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Difference between revisions of "Trauma Registry Project FAQ"

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! # !! Question !! Answer !! Status
 
! # !! Question !! Answer !! Status
 
|-
 
|-
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| 1 || How do we distinguish a patient who has no prehospital section because there was no EMS engagement from a patient who who has no prehospital section because the data is missing?  || The section could be populated with a negation indicator, however, the semantics are unclear on negating a section. Instead, the prehospital transport question, in the hospital section, can be used. A "not applicable" value means that there was no prehospital transport--i.e., no professional service rendered--while a null would indicate that the information is unknown. (OK 2/24 - but annotate to make it clear). If not present, unk or na allowed. ACS: Do you need to know why it's missing, if it's missing? If so, how do you do it today? || Open.
+
| 1 || How do we distinguish a patient who has no prehospital section because there was no EMS engagement from a patient who who has no prehospital section because the data is missing?  || The prehospital section can contain a null flavor of "not applicable" ("NA") meaning that there was no such event (i.e., the patient was a walk-in) or of "unknown" ("UNK") meaning that the information is not available.
 +
|| Resolved
 
|-
 
|-
−
| 2 || How are identifiers assigned? || * The provider institution assigns patient identifiers, and ACS uses the facility identifier with the patient identifier to ensure uniqueness. Both of these can be stored as II extensions. The II roots must be OIDs (or UUIDs), though they maybe null. For now, vendor software assigns provider institution OIDs that can be used as II roots (for documents, patients, or any other resource).
+
| 2 || How are identifiers assigned? ||  
−
**The Facility Id should be ACS OID root plus the ACS-assigned 5-digit ID.
+
*Patient (incident) and document:
−
***In the event a state or regional group submits on behalf of a facility, that organization would be the custodian, and would need an ACS ID.
+
**Set ID (event): root = ACS OID + ".4." + facilityID + ".1"; extension = patient ID
−
**The document id should be the (software-assigned) institution OID plus locally generated document id. ACS doesn't know what that id is; it's up to the implementer.
+
**Document ID (instance or version of document): root = ACS OID + ".4." + facilityID  + ".2"; extension = text, unspecified but unique
−
***SetId is for the patient record; document.id shows the version unique identifier; document.effectiveTime puts those versions in order. No versionNumber necessary.
+
**Effective time: last modified date
−
****ntdsschema2013.1.1.xsd datetime property is precise to the minute
+
**Version number: do not use
−
***Facilities may update submissions; use the CDA version number property.
+
*The Facility Id should be ACS OID + ".4." + facilityID (ACS-assigned 5-digit ID).  
−
**The patient ID is functionally the same as the document id. 
+
*Patient id within the record target can be the same as the setId
−
|| Open (versioning)
+
 
 +
 
 +
|| Resolved
 
|-
 
|-
−
| 3 || Are time zones required on time stamps? || Time zones are recommended. This will be a text recommendation in the guide. || Open (not yet applied)
+
| 3 || Are time zones required on time stamps? || Yes|| Resolved
 
|-
 
|-
−
| 4 || Are time intervals inclusive or exclusive? || The abstract data types specification stipulates no default assumption, but the IVL pattern does support the Boolean properties lowClosed and highClosed that allow the user to specify the boundary type. || Closed
+
| 4 || Are time intervals inclusive or exclusive? || The abstract data types specification stipulates no default assumption, but the IVL pattern does support the Boolean properties lowClosed and highClosed that allow the user to specify the boundary type. || Resolved
 
|-
 
|-
 
| 5 || confirm validation can include constraint identifier in error message || Grant reports no, but NTDS identifiers will be provided as they are today || closed
 
| 5 || confirm validation can include constraint identifier in error message || Grant reports no, but NTDS identifiers will be provided as they are today || closed
 
|-
 
|-
−
| 6 || Do we need a code system for actEncounterCode (FLD) || AMS? || Open
+
| 6 || Do we need a code system for actEncounterCode (FLD) || Yes; VALUE SET: ActEncounterCode (2.16.840.1.113883.1.11.13955) || Closed
 +
|-
 +
| 7 || Should we specify section title in IG (content, not just presence) || Yes; "should" for title. Text is up to implementer. || Closed
 +
|-
 +
| 8 || Put last modified date in version rather than create? || See #2. || Closed
 +
|-
 +
| 9 || May need to break Transport Mode into two templates || One template, two paths; make sure DI can read this.  || Resolved
 +
|-
 +
| 10 || Value sets without enumerated members are not listed in appendix: Trifolia issue || Listing can be forced. || Closed.
 +
|-
 +
| 11 || Missing LOINCs || Most received; some questions on missing items, and address codes requested. AAAM question seems close to resolution; still awaiting closure from LOINC. Unless & until LOINC/AAAM answer, we use American College of Surgeons National Trauma Data System; 2.16.840.1.113883.3.2898.5.1, codes IS_01, Injury kind and IS_02, Injury severity || Open
 +
|-
 +
| 12 || Need question codes for coded address elements || "ANSI FIPS" now in GNIS: use GNIS pending ACS approval || closed
 +
|-
 +
| 13 || Missing circ values for ED || Hospital & ED; we've put it in the more general place. Stet. || Closed
 +
|-
 +
| 14 || P_05: field encounter does not end when unit leaves scene. Do we need to break this out? ||  Yes; done || Closed
 
