Incongruence with "patient transfer" procedures

[funaesthesia (Clemens Rieder, M.D.)]

Hi everyone !

I want to map transfer procedures where patients are transferred between hospitals or dedicated wards within the same hospital.

A quick glance at “patient transfer” concepts of SNOMED showed that all concepts belong to the concept_class of Procedure and the majority belongs to the domain of Observation whereas only 5 are mapped to the Procedure domain.

I think mapping an active process (i.e. “Taking a patient, putting them on the stretcher, transferring them to another physical location”) should belong to the Procedure domain and not the Observation domain.

Checking the hierarchy shows that the domain switches from Procedure to Observation within the first step down the ladder.

What are your thoughts on that?

[MPhilofsky (Melanie Philofsky)]

Check out the Visit Detail table, “The VISIT_DETAIL table is an optional table used to represents details of each record in the parent VISIT_OCCURRENCE table. A good example of this would be the movement between units in a hospital during an inpatient stay or claim lines associated with a one insurance claim.”

Also, the Procedure table should contain “This table contains records of activities or processes ordered by, or carried out by, a healthcare provider on the patient with a diagnostic or therapeutic purpose.”

[funaesthesia (Clemens Rieder, M.D.)]

Thank you for your reply!

I use the VISIT_DETAIL for in-house transfers already.
Regarding your second paragraph one could argue that a transfer to - let’s say - a cardiac ICU in a different hospital could be a therapeutic purpose. Or do you think differently?

[MPhilofsky (Melanie Philofsky)]

@funaesthesia

one could argue that a transfer to - let’s say - a cardiac ICU in a different hospital could be a therapeutic purpose. Or do you think differently?

I’m going to disagree.

However, using your logic, going on vacation is a therapeutic purpose

[funaesthesia (Clemens Rieder, M.D.)]

@MPhilofsky

However, using your logic, going on vacation is a therapeutic purpose

It sure is!

So how would you treat any inter-hospital transfers with the OMOP CDM? Should I ignore the fact that they are members of the Observation domain and continue mapping to the concepts mentioned above?

[MPhilofsky (Melanie Philofsky)]

You can continue to use the Visit Detail table. The FK to the Care Site table will distinguish the two.