EMS Run Report CDA Meeting 110217

HL7 project team meeting, 17 February, 2011, 12:00 PM ET

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Attendees

• Jay Lyle, project manager, Ockham Information Services
• Sarah Ryan, vocabulary facilitator, Ockham Information Services

Agenda

1. Agenda check
2. CDA structure
3. Vocabulary batch one
4. Action Items and Issues
5. Other business

Minutes

We reviewed SD responses to CDA questions

We discussed the SNOMED CT vs ICD-10 question again. Our original reason for advocating SCT was that it would support better logical processing than ICD-10, which is a classification system. My example of choice is congenital rubella: do you find it in the perinatal disease branch or the infectious disease branch? If you make a decision which to use, how do you make sure all of your organization follows suit? How do you communicate that kind of decision to your partners?

However, we have not found many problems. Stridor presents an issue, but NEMSIS has made a determination (R05) and it seems reasonable.

Further, our original position was based on the idea that the software user would be insulated from the terminology. The software would present terms, and the user would select, and whether the underlying system contained 10,000 ICD codes or 100,000 SNOMED concepts was immaterial. But the use case now shows manual coding. To support these workers, and in the absence of signal issues in representation, we have changed our recommendation to ICD-10.

Finally, we discussed the registration and publication of codes. It may be possible, even preferable, to have NEMSIS not only maintain custody of the EMS code system, but of the value set definition. These sets can be distributed via HL7, but they could also be distributed via PHIN VADS, a system that is less backlogged and more developer-friendly than the HL7 vocabulary repository.

Action Items

Action	Responsible	Description	Timeline	Status
SD questions	Jay	See issues	2/10	open
update vocabulary approach document	Sarah	vocabulary principles, approach priorities, preferred systems	2/17	open

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		open
Coding strength	Are all RR codes CNE, except, presumably, ICD/RxNorm sets?		open