|-
 
|-
−
| 7 || Should we specify section title in IG (content, not just presence) || Yes; "should" for title. Text is up to implementer. || Open
+
| 15 || Ensure SCT coded elements use correct OID (system = 2.16.840.1.113883.6.96) (page 21, 56, 74) ||   || Closed
 
|-
 
|-
−
| 8 || Put last modified date in version rather than create? || document.effectiveTime is document generation; should not change with new versions. InjuryEvent.effectiveTime may change if record is updated. The time the event occurred is an observation. Version is also needed; synchrony to be discussed on a future call on workflow. || Closed
+
| 16 || Gender has incorrect system name (page 12, 60) || HL7 Administrative Gender, not SCT  || Closed
 
|-
 
|-
−
| 9 || May need to break Transport Mode into two templates || One template, two paths; make sure DI can read this.  || Open
+
| 17 || style question: should we have a template for prehospital encounter entry, or should those contents go in the section template? No. || || closed
 
|-
 
|-
−
| 10 || Value sets without enumerated members are not listed in appendix: Trifolia issue || No. add a fake entry. || Closed.
+
| 18 || style question: should qualifier questions (supplemental O2, resp assistance) be closer to the vitals they modify? || No; those two elements are re-used || closed
 
|-
 
|-
−
| 11 || Missing LOINCs || Most received; some questions on missing items, and address codes requested. Need to choose a deadline for AAAM. Discuss in September. || Open
+
| 19 || add text explaining author & custodian, when they might be different || || Closed
 
|-
 
|-
−
| 12 || Need question codes for coded address elements || Question requested from LOINC. FIPS has been retired, asserting that "INCITS" is the new steward of these values, but charges for them. However,ANSI now publishes "ANSI FIPS" for the Census: we'll use these. (http://www.census.gov/geo/reference/ansi.html) || Open
+
| 20 || Use LOINC displayName values ||  || Open
 +
|-
 +
| 21 || Heart rate: change 8893-0 to 8867-4 ||  || Closed
 +
|-
 +
| 22 || Hospital GCS needs qualifier (not field) || May use same template, with optional qualifier. 55285-1  Glasgow coma score special circumstances. 10/28: the structure handles the requirement, but the names are confusing. Might it be better to have "Glasgow score without qualifier" and "Glasgow score with qualifier" (rather than "Nervous System Observation Organizer Entry" and "Nervous System Observation Organizer")? || Closed
 +
|-
 +
| 23 || Question: constrain time to TS, rather than prohibiting center & width?  At least remove constraints. ||  || closed
 +
|-
 +
| 24 || Injury address is coded, just like patient address. Reuse (& rename) || consider later using LOINC 69447-1 for injury address; 18581-9 for patient. || Closed
 +
|-
 +
| 25 || Rename "Value Set: Abbreviated Injury Scale Severity 2.16.840.1.113883.3.2898.11.7" to "Injury Kind" or "Abbreviated Injury Scale Injury Kind" || It's not a severity || Closed
 +
|-
 +
| 26 || Either replace SCT code with TBD at 30020 or make sure to remember to replace it  ||  || Closed
 +
|-
 +
| 27 || Add zip code to coded address structure  || || Closed
 +
 
 
|}
 
|}
  
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| 1 || (age units) Minutes in HL7 not in NTDS; Weeks in HL7 not in NTDS || I don't recall deciding to add these, so we should probably remove those two.
 
| 1 || (age units) Minutes in HL7 not in NTDS; Weeks in HL7 not in NTDS || I don't recall deciding to add these, so we should probably remove those two.
 
NEMSIS has minutes but not weeks.  
 
