HL7 project team meeting, 26 January 2012, 12:00 PM ET

Back to EMS DAM

Attendees

Routes:

Mismatches for our EMS values include

devices
ambiguous terms (nasal and intranasal -- clarify with NEMSIS)
things in SCT missing from FDA (intraosseous)
things not modeled as a route in SCT or FDA (tracheostomy -- would it be considered endotracheal?)
nulls ("other"--we will handle with a null flavor)

Options for devices

Option 1: Use NEMSIS concepts. HL7 model demonstrates sufficient semantic elbow room. Make a NEMSIS a system or add to LOINC.
Option 2: Constrain NEMSIS to routes of administration from FDA
Option 3: Use NEMSIS concepts in interface, but support analysis by modeling semantic structure
1. Option 3a: When EMT selects "endotracheal tube", write SCT code "endotracheal route," and create associated device class in clinical statement model for endotracheal tube
2. Option 3b: When EMT selects "endotracheal tube", write SCT compositional expression "372452007 |endotracheopulmonary route|: 424226004 |using device|=26412008 |endotracheal tube, device|"
3. Option 3c: When EMT selects "endotracheal tube", write NEMSIS code "endotracheal tube." Provide lookup table to expression: "endotracheal route using device = endotracheal tube"

Decisions

NEMSIS confirms a need for device information; we also need to conform to FDA to ensure interoperability.
We will adopt approach 3a using FDA rather than SCT. 3b still an option if we can work out the SCT/FDA issue
Clay and Jay will confirm NEMSIS requirements
Clay, Jorge (NEMSIS), and implementers will confirm technical approach
We still need an approach for intraosseous -- perhaps SCT

DSTU change control and schedule deferred to next meeting, in 2 weeks.

Issue	Description	Resolution	Status
update vocabulary approach document			open
PHIN VADS	reassess plan to publish via PHIN VADS in light of LOINC/NLM/SCT approach		open