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Remote (telemetry) BP readings

CDM Builders
#1

We have remote BP and heart rate readings, most via telemetry, that we are wondering how to store in the measurements table. I can find no type concept,measurement_type_concept_id, that describe data coming in via telemetry, nor a concept id that fits telemetry; the closest being
Self measured blood pressure reading (Athena) but that does not differentiate between D/S.

The closest thread that I can find to this is:Vocabularies for wearables and telemetry data

This being telemetry, self measured, we are concerned about the accuracy of uploading such reads as EHR Encounter Record; how should we record such values?

#2

How about domain_id = ‘Type Concept’ and SNOMED.44802039 | Remote assessment
or
SNOMED.37111277 | Ambulatory blood pressure monitoring report
SNOMED.44811765 | Ambulatory electrocardiographic monitoring report if you are using a multi-parameter patient monitor or electrocardiograph

#3

That is a non-standard concept; I wish it was not.

#4

I must have an old SNOMED vocabulary - mine had concept.invalid_reason = NULL.

#5

For the concept_id, would you consider the telemetry readings as “continuous” monitoring?
If so, would the following work?

For the measurement_type_concept_id, would the following be a closer fit than ‘EHR Encounter Record’, which as you note doesn’t seem optimal?
Patient self-tested

#6

This is very interesting, so does mine, but not Athena. We are AOU, so sometimes our vocabualry is behind, but I thought we were up to date now. Regardless, ours also does not have the ‘S’ standard_concept, which is required.

Athena:
image

Ours:

concept_name concept_id standard_concept invalid_reason
Remote assessment 44802039

UPDATE: Ours does not have invalid_reason as NULL but as a empty space. Sorry @roger.carlson , NULLs are evil and should be burned from the memory of humankind.

Also, this forum does not support the markdown strike-though with ~.

#7

Whilst I have never seen the machines, I have been told that they are standard automatic cuffs that have a telemetry module in them that sends the data up on a successful reading, so no, they are not continuous. Some patients would measure multiple times a days, some once a week.

Out of the list of the 80 valid ‘Type Concept’, this seems the best.

#8

After digging deeper into the data, we found that we also have remote BP data that is coming in from pharmacies with unknown measurement practices. After discussing this with my collogues, we have decided to leave the concept_id the same as it always was but update all BP readings, not taken by one of our providers or nurses, as measurement_type_concept_id of 32865 (see quote below); this should allow for tool builders distinguish between valid healthcare data and data that may, or may not, have a high degree of accuracy.

As we are an encounter based system, some of our mapping to visits can be a little esoteric. As we create an encounter for the telemetry BP readings, that have no other interactions with anything, I am mapping these said encounters to visit_concept_id 32693 (health examination), this is unless someone else has a better mapping. I could find nothing in the accepted list that made more sense. I did this instead of Laboratory Visit as the details for this value says it is a visit at a care site.

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