NEMSIS has minutes but not weeks.  
−
|| Open
+
|| Closed
 
|-
 
|-
−
| 2 || Industry incorrect || I don't know why LOINC assigned some codes and not others. We should use the NAICS top-level values, not the LOINC answer codes. || Open
+
| 2 || Industry incorrect || I don't know why LOINC assigned some codes and not others. We should use the NAICS top-level values, not the LOINC answer codes. || Closed
 
|-
 
|-
−
| 3 || Any long list incomplete (e.g. industry) || can we set up Trifolia for this, or do we need to publish a spreadsheet (or use PHIN VADS or VSAC) || Open
+
| 3 || Any long list incomplete (e.g. industry) || can we set up Trifolia for this, or do we need to publish a spreadsheet (or use PHIN VADS or VSAC). No: we need to publish some other way. || Closed
 
|-
 
|-
−
| 4 || Code for “Other Race” is in NTDS but not in HL7 || We propose to use "OTH" flavor of null || Open
+
| 4 || Code for “Other Race” is in NTDS but not in HL7 || We propose to use "OTH" flavor of null || Closed
 
|-
 
|-
 
| 5 || LA17105-0 - Patient Chemically paralyzed – In HL7 is not a NTDS code || Included based on harmonization with NEMSIS || Closed
 
| 5 || LA17105-0 - Patient Chemically paralyzed – In HL7 is not a NTDS code || Included based on harmonization with NEMSIS || Closed
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| 10 || No code for ‘Other’ protective devices || We propose to use "OTH" flavor of null || Closed
 
| 10 || No code for ‘Other’ protective devices || We propose to use "OTH" flavor of null || Closed
 
|-
 
|-
−
| 11 || Need country codes || Use VS 2.16.840.1.113883.3.88.12.80.63 (HITSP), system 1.0.3166.1.2.2, name Country Codes || Open
+
| 11 || Need country codes || Use VS 2.16.840.1.113883.3.88.12.80.63 (HITSP), system 1.0.3166.2.2.2, name Country Codes, OR HL7 V3 VS 2.16.840.1.113883.3.88.12.80.63, same system oid, name Country2? use the latter. || Closed
 
|-
 
|-
−
| 12 || Need State codes || Use VS 2.16.840.1.113883.3.88.12.80.1 (HITSP), system "NA", name FIPS 5-2 (State) (available at http://www.census.gov/geo/reference/ansi_statetables.html) || Closed
+
| 12 || Need State codes || Use VS 2.16.840.1.113883.3.88.12.80.1 (HITSP), system 2.16.840.1.113883.6.92, name FIPS 5-2 (State) (available at http://www.census.gov/geo/reference/ansi_statetables.html) || Closed
 
|-
 
|-
−
| 13 || Need County codes || Use VS "NA", system "NA", name FIPS 6-4 (County) (available at http://www.census.gov/geo/reference/codes/cou.html) || Closed
+
| 13 || Need County codes || Use VS 2.16.840.1.114222.4.11.829 "PHVS_County_FIPS_6-4"; system OID 2.16.840.1.113883.6.93 (available at http://www.census.gov/geo/reference/codes/cou.html) || Closed
 
|-
 
|-
−
| 14 || Need City codes || Use VS "NA", system "NA", name ANSI Codes for Places (available at http://www.census.gov/geo/reference/codes/place.html). Or, NEMSIS uses GNIS, available at http://geonames.usgs.gov/domestic/download_data.htm || Open
+
| 14 || Need City codes || Use VS GNIS civil and populated places, new OID 2.16.840.1.113883.3.2898.11.28, system 2.16.840.1.113883.6.245 GNIS, available at http://geonames.usgs.gov/domestic/download_data.htm || Closed
 
|}
 
|}
  
 
=Project processes=
 
=Project processes=

Latest revision as of 14:54, 24 November 2014

Back to Trauma Registry page

Modeling

# Question Answer Status
1 How do we distinguish a patient who has no prehospital section because there was no EMS engagement from a patient who who has no prehospital section because the data is missing? The prehospital section can contain a null flavor of "not applicable" ("NA") meaning that there was no such event (i.e., the patient was a walk-in) or of "unknown" ("UNK") meaning that the information is not available. Resolved
2 How are identifiers assigned?
  • Patient (incident) and document:
    • 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
  • The Facility Id should be ACS OID + ".4." + facilityID (ACS-assigned 5-digit ID).
  • Patient id within the record target can be the same as the setId


