EMS Run Report CDA Meeting 110310

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

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Attendees

• Jay Lyle, project manager
• Sarah Ryan
• Clay Mann
• Keith Boone
• Greg Mears

Agenda

1. Agenda check
2. IHE specification
3. PHIN VADS
4. Action Items and Issues
5. Other business

Minutes

Sundak not being present, we did not address the vocabularies

Questions sent and answered

1. Clarification: Most of the TF addresses implementation systems. The document IG will not.
   1. OK
2. The supplement & CM contain some fairly heavy proliferation of sections. In many cases, there seems to be a section for every question. That seems top-heavy to me, but I can't judge because the rationale for including all those layers is not clear. This practice also puts the question code in the section header, several relationships away from the answer. (I presume that's where those "assert" values are coming from.)
   1. The section headings support better legibility in the human presentation. If the machinery works, distance should not be a problem.
3. In some cases, two sections lay claim to the same NEMSIS element (e.g., chief complaint & review of systems, both in their own sections and in Injury Incident Description). Would IHE have a preference for a location for these, subsectioning, or duplication? (See attachment)
   1. We'll put specific questions (e.g., Chief Complaint) in their designated sections, and put anything else in the broader section.
4. In some instances, an element is market R in one table (6.1.1.Y.3 Data Element Index) and C in another (6.1.1.Y.4 Specification).
   1. Not addressed
5. One requirement is for a narrative of IV fluids administered. NEMSIS contains only an IV site.
   1. We can
      1. Not meet the IHE requirement
      2. Use the IG to direct implementers to include the descriptive narrative in the text field for the SBADM with the site
      3. Add the requirement to NEMSIS
   2. the text field should suffice

Issue: our activity is for level 3; implementers expect to have a usable level 1 CDA specification this summer.

• Approach: we'll package all of the level 3 constraints into a separate template and include it optionally.
• Remaining question: do we also need a level 2 option?

Issue: RR elements were defined by state agencies; we need to ensure that ED physicians have appropriate input

• We'll schedule an out-of-cycle meeting to address

Action Items

Action	Responsible	Description	Timeline	Status
SD questions	Jay	See issues	2/10	Closed
update vocabulary approach document	Sarah	vocabulary principles, approach priorities, preferred systems	2/17	open
PHIN VADS	Sarah	Contact Sundak	2/24	closed

Issues

Issue	Description	Resolution	Status
Run Report Scope	Event model contains hospital information: is this 'run report' information?	No, per Clay, 2/3/11	Closed
SD question 1	Need OIDs, URN	URN: make one up, per B Dolin. OIDs: request a 'root' document OID and write our extensions, for later import into the repository.	closed
SD question 2	harmonizing sections with IHE, HITSP, etc.	Use CCD as appropriate, or downstream templates as necessary. No registry or process exists.	closed
MDHT question 1	approach for many questions: model question as separate template, create new association, use Type to assign template	confirmed by Sean	closed
Coding strength	Are all RR codes CNE, except, presumably, ICD/RxNorm sets?		open