Igor Sirkovich, 2008

Hello,

Does anyone why codeEntity of the MaterialKind and MaterialKind2 in REPC_HD000200UV - A_CarePlan is bounded to ExposureAgentEntityType? Wouldn't it make more sense to bound it to a broader MaterialEntityClassType?

ExposureAgentEntityType indicates the material to which the patient was exposed which is believed to be related to the adverse reaction. We have a business requirement to indicate a Medical Device that was used for the substance administration.

Thanks,

Igor Sirkovich

Information Architect, HL7 & Integration CC e-Health Standards Team Continuing Care e-Health

Thanks Hugh!

We did have a look at the pharmacy DMIM PORX_DM000000 and the way it links a Device to a Substance Administration would work well for us, but unfortunately this link is not part of the CarePlan, which we are using for our e-Referrals.

Why aren't you sure widening codeEntity of the MaterialKind to allow any MaterialEntityClassType is right? I think it would make the Care Plan model flexible enough to meet various business needs.

Regards, Igor

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Original Message-----

From: Hugh_Glover [1] Sent: Tuesday, July 29, 2008 7:24 PM To: Sirkovich, Igor (MOH); "'patientcare'" Subject: RE: AdministerableMaterialKind - REPC_HD000200UV - A_CarePlan

I've not got any of this in front of me, but ExposureAgent sounds wrong; but I'm not sure widening it to cover anything is right either. If you look at the pharmacy DMIM PORX_DM000000 you will see a device represented somewhere at the top of one of the acts (sorry - from memory). This is specifically there to represent the device in the case you are talking about. This is a good place to start to see if the PatientCare model covers what you need. Regards Hugh

Igor,

What Hugh is referring to on the Pharmacy DMIM separates the participation of a consumable (as depicted on the Patient Care's Care Plan RMIM) from the participation of a device in SubstanceAdministrationProcess (either as the dispensed item or as the device use in administration).

I did exchange notes with the Patient Care co-chairs last night on your comment/issue, and indicated that we would take up your comment as a normal Care Plan DSTU comment and deal with it in Vancouver.

Meanwhile, the thing to do is not to abstract the codeEntity upward to MaterialEntityEntityClassType (that would include Devices as consumable AdministrableMaterial). The way forward would be to replicate in the Care Plan RMIM, the device structure as modeled in Pharmacy DMIM. That way, the dispensing of a device or the use of a device in substance administration can be clearly identified in the Care Plan (if necessary).

Regards,

John Kufuor-Boakye 780-439-3066 (desk phone) 780-951-4376 (cell)

Thanks John!

I agree that replication of the way the device is used in substance administration, as modeled in Pharmacy DMIM, in the Care Plan RMIM would be the best solution. However we have found one issue with the AssignedDevice universal (COCT_RM090300UV) CMET that is used in the Pharmacy DMIM - there is no Entity Code defined for Device. Thus, there is no way to indicate what kind of device was used for substance administration, e.g. Syringe, Pen, AutoInjector, etc...

I suggest we need to submit a request to include the Device codeEntity in COCT_RM090300UV. Do you know which working committee is responsible for this CMET?

Thanks, Igor

Hi Igor,

I suggest you direct your request to the INM (Infrastructure & Messaging) Technical Committee. They are responsible for all CMETs and Shared messages.

Regards,

John Kufuor-Boakye

Igor,

I would suggest you submit this as a request for CMET change which is supported by Patient Care. It would be very helpful if you write up the request following HDF:

starting with a use case, (like in the message you want to include syringe etc. in the care plan), storyboard and the need for the CMET.

then name the deficiency in the CMET and come up with the solution.

John and myself can assist with that.

We also can use this use case then for the advancement of the Care Plan R-MIM and perhaps we would need a joint session with Pharmacy to see how the two D-MIMs (Care Provision and Pharmacy) fit together. We did have other requests, e.g. in NL for being able to link care provision and pharmacy together in one model. Tom de Jong has been doing something in this area for the exchange record for juvenile care. However I do not have the details and will ask him.

Igor, will you be in Vancouver in Sept? Else we can work on this partly via the mail.

Hugh, what do you think of a joint meeting in Vancouver? (we had this before on concern tracker and allergies).