Clinical Statement OO RMIM Review

Clinical Statement Review of Measured Observation RMIM (POOO_RM410000UV) Rik Smithies 08-Feb-2007

Parent	Element	Attribute	CS Equivalent	Issue	Recommendation
EventChoice	Component4	priorityNumber	sourceOf2	Attribute not present in CS	Consider adding to CS ?
AnnotationIndicator	(self)	.	Act	Too few attributes, missing code.	Review purpose of AnnotationIndicator. This act and actRef has all fields mandatory and fixed. There's no optionality at all within structure, hence it’s basically a boolean flag. There are other ways to model this perhaps.
AnnotationIndicator	subjectOf5	subsetCode	sourceOf2	Attribute not present in CS	Review purpose of AnnotationIndicator
Annotation	(self)	reasonCode	Act	Attribute not present in CS	Review RMIM. Use Act.code to include the reason ?
Annotation	author	contextControlCode	(same)	Attribute missing from RMIM	Add to RMIM
Annotation	dataEnterer	contextControlCode	(same)	Attribute missing from RMIM	Add to RMIM
Consent	.	.	.	CMET incompatible	Ideally Consent acts would be CS conformant but this CMET has several issues. Alternative is to declare consent out of scope of CS. However it uses participations and roles that you would expect to fit properly with CS, yet in an non-CS way. Possible way forward is to add the Consent CMET to CS.
Consent	responsibleParty	noteText, time, signatureCode, signatureText	.	Attribute not present in CS	.
Consent	performer	noteText, signatureCode, signatureText	.	Attribute not present in CS	.
Consent	R_ResponsibleParty	.	.	CS has only assignedEntity, which is very different, class code mismatch, ASSIGNED vs AGENT	Not easy to align this with CS. Closest in CS is to use RelatedEntity instead (currently there but not connected to RESP). But even this isnt a good fit.
ActRequest	author	.	ActReference	Not allowed to have an author on an actReference.	If this is a true act reference then the author is found by de-referencing the act ref. There is no other information in the actRequest that can be used unless the act ref is followed. So unless the purpose of this act ref is purely to allow the author to be shown (in which case it should be 1..1) it can be removed.
EventChoice	indirectTarget	typeCode=IND	.	Not allowed in CS. This is only a subtype of top level PART, so none of the CS participations can accommodate this.	What is this for in model ?
EventChoice	custodian1, custodian2	typeCode=CST	.	Not allowed in CS. This is only a subtype of top level PART, so none of the CS participations can accommodate this.	Consider adding to CS ? Not obvious how a service delivery location can be a custodian (custodian1).
location	R_ServiceDeliveryLocation	.	HealthCareFacility	R_ServiceDeliveryLocation is much richer	Consider replacing HealthCareFacility with the R_ServiceDeliveryLocation CMET. CS isnt in the business of defining this kind of thing, and anyone using the standard CMET will be non-conformant unless we expand the model.