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OO CRLRI-007 - Usage Note for SPM Section 6.1.1.3.4

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Submitted by: Eric Haas Revision date: Jan 21 2014
Submitted date: Jan 21 2014 Change request ID: OO CRLRI-007
Standard/IG: Implementation Guide Artifact ID, Name: Usage Note for SPM Section 6.1.1.3.4


Issue

Based on NIST google groups discussion for both LRI and ELR-R1. The current usage notes regarding SPM inheritance are insufficient.


6.1.1.3.4 SPECIMEN INHERITANCE "When reporting child results, the specimen information reported on its parent are not automatically assumed to be inherited by the children. Each child OBR must include the relevant specimen segment(s) for the observations being reported. "

  • From google groups discussion : " we suggest that for Micro/Susceptibility, the SPM segment(s) are ONLY present on the parent (culture), NOT on the susceptibilities. While for non-micro/susceptibilities we would suggest that the parent has ALL SPM segments that apply to the tree, and the Children only enumerate the one(s) applicable to them. If the child does not list the SPM, then the parent’s are assumed. That would be consistent with micro/susc and still keep the inheritance rule simple."
  • Question: is it possible to progamatically identify Micro/Susceptibility from other Parent child messages without maintaning a table of LOINCs?
  • Further comments from google groups discussion " In ELR-R1 IG there is an untestable condition predicate that state's the SPM is required only for the Parent OBR - since we have no way of identifying the parent. We simplified the rule in the tool to state at least one OBR needs an SPM. There is no error if you have an SPM after each OBR however." (We carried this Conformance statement forward to ELR-R2 although still unclear how to best implement for PH)
  • More Questions what about "sibling" OBRs.( multiple orders on a single sample.) Will one SPM in message cover them as well? Should this fail validation?
  • How is this done in v231 using OBR-15?

Recommendation

6.1.1.3.4 SPECIMEN INHERITANCE "???"


Rationale

Clarity for implementors on the usage of SPM.


Discussion

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Resolution