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NHCS R1 Comments

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April 13 - 19, 2015 - HL7 Implementation Guide for CDA R2: National Health Care Surveys R1, DSTU US Realm - Available for Comments

An update has been made to the HL7 Implementation Guide for CDA Release 2: National Health Care Surveys Release 1, DSTU US Realm. This update is available to HL7 members here as a DOT release for commenting prior to reconciliation and publication. As a DSTU update, this new version will not go through the usual HL7 balloting process but will use the DSTU Update process with industry review on the HL7 wiki. The full list of changes in this release are documented in the update and can be summarized as follows:

  1. Many templates were versioned due to the versioning of contained templates (see the detailed section “Changes from Previous Version” in Volume 2 of this guide for a detailed view of these changes).
  2. Document-Level Templates. The document-level templates were refactored to report the survey data by setting of visit (inpatient, outpatient and emergency department) rather than by survey as in the previous release. To reflect this organizational change the names of all three document-level templates have changed:
    1. Inpatient Encounter (NHCS-IP) (V2) (was National Ambulatory Medical Care Survey)
    2. Outpatient Encounter (NHCS-OPD, NAMCS, NHAMCS-OPD) (V2) (was National Hospital Ambulatory Medical Care Survey - OPD)
    3. Emergency Department Encounter (NHCS-ED, NHAMCS-ED) (V2) (was National Hospital Ambulatory Medical Care Survey - ED)
  3. Section-Level Templates. Also to reflect the organization change, the related encounters have been split into three sections:
    1. Inpatient Encounters Section
    2. Outpatient Encounters Section (V2) (was Continuity of Care Section)
    3. Emergency Department Encounters Section
  4. Diagnosis Section has been renamed Problems Section to allow problems, symptoms etc. rather than constraining to just Diagnoses.
  5. Two sections-level templates were retired and their contained templates moved into the Emergency Department Encounters Section:
    1. Hospital Admission Section
    2. Observation Unit Stay Section
  6. Entry-Level Templates - The current visit encounter has been split into three specialized encounters:
    1. Current Inpatient Visit
    2. Current Outpatient Visit (V2) (was Current Visit)
    3. Current Emergency Department Visit
  7. Ten new entry-level templates were added:
    1. Admission Priority Observation
    2. Current Inpatient Visit (see above)
    3. Current Emergency Department Visit
    4. Specialty Unit Stay Encounter
    5. Follow-Up Attempt Outcome Observation
    6. Point of Origin Observation
    7. Present on Admission Observation
    8. Admission Diagnosis Observation
    9. Patient's Reason for Visit Observation
    10. Procedure Follow-Up Attempt Observation
  8. Five new value sets were added:
    1. Follow-up Attempt Outcome (NCHS)
    2. Point of Origin (NCHS)
    3. Priority (Type) of Admission or Visit (NCHS)
    4. Specialty Unit Type (NCHS)
    5. Type of clinic/location (NCHS)

During the one week comment period running from April 13 - April 19 2015, please submit your comments below including at least your name, item, existing wording, proposed wording, and comment. Thank you.


Enter your comments below this line by clicking on the Comments (edit) link.

Sarah Gaunt: Filenames and name of IG - need to make sure these are all correct and aligned.

Sarah Gaunt: Volume 1: Acknowledgments: LOINC copyright date needs to be changed from 2013 to 2015

Sarah Gaunt: Volume 1: Extensions to CDA: Needs any new extensions added (any that are approved at the time of publication - there are a few that are going through SD right now which is why I have added this).

Sarah Gaunt: General: Replace value set/ code system placeholder codes and oids with correct codes and oids.

Sarah Gaunt: Volume 1: Update acknowledgments table with proper names/ titles etc.

Sarah Gaunt: Volume 2: Medications: Continued medications - add note to explain how to enter continued medications i.e. low effectiveTime < admission time.

Sarah Gaunt: Volume 2: Discharge Disposition: Split disposition into three value sets - one for inpatient and one for outpatient and one for ED.

Resolution: We will make all of the modifications described above.