Harmonization: Fix description of Act.ReasonCode

Dropped - not brought forward. The misuse of reasonCode continues to exist in various models, but the RIM description in itself is clear enough. Rene spronk 13:09, 5 October 2006 (CDT)

Editing of harmonization proposals prior to a harmonization meeting is restricted to the proposal submitter and the co-chairs of the steward comittee. Other changes will be undone. Please add comments to the "discussion" page associated with this proposal.

Recommendation for HL7 RIM Change	RECOMMENDATION ID:
Submitted by: INM	Revision (# and date): 20060719
Date submitted:	Committee status:
Submitted by: Rene Spronk
NAME: Fix description of Act.ReasonCode

Stewards Position

TC	RECOMMENDATION APPROVAL STATUS	AFFECTED ENTITIES OF INTEREST TO TC (responsibility level: S=Steward; I=Interested)
INM	not discussed	I

Issue

One paragraph summary of the issue and the solution as detailed in this proposal.

Recommendation(s)

Change the Discussion part of Act.reasonCode..

No instance talking about the validation action will ever be created. The guidance in the RIM is meant to guide against putting indications, problems and similar items into reasonCode. In those circumstances, ActRelationship is far more appropriate.

Rationale

The RIM description for Act.reasonCode is as follows (our italics):

Definition:A code specifying the motivation, cause, or rationale of an Act, when such rationale is not reasonably represented as an ActRelationship of type "has reason" linking to another Act.

Examples: Example reasons that might qualify for being coded in this field might be: "routine requirement", "infectious disease reporting requirement", "on patient request", "required by law".

Discussion

Most reasons for acts can be clearly expressed by linking the new Act to another prior Act using an ActRelationship of type "has reason". This simply states that the prior Act is a reason for the new Act (see ActRelationship). The prior act can then be a specific existing act or a textual explanation. This works for most cases, and the more specific the reason data is, the more should this reason ActRelationship be used instead of the reasonCode.

The reasonCode remains as a place for common reasons that are not related to a prior Act or any other condition expressed in Acts. Indicators that something was required by law or was on the request of a patient etc. may qualify. However, if that piece of legislation, regulation, or the contract or the patient request can be represented as an Act (and they usually can), the reasonCode should not be used.

The D-MIM walkthru of the control act wrapper states:

reasonCode: A code specifying the motivation, cause, or rationale of the Act. The reasonCode should only be used for common reasons that are not related to a prior Act or any other condition expressed in Acts. Example reasons that might qualify for being coded in this field might be: "routine requirement", "infectious disease reporting requirement", "on patient request", or "required by law". The reasonCode attribute identifies types of reasons, or broad categories of reasons. It is not to be used for the identification of fine-grained reasons for the Act. The value of this attribute shall not be interpreted as a refinement of the trigger event identified in the code attribute; it's value is "for information" only.

Recommended Action Items

• Implement the proposed solution