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Act in DEF Mood

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Introduction

Various challenges with using DEV (or EVN.CRT) mood have been identified. These are detailed here: http://wiki.hl7.org/images/d/d1/EMeasureMNMPresentation_17July2009.pdf

Defining the Issue

(From M&M discussions Q2 in Atlanta, and others)

DEF and CRT mood are not usable as Mood Codes because the usual rules around the meaning of participations and Act attributes inevitably lead to conflict. For example, as things presently stand:

  • How do I DEF a test that can only be ordered by an RN? I cannot since I cannot use other mood codes, and the author is the one who authored the definition.
  • How do I create a CRT for a class in "INT" mood? I cannot unless I add a new mood INT.CRT.
  • How do I specify a DEF for an ACT that should be created in "suspended" status? I cannot since status belongs to the DEF, unless I create a second status attribute, as GS suggests below.
  • If there is a need for both EVN.CRT and CRT, is there not also a need for everyOtherMoodCode.CRT? Probably

Recommendations

[1] Document characteristic attributes: Current thinking is to assume that in EVN.CRT mood, no properties are documentation characteristic. Gunther suggests that we may need to split Act.statusCode into an Act.actStatusCode and an Act.recordStatusCode.

[2] Vocabulary binding: Current thinking is to include a local code, which in the local code system reflects a value set.