Ems outcomes issues

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1. Request LOINC document codes, or LOINC question for prior document type with answers
2. Request LOINC harmonize (collapse) 11373-8 (DEEDs) & 69543-7 (EMS)
3. Ask EC why DEEDs & CCDA specify Dx as LOINC's narr version 11535-2 rather than Nom 8651-2

Closed

1. C-CDA uses SCT for Dx; EMS uses ICD10. Use translation for now; change EMS? Use C-CDA.
2. Request CIC, PC, EC, VOC to harmonize disposition values for ED and Inpatient. No distinction: one document. If encounters are regarded as distinct, two documents would be appropriate.
3. Prior report? External document
4. Confirm UB04 currency. Used in C-CDA 1.1
5. Is Cause a sub-entry to diagnosis or complaint? No; it gets its own section.
6. ED diagnosis: admit or discharge? Discharge.
7. ICU length: new encounter with timestamp, or observation? Observation
8. Ventilator days: sum of procedure times, or observation? Observation
9. Outcome: doesn’t seem to fit CCDA assumptions for Functional, but Assessment
10. How much should this specification leverage C-CDA templates? We wish to make generation and comparison as easy as possible for implementers: does using an exising template with much superfluous information that may be nullified make things easier or harder? Should we follow the structural pattern without asserting conformance?
    1. See analysis
    2. NEMSIS prefers alignment; SD also suggests it's worthwhile unless implementers complain (BM 8/12)
11. How to assert context & differentiate ED and Inpatient data? Using 2 uber-sections, each containing, e.g., procedures.
    1. And can we mix content--can an uber-section contain both sections and entries?
    2. No: use act reference to encounter context. (BM 8/12)
12. C-CDA: Diagnosis in SCT, trans to ICD. NEMSIS expects ICD. Null the code and include translation? Or just don't use CCDA?
    1. See above: conform.
13. Are there alternatives to use of LOINC 75859-9  Rankin scale for outcome? Typically used for neurology, but no explicit constraint.
14. Can SD define deterministic rules for how to display in-line examples drawn from a validated holistic example? This would greatly improve the quality and efficiency of example generation.
15. How do discharge summaries typically report discharge disposition for both inpatient & ED?
    1. ED discharge isn't really a 'discharge'; not standard (JM 8/12)