Consolidated CDA R2 DSTU, Oct 2014 version, final pre-publication QA comments

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Comments from Benjamin Flessner

Medication Timing

Comment 155 (flessner). The guide has no indication of the single-administration timestamp model and as such, is back to the 1.1 version's problem of being unable to convey this information. Now, I know the "xsi:type='TS'" approach doesn't work because "TS" is not a valid specialization of "SXCM_TS," but the following example schema-validates just fine and continues to convey the intended information of a "single-administration" timestamp which was vetted by Structured Docs and Pharmacy.

<effectiveTime value="20141103142615+0500" />

Race Code ValueSet

Comment 592 (flessner). RaceCategory and Race were differentiated into two separate code systems, but the MU2 list explicitly excluded 2131-1:Other Race as an allowed code. If this ValueSet was created to mimic the requirements of MU2, then this code should be stricken from the ValueSet.

Vital Signs

Comment 103 (flessner) Vital Signs Observation interpretationCode (CONF 1098-7307) should have the same ValueSet conformance as Result Observation interpretationCode (CONF 1098-32476)

Comment 104 (flessner) (missing examples). This is less serious, but C-CDAR1.1 included LOINC codes for BMI and BSA. It would be helpful to keep these in the R2 document, especially since BMI is required by MU2. (And also because the voc.xml file distributed with the publication does not actually contain this ValueSet at all...)

Missing Hyperlinks

Incredibly minor, but I did post these as ballot comments originally... (flessner) Comment 11 – new CONF 1098-31484 – missing hyperlink to ValueSet Comment 333 – new CONF 1098-8559 – missing hyperlink to ValueSet Comment 89 – UnitsOfMeasureCaseSensitive is still missing the hyperlink to http://unitsofmeasure.org/ucum.html

Comment from Harry Solomon (sent to SDWG listserv)

The section numbering in Volume 2 is all screwed up.

Comments from David Tao

Erroneous links to value set source

I was checking out one of my previous comments about smoking status and tobacco use, and decided I was OK with retracting my objection. However, I wanted to take a look at the value sets again, and noticed that the value set OID is 2.16.840.1.113883.11.20.9.38 (same as in CCDA 1.1) but that the Value Set Source is http://vtsl.vetmed.vt.edu/ (which was not mentioned in CCDA 1.1).

So I went to that URL and was surprised to find that it is a Veterinary terminology services laboratory, and the web page talks about incorporating veterinary extensions to SNOMED-CT and defining veterinary-specific subsets of terminologies. I was also even more surprised to find http://vtsl.vetmed.vt.edu/ listed as the "Value Set Source" for MANY value sets in CCDA 2.0. I did not see it mentioned at all in CCDA 1.1. It occurs 50 times in CCDA 2.0 volume 2.

Is it really correct to state that Veterinary Terminology Services Lab as the value set source for all those value sets, including very common ones such as Allergy/Adverse Event Type, Body Site, Encounter Planned, Goal Achievement, Current Smoking Status, Patient Education, Problem Status, etc.? Or is that a typo that somehow crept in through tooling, etc? Should it have referred to VSAC rather than VTSL?

In email conversations, both Rob McClure and Mark Roche felt that my comment is correct

Typo in Figure 194 in Volume 2

Figure 194 in volume 2 has a typo, "Suststance" which should be "Substance"