When is now NOW? (#FHIR Question)
Jan 25, 2019[Guest post from Jean Duteau]
FROM SPACEBALLS: THE MOVIE
Dark Helmet: What the Hell am I looking at?! When does this happen in the movie?! Colonel Sandurz: “Now.” You’re looking at “now,” sir. Everything that happens now [indicates himself and Helmet] is happening “now.” [Indicates the screen] Dark Helmet: What happened to “then”? Colonel Sandurz: We passed “then.” Dark Helmet: When? Colonel Sandurz: Just now. We’re at “now,” now. Dark Helmet: Go back to “then”! Colonel Sandurz: When? Dark Helmet: Now! Colonel Sandurz: Now? Dark Helmet: Now! Colonel Sandurz: I can’t. Dark Helmet: Why?! Colonel Sandurz: We missed it. Dark Helmet: When?! Colonel Sandurz: Just now. Dark Helmet: … When will “then” be “now”? Colonel Sandurz: Soon.
Recently, a request came up in Pharmacy to determine how best to model the request to take a medication immediately and then follow that up with a regular schedule. As the Pharmacy Workgroup dealt with the request, we realized that this wasn’t a Pharmacy-specific request. There are many times in healthcare that something needs to happen “NOW” and the means of representing “NOW” needed to be something non-Pharmacy-specific.
The obvious first place to look for representing “NOW” is the Timing datatype. Within that datatype, the ‘when’ code data element seems like the obvious place to represent “now”. Simply adding a code of “NOW” to the EventTiming value set seems like it solves the problem. We gain the use of the ‘offset’ data element to say “Do X 5 minutes from NOW”.
The problem of adding a code of “NOW” to the EventTiming value set is that “NOW” just doesn’t seem to be an event like the other codes in this value set. If you look at the set of events, every one of them is something that occurs and can eventually have a specific point in time assigned to it. ”NOW” isn’t like that. If you read the excerpt at the beginning of this post, you can see the problem with NOW. Every point in time either was NOW, is NOW, or will be NOW. So what does “NOW” as an event mean? It would be the one code that isn’t like the others.
I can’t see any other way to represent the general concept of “NOW” other than the option above, but I might be missing something. I’d love to hear about alternative ways of saying “Do X NOW”.
…and I’d love to hear about it NOW.