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Consultations to Clinical Specialties

CDM Builders
#1

I’m having difficulty locating the documentation & strategy for Consultations (to different providers/specialties). Our researchers usually track this via procedure orders in EMR, but I’m having difficulty finding appropriate concept in this domain. In the inpatient context, there are not separate encounter types for this care.

I see many Observation concepts for “Specialty Consult note” (Obstetric Consult Note, Psychiatry Consult Note, etc). Is this how others are handling? Or, am I missing another element where this care should live?

Example: Athena

#2

Hello @ehenning and welcome to OHDSI!

Do the records for these “consultation procedure orders” have a code associated with the record?

Can you give some examples of the source data? I’m not sure I understand what you are asking.

#3

@ehenning I’m not sure where you are, but many EHRs don’t record standard codes for the REFERRAL to a specialist, and thus they don’t make it into OMOP without specific mapping. For the procedure of the consultation, in the US these can be tracked through specific procedures, usually against CPT4 codes that are associated with a provider who has a specialty of the relevant type. In other domains, it may be these are mapped into SNOMED.

#4

@ehenning Welcome to OHDSI. Do you have a “use case” for keeping the Consultation information? Not sure this information can be used by any of the standard analytic tools. The OHDSI CDM is not a warehouse, but rather designed for analytic studies. Does not mean you cannot add the referral records if they are important to your site’s internal studies. Does mean that when doing an ETL into the OHDSI CDM not everything in your EHR needs to be, or should be, added to the OHDSI CDM. It is usually easy to determine what should go into the OHDSI CDM because how/where the data goes is straight forward. It is when you are having “difficulty finding appropriate concept in this domain” that you need to determine if the data belongs in the CDM. Welcome to the journey.

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