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Agenda review and Introductions

ODH FHIR ballot recon- Lori

Discussion on v2 Vital Records death reporting IG- Mead

Discussion items

5 minAgenda review and introductionsLaura
40 minODH FHIR ballot reconLori


16- persuasive

Create descriptions that specifically reference occupation and update the LOINC description.

17- Persuasive

Issues with lack of specificity. To the extent that we can we will offer some additional clarification or better descriptions. Will try to go through a document where there are annoying pieces of generic text, or lack of descriptive text. Will review generic text and inset more relevant descriptions as able.


19- Not persuasive.

In the OccupationalDataFor HealthModel, there is only one section. There is no way to put content anything other than a section. This an artifact of the logical modelling approach used. Simplifying make it easier to id and but is not wrong. There is now way to put content in anything other than a section. At least one section needs to be defined in order to use the composition resource.


18- Persuasive

Section name change. Replace current OccupationalDataSummary” with odh-OccupationalDataSectionModel

There needs to be description for OccupationalDataSectionModel. NIOSH will provide updated definition language for the overall definition model.


20- Persuasive

NIOSH will provide an updated definition for OccupationalDataforHealth.


21-Considered-question answered

It is believed that this logical model is appropriate.


35- Persuasive

Suggesting to use a different definition as proposed. Will change as recommended.


38- Persuasive with mod

This was a question. ODH is not designed to support billing activities. Would this be linked to workman’s comp? This should be in the clinical portion of the record not the administrative. Could this sentence just not be pulled out? There was concern that some of this information could have negative effect on a person’s employment. Will update wording: While other uses of this model are not precluded… the model is not designed for other purposes, but could be used for other purposes if they are supported by this model.


40 & 41- Non persuasive

Because industry and occupation are always managed together and would never be handled separately they would need to be related appropriately. Industry is bound to occupation. Industry should be subordinate to occupation in both cases.


Motion- Lori moves to accept all comments as dispositioned.

Second- Mark



For- 12

35 minDiscussion on v2 Vital Records death reporting IGMead 


Vital Records Death Report new STU

Attempting to accommodate newly found requirements. Were trying to make the January ballot but was unsuccessful. Now trying to go to May ballot.

  • Expanding Scope
    • Introduce medical examiners and funeral directors as actors
    • The EDRS (electronic death reporting system) needs to be accommodated
    • Now multiple actors can provide portions of the death report, these need to be coordinated.
    • Therefore new exchanges:
      • Immediate death report
      • Case ID assignment
  • Currently the model uses ADT transactions to support the various communications. (A04, A08, A11)
  • Content preview
    • Intro- the usual
    • Message Components- Added to explain additions from NIST
    • Use Cases- provides more detail of the exchanges taking place
    • Message Infrastructure- Where you get the stuff, including data fields, vocab, conformance constraints
    • Notable features-
      • Flavors: Can be applied to data types and to segments; defined in the profiles
        • Allows for constraints on field components, segments, value set bindings
        • There constraints on all segments included in the IG
    • Profile composition: A conformance profile plus one more profile components
      • Need to address vocabulary requirement; the only way to specify the use of a specific value set is at the segment level, not a conformance profile level.
      • Profile component bound to observation and identifier type value sets
      • Some use cases may be supported by composite profiles vs conformance profiles
      • You can define co-constraints in NIST for observations. Wanted to create one definition for the observations to be more manageable, and then will bind the different observations to different value sets in a composite profile.
      • After IGAMT- reading the IG (Implementation Guide Authoring and Management Tool) **Unfortunately IGAMT is managed by NIST that is currently shut down with the feds.
        • IGAMT:
          • Provides integrity checks- The coordination with the testing tool allows you to find mistakes in your specification as well as in your test messages
          • Integrates with a testing tool for QA
          • Generates a text document for the ballot- hard to read, long
  • Store value sets in PHIN VADS
    • Helpful for reuse
    • Allows vocabulary updates without republishing
    • PHIN VADS views support download of all value sets by implementers
    • For the ballot package, will include the content of the PHIN VADS view in the package so the reader can see what’s in the value set.
  • Submitting a change to PHIN VADS may take a few days. NIST gets a download nightly from PHIN VADS which may introduce some delays. NIST doesn’t really have a test environment and production environment, which also may add delays.
  • Project itself:
    • Currently has an active PSS
    • Will need to submit a NIB, deadline looming (Feb 17th)
    • Notice needs to be submitted by a co-chair
    • Will be balloting as an STU
    • CDA guide will eventually be updated to include the same stuff
    • For funeral director implementations, FHIR (RESTFul APIs) will likely be more light weight
    • There are people working on FHIR death reporting….

Action items