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  • Agenda review = II declined
  • valueAttachment
    • Cerner had implemented this for lab for referral studies to attach the lab report pdf for genomics reports or flowcytology studies
    • Are extensions version specific? It will probably propagate to later versions, for pre-adoption is allowed, but would be considered custom for those versions, but at least it is standardizes
    • If it is all transcribed would be diagnosticReport.presentedForm – what if only partial or no extraction; shouldn't it still be in the same spot, because you could manually abstract and add or the lab could already have sent you the discrete data
    • Example: https://files.labcorp.com/testmenu/480260.pdf
    • Normally diagnosticReport has several observations
    • Data absent reason – could we add a value to the valueset there to indicate to refer to presentedForm element
    • We may still need valueAttachment for graphs produced by instruments
    • Labs think of the pdf as a result – in V2.x this is ED datatype in OBX-5
    • Describe the use cases:
      • Graph off instrument
      • Pdf of referral lab test that ONLY has pdf scan
      • Pdf with additional discrete results that are also in the pdf, but are provided by the sender
      • Pdf has been sent without discrete result and it is being forwarded
    • Media/DocRef:
      • They have been merged – see report on Minutes Aug 29 minutes – ADD linkon OO Main Call Notes August 29, 2019
      • Align status between documentReference and diagnosticReport
      • Diag: ADD ALL Values here Registered / partial / prelim
      • DocStatus: is missing appended, registered (not sure that would apply to documents), partial, unknown, canceled / corrected
      • As a recipient of document how do you treat unknown status
      • Should documentReference be renamed, since it now objectReference
      • Do we want to rename docStatus
      • Difference in category value set between these 2 as well – is often used to decide routing; not comparable – LOINC being used here, but it seemed you cannot rely on the mapping to this code that was not specifically designed for this. Category repeats, so could create more than 1 hierarchy so you can identify the type as well as the domain where it is used
      • UScore DiagnosticReport extension – add the LINK?!?!
      • Examples diagnosticReport urinalysis JSON
        • Reference should be to the ID of the observation not the "organization/urine-color" and it should not have the display there
        • Reference display is just to help give an idea of what resources are being referenced in the example report - it would be nice to have an example that has ALL the parts of the diagnostic report available to better understand the relationship between all the referenced resources
        • Using the = negative as part of the display section is misleading that the reference could identify the test and display the result
      • Adjourned 4:51 PM EDT

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