 Resolved
3 Are time zones required on time stamps? Yes Resolved
4 Are time intervals inclusive or exclusive? The abstract data types specification stipulates no default assumption, but the IVL pattern does support the Boolean properties lowClosed and highClosed that allow the user to specify the boundary type. Resolved
5 confirm validation can include constraint identifier in error message Grant reports no, but NTDS identifiers will be provided as they are today closed
6 Do we need a code system for actEncounterCode (FLD) Yes; VALUE SET: ActEncounterCode (2.16.840.1.113883.1.11.13955) Closed
7 Should we specify section title in IG (content, not just presence) Yes; "should" for title. Text is up to implementer. Closed
8 Put last modified date in version rather than create? See #2. Closed
9 May need to break Transport Mode into two templates One template, two paths; make sure DI can read this. Resolved
10 Value sets without enumerated members are not listed in appendix: Trifolia issue Listing can be forced. Closed.
11 Missing LOINCs Most received; some questions on missing items, and address codes requested. AAAM question seems close to resolution; still awaiting closure from LOINC. Unless & until LOINC/AAAM answer, we use American College of Surgeons National Trauma Data System; 2.16.840.1.113883.3.2898.5.1, codes IS_01, Injury kind and IS_02, Injury severity Open
12 Need question codes for coded address elements "ANSI FIPS" now in GNIS: use GNIS pending ACS approval closed
13 Missing circ values for ED Hospital & ED; we've put it in the more general place. Stet. Closed
14 P_05: field encounter does not end when unit leaves scene. Do we need to break this out? Yes; done Closed
15 Ensure SCT coded elements use correct OID (system = 2.16.840.1.113883.6.96) (page 21, 56, 74) Closed
16 Gender has incorrect system name (page 12, 60) HL7 Administrative Gender, not SCT Closed
17 style question: should we have a template for prehospital encounter entry, or should those contents go in the section template? No. closed
18 style question: should qualifier questions (supplemental O2, resp assistance) be closer to the vitals they modify? No; those two elements are re-used closed
19 add text explaining author & custodian, when they might be different Closed
20 Use LOINC displayName values Open
21 Heart rate: change 8893-0 to 8867-4 Closed
22 Hospital GCS needs qualifier (not field) May use same template, with optional qualifier. 55285-1 Glasgow coma score special circumstances. 10/28: the structure handles the requirement, but the names are confusing. Might it be better to have "Glasgow score without qualifier" and "Glasgow score with qualifier" (rather than "Nervous System Observation Organizer Entry" and "Nervous System Observation Organizer")? Closed
23 Question: constrain time to TS, rather than prohibiting center & width? At least remove constraints. closed
24 Injury address is coded, just like patient address. Reuse (& rename) consider later using LOINC 69447-1 for injury address; 18581-9 for patient. Closed
25 Rename "Value Set: Abbreviated Injury Scale Severity 2.16.840.1.113883.3.2898.11.7" to "Injury Kind" or "Abbreviated Injury Scale Injury Kind" It's not a severity Closed
26 Either replace SCT code with TBD at 30020 or make sure to remember to replace it Closed
27 Add zip code to coded address structure Closed

Terminology

# Question Answer Status
1 (age units) Minutes in HL7 not in NTDS; Weeks in HL7 not in NTDS I don't recall deciding to add these, so we should probably remove those two.

NEMSIS has minutes but not weeks.

Closed
2 Industry incorrect I don't know why LOINC assigned some codes and not others. We should use the NAICS top-level values, not the LOINC answer codes. Closed
3 Any long list incomplete (e.g. industry) can we set up Trifolia for this, or do we need to publish a spreadsheet (or use PHIN VADS or VSAC). No: we need to publish some other way. Closed
4 Code for “Other Race” is in NTDS but not in HL7 We propose to use "OTH" flavor of null Closed
5 LA17105-0 - Patient Chemically paralyzed – In HL7 is not a NTDS code Included based on harmonization with NEMSIS Closed
6 LA17388-2 No airbag present – Not an NTDS code and currently the represented NA – null flavor case. This is the only case where I found a NTDS Null coded into a LOINC code. Included based on harmonization with NEMSIS. And "not present" isn't really a null. Closed
7 Protective Devices: Code Distinction issue – The lap and shoulder belt codes now contain the ‘Only’ description which is not accurate to the existing NTDS codes. Included based on harmonization with NEMSIS Closed
8 Child seat breakdown now in protective devices, no distinct field/element? Included based on harmonization with NEMSIS Closed
9 No code for “Airbag Present” Based on harmonization with NEMSIS--Airbag status contains this information Closed
10 No code for ‘Other’ protective devices We propose to use "OTH" flavor of null Closed
11 Need country codes Use VS 2.16.840.1.113883.3.88.12.80.63 (HITSP), system 1.0.3166.2.2.2, name Country Codes, OR HL7 V3 VS 2.16.840.1.113883.3.88.12.80.63, same system oid, name Country2? use the latter. Closed
12 Need State codes Use VS 2.16.840.1.113883.3.88.12.80.1 (HITSP), system 2.16.840.1.113883.6.92, name FIPS 5-2 (State) (available at http://www.census.gov/geo/reference/ansi_statetables.html) Closed
13 Need County codes Use VS 2.16.840.1.114222.4.11.829 "PHVS_County_FIPS_6-4"; system OID 2.16.840.1.113883.6.93 (available at http://www.census.gov/geo/reference/codes/cou.html) Closed
14 Need City codes Use VS GNIS civil and populated places, new OID 2.16.840.1.113883.3.2898.11.28, system 2.16.840.1.113883.6.245 GNIS, available at http://geonames.usgs.gov/domestic/download_data.htm Closed

Project processes

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