CDA R3 Service Location Certification

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Submitted by: Harry Solomon	Revision date: 22 Sept 2009
Submitted date: 20 Jan 2009	Change request ID: <<Change Request ID>>

Issue

In December 2008, the American College of Cardiology, American Heart Association, and 12 subspecialty societies issued a Health Policy Ststement on Structured Reporting. It set out a policy goal of improving cardiology processes through standardizing structured documentation of procedures.

Published in association with the Health Policy Ststement was a consensus set of Key Data Elements and Definitions for Cardiac Imaging to be included in structured report documents. Among those were two administrative data elements associated with the service delivery location:

• accreditation status
• accreditation entity

These were specified in support of another quality improvement initiative, associated with certification/accreditation of cardiac imaging labs. The professional societies believe that accreditation status is an important aspect of indicating report quality, as some of the accreditation measures will deal with adherence to standardized structured report documentation.

The professional societies are therefore very interested in encoding accreditation status in the CDA header. Note that this can then be used to investigate from the aggregate of report documents whether accreditation actually results in improved diagnostic quality, patient outcomes, and cost effectiveness.

Recommendation

Add accreditation/certification attributes to the identity of the Service Delivery Location in the CDA header.

A suggested RIM-based model is:

• from HealthCareFacility role (Service Delivery Location), add an IDENT RoleLink to a new role LicensedEntity, with a scoper Entity of the accrediting organization. The LicensedEntity class conveys all the required information attributes for accreditation, including effectiveTime.

Discussion

ACCF/ACR/AHA/ASE/ASNC/HRS/NASCI/RSNA/SAIP/SCAI/SCCT/SCMR 2008 Health Policy Statement on Structured Reporting in Cardiovascular Imaging, Pamela S. Douglas, MD, MACC, FAHA, FASE, Chair, Robert C. Hendel, MD, FACC, FAHA, Co-Chair, Jennifer E. Cummings, MD, FACC, John M. Dent, MD, FACC, FASE, John McB. Hodgson, MD, FACC, FSCAI, Udo Hoffmann, MD, MPH, Robert J. Horn, III, W. Gregory Hundley, MD, FACC, FAHA, Charles E. Kahn, Jr, MD, MS, Gerard R. Martin, MD, FACC, Frederick A. Masoudi, MD, MSPH, FACC, Eric D. Peterson, MD, MPH, FACC, FAHA, Geoffrey L. Rosenthal, MD, PhD, FACC, Harry Solomon, Arthur E. Stillman, MD, PhD, FAHA, Shawn D. Teague, MD, James D. Thomas, MD, FACC, FAHA, Peter L. Tilkemeier, MD, MMM, FACC, FAHA, FASNC, and Wm. Guy Weigold, MD, FACC, J. Am. Coll. Cardiol., 2009; 53:76-90, doi:10.1016/j.jacc.2008.09.005

ACC/AHA/ACR/ASE/ASNC/HRS/NASCI/RSNA/SAIP/SCAI/SCCT/SCMR/SIR 2008 Key Data Elements and Definitions for Cardiac Imaging, American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Cardiac Imaging), Robert C. Hendel, MD, FACC, FAHA, FASNC, Chair, Matthew J. Budoff, MD, FACC, FAHA, John F. Cardella, MD, FSIR, FACR, FAHA, Charles E. Chambers, MD, FACC, FSCAI, John M. Dent, MD, FACC, David M. Fitzgerald, MD, FACC, FHRS, John McB. Hodgson, MD, FACC, FSCAI, Elizabeth Klodas, MD, FACC, Christopher M. Kramer, MD, FACC, FAHA, Arthur E. Stillman, MD, PhD, FAHA, Peter L. Tilkemeier, MD, MMM, FACC, FAHA, FASNC, R. Parker Ward, MD, FACC, Wm. Guy Weigold, MD, FACC, Richard D. White, MD, FACC, FAHA, Pamela K. Woodard, MD, FAHA, J. Am. Coll. Cardiol., 2009; 53:91-124, doi:10.1016/j.jacc.2008.09.006 doi:10.1016/j.jacc.2008.09.006

Resolution

(Resolution is to be recorded here and in the referenced minutes, which are the authoritative source of resolution).