Add event ClinicalFinding to support structured data using FHIRCast

[NiklasSvenzen]

To be able to pass real time structured data between two clinical applications, it would be great to have a FHIRCast event that supports this. A typical use case is when integrating a PACS viewer and a reporting system, where the reading physician wants to include discrete measurements (findings) from the viewer directly into the report without having to retype all the data.

Suggestion:

structured-data-clinical-finding
Description:
A clinical finding has been observered containing strucutred data

Example:

{
  "context": [
    {
      "key": "patient",
      "resource": {
        "resourceType": "Patient",
        "id": "ewUbXT9RWEbSj5wPEdgRaBw3",
        "identifier": [
          {
            "system": "urn:oid:1.2.840.114350",
            "value": "185444"
          },
          {
            "system": "urn:oid:1.2.840.114350.1.13.861.1.7.5.737384.27000",
            "value": "2667"
          }
        ]
      }
    },
    {
      "key": "study",
      "resource": {
        "resourceType": "ImagingStudy",
        "id": "8i7tbu6fby5ftfbku6fniuf",
        "uid": "urn:oid:2.16.124.113543.6003.1154777499.30246.19789.3503430045",
        "identifier": [
          {
            "system": "7678",
            "value": "185444"
          }
        ],
        "patient": {
          "reference": "Patient/ewUbXT9RWEbSj5wPEdgRaBw3"
        }
      }
    },
    {
      "key": "ClinicalFinding",
      "resource": {
        "resourceType": "Observation",
        "id": "a67tbi5891trw123u6f9134",
        "status": "preliminary",
        "category": {
	      "system": "http://terminology.hl7.org/CodeSystem/observation-category",
	      "code": "imaging",
	      "display": "Imaging"
        },
        "code": {
	      "system": "http://hl7.org/fhir/ValueSet/observation-codes",
	      "code": "10193-1",
	      "display": "Physical findings of Breasts Narrative"
        },
	"issued": "2019-05-05T13:28:17.239-05:00",
        "identifier": [
          {
            "system": "dcm:121151",
            "value": "Lesion-1"
          }
        ],
        "component": [
    	  {
	    "code": {
              "coding": [
                {
                  "system": "https://loinc.org",
                  "code": "21889-1",
                  "display": "Size Tumor"
                }
              ]
            },
            "valueQuantity": {
              "value": 13.3,
              "unit": "mm",
              "system": "http://unitsofmeasure.org",
              "code": "mm"
            },
          },
    	  {
      	    "code": {
              "coding": [
              {
                "system": "dcm",
                "code": "121242",
                "display": "Distance from Nipple"
              }
            ]
          },
          "valueQuantity": {
            "value": 60,
            "unit": "mm",
            "system": "http://unitsofmeasure.org",
            "code": "mm"
          },
        },
        {
      	  "code": {
            "coding": [
              {
                "system": "http://snomed.info/sct",
                "code": "19100000",
                "display": "Structure of lower inner quadrant of breast (body structure)"
              }
            ]
          }
        },
        {
      	  "code": {
            "coding": [
              {
                "system": "dcm",
                "code": "111345",
                "display": "Macrocalcifications"
              }
            ]
          }
        }
      ]
    }
  ]	
}

[isaacvetter]

Should this event be Observation.open ?