Trauma Registry Minutes 5 August 2014

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attendees

• Chrystal Caden-Price, ACS
• Melanie Neal, ACS
• Jay Lyle, Ockham, PM
• Abdul-Malik Shakir, Hi3 Systems
• Sarah Ryan, Ockham
• Richard Hale, ESO Solutions
• John Bennet, Lancet Technology
• Grant Dittmer, Digital Innovations
• Dave Karres, CDM
• Jody Summers, CDM
• Troy Whipple, ImageTrend
• Michael
• Clay Mann, NEMSIS TAC

minutes

• review of message & design decisions
  • If there is no visit information, use nulls. May send all fields in section if desired, or null the top: it can cascade. DI can digest either.
  • IDs
    • Set ID (event): root = ACS OID + ".4." + facilityID + ".1"; extension = patient ID
    • Document ID (instance or version of document): root = ACS OID + ".4." + facilityID + ".2"; extension = text, unspecified but unique
    • Effective time: last modified date
    • Version number: do not use
  • Some facility IDs identify more than one facility
    • This is a governance issue, not a design issue, unless there is a requirement to represent groups of facilities.
  • Use GNIS for state, county, & location. GNIS incorporates FIPS for state and county. Send 5-digit for county: ACS can strip out state if desired.
    • That’s NEMSIS: ACS still uses FIPS for city. Open issue.
  • We can use address part type codes for coded address part observations; no need for LOINC codes. Still need OIDs.
  • Add minutes to age units
  • Need to make the specification open.
    • To allow nulls
    • To allow adoption of future values prior to their adoption
  • Require time zone offset
  • Facility is custodian of clinical data. Submitter is author of document. These are usually the same; sometimes distinct.
  • Add statuscode to Organizers in guide
  • Example file: assigned author should use organization; remove TBDs
• transition planning
  • We see a 2017 timeframe for supporting CDA submissions
    • ACS issues: Selecting appropriate version, Ability to validate, Patient-based submission process not yet determined, What does it take to update the standard to a current dictionary, ballot
    • Whether to update to 2015: open question
      • Confirm change list (6 new, 2 change?) see change log on site
      • (note 2015 does not reflect harmonization: airbag, protective devices, child specific restraint, payment, disposition)
      • Tentative goal: 2017 submission of 2016 dictionary
    • Consider including version of standard in document? No; just use incident date.
    • Question: new template ID or put version date in extension?
    • Should the CDA guide include the business rules currently in the dictionary?
    • Look into feasibility of publishing terminology at VSAC.
      • Confirm resources availability with ACS
      • Also knowledge transfer for future maintenance

• Maintenance planning
  • Dictionary revised annually. Goal is to reduce that frequency.
  • Midterm changes rare.
  • Still have to support latest standard version.

• Testing
  • Validator bug prevents DI validation during meeting
  • Updated sample to validate against xsd
  • Distributed schematron; sample not yet valid per schematron
  • Jay to complete sample--all elements to be present
  • May be possible to use SmartCDA to test terminology

• Next
  • Meetings will continue, same time
  • Issues: post to wiki (or mail Jay)

Open Action Items

• Jay: Confirm AAAM solution with LOINC

Look into feasibility of publishing terminology at VSAC.