Concept set #289 "Consultation with patient": meaning in the ICU context?

[BorisDelange]

@glichtner, I don't fully understand what this concept set is meant to capture in an intensive care setting. Could you clarify the intent?

Current state

The set is anchored on the SNOMED concept 37164964 / 1237136005, "Consultation with patient" (Procedure), with descendants included. SNOMED has no text definition for it; it sits under "Patient encounter procedure" and "Consultation", so it represents a clinical encounter between a clinician and the patient, recorded as an event.

With descendants, it currently resolves to 10 concepts:

1. 37164964 / 1237136005: Consultation with patient
2. 37168078 / 1269515004: Face to face consultation with patient
3. 40489429 / 448337001: Telemedicine consultation with patient
4. 4089048 / 185387006: New patient consultation
5. 4027135 / 12843005: Subsequent hospital visit by physician
6. 1450350 / 2365641000000100: Group face to face consultation
7. 4211804 / 416520008: Consultation for unaccompanied minor
8. 764768 / 6051000124107: Pharmacokinetic consultation
9. 764769 / 6061000124109: Risk evaluation and mitigation strategy consultation
10. 37208165 / 461231000124109: Consultation for suicide risk management

In an ICU context I find this list hard to interpret. It mixes generic encounter types (face to face, telemedicine, new vs subsequent visit) with very specific, unrelated outpatient consultations (pharmacokinetic, risk evaluation and mitigation strategy, suicide risk management). It is not obvious to me what clinical variable this is meant to represent for a critically ill patient.

What did you have in mind for this concept set, and which of these concepts should it actually include?

I'll leave the set as is until I hear back.

[MaximMoinat]

@BorisDelange We had the same question while going through the concept sets for our Erasmus data. The closest we have for these consultations are the visit occurrence (which we can filter by specialism) or the nurse's notes. Again, should be clear what the clinical relevance is.

We had the same comment for the hospital/icu 'admission' and 'discharge' concept sets, which have now been removed as these are also defined visit occurrences for us.