after all). Condition table has condition_start_datetime
and condition_end_datetime
. I believe these fields are not often used, but they may be used for your usecase. And the beauty of this decision lies in its simplicity. You don’t need to create anything custom. It may be a bit counterintuituve, but it should work.
It can be measurement, condition, procedure, observation. Whatever works best for you. I think with certain exercises in debating skills and techniques this information may fit almost anywhere.
Regarding modifyers (from official CDM 5.4 documentation)
They are under construction at the moment, as you can see here - the main thread for modifyers, and here, and there are even more topics.
So ideally you need to pick one concept to be a modifyer for a procedure. But thicky thing. You don’t have one concept for each position. So you may need to create new concepts.
Absolutely. But when the patient comes and says “I had an appendectomy 25 years ago”, the best you can do is History of event longer than 10 years ago + appendectomy + patient reported.