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Date: 9/24/2020

Quarter: 12:00 - 13:30

Chair : Laura Rappleye

Scribe: Craig Newman

Minutes Approved as Presented 

This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."


Set goals, objectives or some context for this meeting.

Discussion items


Birth Defect Reporting DAM Ballot ReconThanh Cheng
  • The birth defects reporting (BDR) DAM was balloted in Sept 2020
  • ~40 comments were returned including a small number of negative votes
  • ballotcomments_HL7_DAM_BD_R1_D1_2020SEP with dispositions (1).xls
  • Block 1 (comments 36 and 37)
    • Related to the definition of "LN" as LOINC
    • Clarification will be added as to the meaning of LN and to better identify when LOINC codes are being used
  • Block 2 (comments 16 and 17)
    • Related to the responsible party
    • Clarification will be added to better define the attributes of the responsible party
  • Block 3 (comments 3 and 4)
    • Related to harmonizing with the existing FHIR profiles
    • Harmonization with FHIR profiles will happen as part of the development of a FHIR IG based on the BDR DAM
  • Block 4 (comments 9, 11 and 15)
    • Related to workflow considerations
    • Clarification will be added that BDR can apply to non-newborns and that the reports can be made on older individuals (depends on the reporting scope of the jurisdiction)
    • Clarification will be added to indicate that the implementation specifics are out of scope for the DAM
      • The FHIR IG does include uses for both birth location reporting and non-birthing location reporting and the data expectations)
  • Block 5 (comments 20 and 21)
    • Related to the inclusion of multiple birth defect for a single patient
    • Clarification will be added to indicate that multiple defects can be part of 1 report
    • Clarification will also be added to indicate that the report "entity" is the patient
  • Motion to accept the dispositions for blocks 1 through 5 as documented (Thanh Cheng/Erin Holt Coyne) 8-0-0
  • Comments from Nosipho Beaufort
    • Comment 22
      • Persuasive with Mod - Project team will check with Laura Pabst to see how CDC should be acknowledged
    • Comment 23
      • Persuasive with Mod - Clarification will be added that BDR can apply to non-newborns and that the reports can be made on older individuals (depends on the reporting scope of the jurisdiction)
    • Comment 24
      • Non-persuasive - Laterality is already in the DAM
    • Comment 25
      • Question Answered - Will be considered for the FHIR IG (there is a proposal to create a standard extension for this) but we will leave it out of the DAM as the total number of births in a delivery is not an attribute of the subject (but rather the pregnancy/delivery)
    • Comment 26
      • Question Answered - race is inherited from the parent class
    • Comment 27
      • Persuasive with Mod - the status of the test result in terms of including or excluding them as part of the report (ie. it's an implementation scope decision as to whether or not partial or prelim results are reported) but we will add a status attribute to the DAM
    • Comment 28
      • Persuasive - BMI will be removed from the DAM as it can be calculated from other observations
    • Comment 29
      • Question Answered - the cardinality of the attribute indicates if it exists, not if it will always be known (ie, the child will always have a height/length even though it may not always be known)
    • Comment 32
      • Persuasive with Mod - clarification will be added to describe abstractor as on of the Public Health staff roles
    • Comment 33
      • Question Answered - the DAM is agnostic of any systems implementing BDR
    • Motion to accept dispositions as discussed for comments 22, 23, 24, 25, 26, 27, 28, 29, 32 and 33 (Craig Newman/Erin Holt Coyne) 8-0-0
  • Negative comments
    • Comment 12
      • Persuasive with Mod - Add clarification to class 4.11 to indicate the "mother" is the woman who carried the child and is giving birth. We will note that not all women in this role will prefer the term "mother"
    • Comments 13
      • Not persuasive - BDR is not limited to newborns and so some subjects may have a language proficiency, thus the cardinality is 0..*
    • Comment 14
      • Not persuasive - the DAM is agnostic how data is stored in the EHR and doesn't place any constraints on how systems store data
      • Motion to accept dispositions as discussed for comments 12, 13 and 14 (Craig Newman/Mike Yaskanin) 8-0-0
  • Other comments
    • Comment 1
      • Considered for Future Use - we will work with the VR DAM authors and other FHIR IG authors to harmonize the use of autopsy related LOINC codes
    • Comment 2
      • Persuasive with Mod - the cardinality will be changed from 1..* to 0..* and work with the VR DAM authors to harmonize
    • Comment 7
      • Persuasive - the LOINC code will be updated
    • Comment 8
      • Considered for Future Use - there currently isn't a program requirement to report procedures performed outside the birthing event. We can add this if the need arises in the community
    • Comment 10
      • Persuasive - clarification will be added that the definition of reportable birth defects varies by location
    • Motion to accept dispositions as discussed for comments 1, 2, 7, 8 and 10 (Craig Newman/Mike Yaskanin) 8-0-0

Action items