OO CR137-760 - Table 0078 Updates

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Submitted by: Riki Merrick	Revision date: <<Revision Date>>
Submitted date: 31 July 2013	Change request ID: OO CR137-760
Standard/IG: Standard	Artifact ID, Name: <<Artifact ID, Name>>

Issue

See File:OO CR 137-760.doc for problem definition and proposal. See File:Interpretation Codes HL7 Table 0078(48).xlsx for final version of the table.

Discussion

After review of the newly published v2.8 we found 2 more concepts listed in table 0078: OBX - Interpretation qualifiers in separate OBX segments - Came from CR-638 (GE, Harry Solomon - IHE) Per the CR documentation on the wiki this proposal was withdrawn, so should not have been added to table, correct? See: http://wiki.hl7.org/index.php?title=OO_CR021-638_Result_Status_Codes

HM - Hold for Medical Review - Came from CR-635 (Quest, Ken McCaslin) Per the CR documentation on the wiki, this was adopted See: http://wiki.hl7.org/index.php?title=OO_CR018-635_Abnormal_Flag_Vocabulary

If we can get a definition for this concept we can add to the v2.9 table - Rationale listed was: The new code is intended to indicate that the laboratory is deferring interpretation of the result pending input from the ordering provider, due to circumstances with the patient that cause the typical normal ranges to not apply. The result will also not be placed in the patient record pending the ordering provider’s interpretation. - can this be generalized beyond lab, or does it apply ONLY to lab?

Resolution

6/12/2014:  HU = Significantly high: A test result that is significantly higher than the reference (normal) or therapeutic interval, but has not reached the critically high value and might need special attention, as defined by the laboratory or the clinician.  LU = Significantly low: A test result that is significantly lower than the reference (normal) or therapeutic interval, but has not reached the critically low value and might need special attention, as defined by the laboratory or the clinician.  Motion to accept yellow highlight(here the text above). Cindy Johns, Clem McDonald • The code is now not in alignment with V3, but that is o.k. to go through V3 harmonization. These are in LOI/LRI. • Against: 0; Abstain: 0; In Favor: 23 o Ken will follow up on the action items for table 78 column by next week o The consideration to split OBX-8 into two fields will be a separate CR and is not critical for V2.8.2 7/31/2014: Motion to accept changes to Table 78 up to today's date and deal with the to be reviewed items in a new CR by David Burgess, Rob Hausam, no further discussion against: 0, abstain: 0, in favor: 13

2/5/2015: During v2.8.2 ballot reconciliation found response from David E. Sterry, MT (ASCP), Director, Standards Secretary, ISO/TC 212, Clinical and Laboratory Standards Institute:

Correct only R, I, and NS would be flags –

Susceptible-dose dependent, Insufficient evidence, Synergy – resistant, Synergy – susceptible would not be useful or acceptable as flags.

SDD is not an abnormal value it just alerts the physician to use a higher dose. The other terms – insufficient evidence and synergy-R/synergy-S are not terms that I am aware of used in micro AST.