CSCR-069 Rename various ActClassContainer codes

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Submitted by: Bob Dolin	Revision date: Sept 30, 2006
Submitted date: Sept 30, 2006	Change request ID: CSCR-069

Issue

The use and meaning of “entry” and “organizer” is not consistent across CDA, Clinical Statement, and the ActClassContainer hierarchy. The intent of this proposal is to realign the various usages. No changes are needed to definitions or to the ActClass hierarchy itself.

CDA uses the notion of “entry” to describe any clinical statement within a document section, and uses “organizer” to name one of the clones in the clinical statement choice box whose ActClass values are limited to either “BATTERY” or “CLUSTER”. CDA never talks about “containers”.

Clinical Statement uses “organizer” to name one of the clones in the clinical statement choice box whose ActClass values are anything in the ActClassContainer hierarchy. Clinical Statement doesn’t talk about “entries” or “containers”.

The current ActClassContainer hierarchy looks like this:

  - ActClassContainer
     - COMPOSITION
        - DOC
     - ENTRY
        - BATTERY
        - CLUSTER
     - EXTRACT
        - EHR
     - FOLDER
     - ORGANIZER
        - CATEGORY
        - DOCBODY
        - DOCSECT
        - TOPIC

Recommendation

• Submit a RIM Harmonization proposal to rename ActClassContainer codes as shown:

  - ActClassContainer --> ActClassOrganizer
     - COMPOSITION
        - DOC
     - ENTRY --> GROUPER
        - BATTERY
        - CLUSTER
     - EXTRACT
        - EHR
     - FOLDER
     - ORGANIZER --> CONTAINER
        - CATEGORY
        - DOCBODY
        - DOCSECT
        - TOPIC

• The RIM Harmonization proposal would also change definitions accordingly

Discussion

A code is a meaningless mnemonic of a concept, and in itself has no semantics. Assigning a new code for an existing concept that lready has a code is (from a standardization standpoint) an unnecessary exercise. At most the description of the codes needs to be improved. Rene spronk 00:04, 2 October 2006 (CDT)

Jan 11, 2007 - While there is general support to change Entry to Grouper, there is concern with flipping Container and Organizer. The sense is that Container is more generic. We could consider changing the class name instead from Organizer to Container.

Resolution

Motion: Prepare a harmonization proposal moving the recommended list to Harmonization: Changes to the labels, only changes to definitions to adjust to the new labels but not the semantic definition of the concepts. Bob, Patrick Richard Dixon-Hughes: Concern with 13606 nomenclature that is now not exactly in sync.
Abstain: 5, Against: 0, In Favor: 30

[Updated during September Meeting as the wiki was out-of-sync with the minutes]