Health Condition List

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Project Summary

Concern Tracking and Care statements provide a framework for tracking and managing health concerns, however there are many undefined relationships and representations that remain to be defined. Issues identified include.

• Standard representation of how observations should be characterized (eg diagnosis vs problem)
• Standard representation of distinction and linkage between provider roles in problem lists (eg nursing problems vs physician problems).
• Standard representation of common attributes about a problem (eg clinical status, problem severity, etc)
• Methods for adding diagnosis specific attributes (eg Cancer Stage, CHF Class,...)
• Correct representation of problem modifiers and negation. (eg rule out MI, or history of MI vs AMI)
• List maintenance issues in messaging. (eg send full list including history, send full list, but no history, only send updates for a concern)
• Correct relationships terms for episode links and sub-concerns.
  • Multiple Related Episodes
    • Repeated Acute problems (eg, 2 bouts of community acquired pneumonia)
    • For exacerbations and remissions (eg, chronic asthma with multiple acute exacerbations )
  • Different levels of Granularity (eg, internist calls "CAD s/p CABG", cardiologist calls "2 vessel disease with LIMA to mid LAD, SVG to RCA")
  • Causality
    • Assumed in Term (eg Gestational Diabetes <- Pregnancy )
    • Manually Asserted (eg Diabetes & ESRD)
    • Therapy related (GI bleed while on Coumadin for Afib)
  • Others??

Artifacts and related modeling

• ISO 18104
• ISO 22789
• ISO 13940
• CCD
• HITSP IS C32
• The TermInfo Ballot Draft

todo:

• add related articles
• links/pointers to info from campbell, chute, elkin, va, terminfo

Implementors

Canada Infoway

Participants

• Larry McKnight
• John Kufuor-Boakye
• Jim Campbell
• Tom Oniki
• Bob Dolin
•  ? Kevin Coonan

Meetings/T-Conn's

The discussion from the list is deferred to this spot.

Project Committee Overlaps and Dependency

• Orders and Observations
• Structured Doc
• Term Info
• M&M