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Pressure Ulcer Prevention 20110207

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HL7 project team meeting, 10 February, 2011, 12:00 PM ET


Back to Pressure Ulcer Prevention


Patty Greim y Jay Lyle y
Ioana Singureanu John Carter y
Catherine Hoang Moon-Hee Lee
Mimi Haberfeld Donna DuLong y
Charlie Selhorst y Sherri Simons y
You-Ying Whipple y Holly Miller
Walter Suarez y Susan Matney


  1. Agenda check
  2. Overview of class diagrams
    1. Conventions
    2. Subject matter scope
    3. Granularity (& terminologies, DCM, LOINC project)
  3. Plan: schedule detailed model reviews


Jay reviewed the location of documentation on the wiki, pointed out that you cannot browse to it yet, but can search ("pressure ulcer") or use the link sent to the list.

Walter asked about the status of the scope statement; we answered by reviewing the Action Items

Walter asked about the scope of the model; Jay explained that, of the packages in the original model, we are addressing the Pressure Ulcer Risk Assessment (formerly Skin Alteration Risk Assessment) and Pressure Ulcer Intervention.

Jay reviewed the basic assumptions around the UML class diagram.

Question: do we need clinical review? Answer: it was built by nurses, so it should be close to correct. We are performing additional nurse confirmation. And the ballot is another opportunity for input from experts not on our calls: we should invite some.

Model elements are typically observations (made by the assessing nurse) or histories (drawn from the chart).

Model changes

  • High Level
    • "Risk Factor" and "Relevant Lab" may be deleted go away when we confirm that all of their properties have been modeled elsewhere
    • "Clinical Judgement" should be related to or be a property of the Risk Assessment, not the Item.
    • How to express clinical judgement has not been addressed (Boolean is probably insufficient)
  • Instrument
    • Remove FDA age group. 1) it's not international 2) it doesn't express the correct age ranges 3) ages are in the model; the ranges should be expressed as constraints on the respective age-appropriate instrument options

Modeling practice

  • Vocabulary
    • How should co-morbidities be represented?
      • SNOMED CT or ICD? Motion to make them SNOMED ref sets
      • text: concept code or term? Motion for both
      • axis: determine appropriate axes - looks like finding is correct for most items; HX will need to be inferred from class name and made explicit in constrained model
      • multiple terms found: if because there is a hierarchy, use the parent. If because it was modeled twice in different places, see if choosing the correct axis doesn't narrow it down.
    • Standard practice: LOINC for questions, SNOMED CT for answers
      • Except for tightly bound instruments, like Braden scale. All on call agreed.

Action Items

ID Item Who Due Status Notes
10 Identify clinical experts we want to review the ballot Team 2/14 IP
9 Send out schedule with model packages assigned to dates; request for team to address specific questions Jay 2/10 IP
3 Confirm workgroup sponsorship from Patient Care or Clinical Interoperability Council or both Patty and Holly 2/9 IP Working on scheduling time with Stephen Chu (1/20)

Meeting for 2/9, per Wm Goossen (1/24)

4 Find out from Moon Hee how we can encourage or support more participation Patty closed Time change seemed to work well
5 Contact Audrey Dickerson to clarify how IHE specifications relate, affect us Holly closed Met; FSA to be considered in model
6 Contact SMEs to coordinate clinical input into the model Holly IP
8 Find a better time for this meeting Jay, Holly Closed Moved to 3 pm ET
7 Ensure 2/9 PC meeting time is sent to KP participants Jay Closed HL7 info sent 2/1
1 please send feedback on the project scope statement All 1/17 Closed
2 meet to clarify the model boundaries Jay and Donna 1/11 Closed We recommend that the conceptual scope be “Pressure Ulcer Risk Assessment,” one of two key focuses of the KP-VA model.


ID Issue Recorded Status Notes
2 No official HL7 project sponsor 1/10 Open See action item 3, in process (1/12)

PC probably; needs meeting to confirm (1/19)

1 Model boundaries unclear 1/10 Closed See action item 2, to be confirmed (1/12)

Clarified in meeting (1/19)