CSCR-081-PHER-Add Activity Time

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Submitted by: Austin Kreisler	Revision date: 11/24/2008
Submitted date: 11/24/2008	Change request ID: CSCR-081

Issue

In public health reporting it is often important to report not just the effective time of some act, but the activity time associated with the act as well.

Recommendation

• Add the activityTime attribute to the Observation, SubstanceAdministration, Supply, Procedure, Encounter and Act classes in the CS model.

Rationale

There are at least two circumstances in public health reporting where knowing activity time is important. The first is from an administrative perspective, it is important to capture when investigations begin and end. The end of an investigation is often documented via final report. The second circumstance where activity time is important is when investigating some public health event, it is important not just to document the effective time of the event, but all the time spent by participants involved in the event. Since effective time does not capture administrative time, activity time is needed to properly capture all time, administrative or otherwise associated with an event.

Discussion

Activity time captures all time spent on some act (including administrative time) not just the effective time of an act.

Recommended Action Items

Add the following attribute to the Observation, SubstanceAdministration, Supply, Procedure, Encounter and Act classes:

• activityTime – GTS [0..1] optional
  • A time expression specifying when an Act occurs, or, depending on the mood, is supposed to occur, scheduled to occur, etc. The activityTime includes the times of component actions (such as preparation and clean-up). The activityTime is primarily of administrative rather than clinical use. The clinically relevant time is the effectiveTime. When an observation of a prior symptom is made, the activityTime describes the time the observation is made, as opposed to effectiveTime which is the time the symptom is reported to have occurred. Thus the activityTime may be entirely different from the effectiveTime of the same Act.

Additional Clarification (added 2/4/2009)

• Observation: the total time interval for an observation including preparation before the observation begins and clean-up actions after the observation is completed
• Substance Administration: the total time interval for a substance administration including preparation before the substance adminstration and clean-up actions after the substance administration.
• Supply: the total time interval for a supply act including preparation before the supply act occurs and clean-up actions after the supply act has completed.
• Procedure: the total time interval for a procedure including preparation before the procedure begins and clean-up actions after the procedure is completed
• Encounter: (from A_Encounter CMET) the total time interval for an encounter including preparation before the patient arrives and clean-up actions after the patient departs
• Act: (from the RIM) ActivityTime indicates when an Act occurs, not when it is recorded. The activityTime includes the times of component actions (such as preparation and clean-up).
• Exposure: the total time interval for an exposure including preparation before the exposure and clean-up actions after the exposure. Exposures are not normally intentional acts (except perhaps for terrorist acts), so normally there may be no preparation time, but there can certainly be clean up associated with an exposure after the exposure occurs.
• PublicHealthCase: the total time interval for a case including preparation before the case is declared and admninistrative wrap-up actions after the case is closed
• Organizer: Not applicable

Resolution

15-Jan-09 - Motion: Austin, Rita Discussion:

• Clear on some (Observation, SubstanceAdministration, Procedure) not necessarily clear on others (Supply, Encounter and Act)
• Participation time vs. Activity Time - Could we use the times of the participations to derive what one needs? Are we missing any relevant?

Agreed that, while some are clear, to go back and clarify what it means for each one. Tabled until clarification done. Target: 2 weeks (first conference call).

5-Feb-09 - Substantially improved descriptions, but still some ambiguity (e.g., what is "clean-up time"). That is acceptable for current state.

Concerns remain with potential overlap of participation time vs. activity time. Add line of documentation that in certain instances the activity time could be derived from the participation times of the participants if all participants are known to have been recorded and all their participation times are recorded as well. Even with that there will be some concern with certain use cases which one(s) to use.

Motion: To accept with updates provided 4-Feb-2009. Austin, Patrick.

Against: 0; Abstain: 1; In Favor: 5

10 Feb 2009 - CSP v1.2.02 updated - CVB