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Facilitator:

Austin Kreisler hour 1, Gay Dolin hour 2


Date:


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Agenda:


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10:00am EST

  1. Call to order 
    1. Call for Attendance


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      1. Please click the "Sign In" button at the top of the Agenda Page for today's meeting. Once you have signed in, it will indicate you have already signed in and place your name in the Attendees drop down list.


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  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Approve minutes from

      Handy Tip
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      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."

      2020-07-16 Agenda and Minutes

    3. HL7
  3. External Updates - ONC and others
  4. Project Updates
    1. Value Set Issues

      1. see 11:00am
    2. Provenance
    3. PACP Publication Package (Lisa R. Nelson)
    4. Procedure STU Comment 1997 Proposal (Gay Dolin Nick Radov)
  5. Additional Items
    1. Sept. WGM Meeting Scheduling
  6. STU Comments
    1.  Matt Szczepankiewicz(25min) (expand HL7 CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes Companion Guide, Release 2 STU - US Realm 

    2. STU

      Last Update

      Commenter

      Comment

      1983   

       

      Order fulfillment conformance statement that are contradictory

       

      Appendix C has a constraint with root, extension and NULL of UNK

       

      The Provenance entry in the Appendix C is inconsistent with the author entry in the C-CDAr2.1 IG in terms of allowable values and it is misleading.

       

      For the UDI information, can we get clarification on whether it is possible to send other information when we do not have the DI information?

       

      Appendix B UDI
      1.1 UDI Organizer 

      Figure 1: Unique Device Identifier (UDI) Organizer Template ID root is incorrect

       

      (Vocab issue)
      Table 9 of the Companion Guide recommends the LOINC codes 11502-2 for Laboratory Narrative notes and 11526-1 for Pathology Narrative notes. However, these codes aren't actually included in the Note Types value set (urn:oid:2.16.840.1.113883.11.20.9.68) as required by the Notes Section and Note Activity templates in Appendix A. Likewise, although no specific LOINC code is recommended for Imaging Narrative notes, the value set doesn't include any codes from the value set recommended for imaging notes in Table 8 (urn:oid:1.3.6.1.4.1.12009.10.2.5).

       

      In Appendix C, I read the Provenance - Author Participation template as saying you can use the same trick as in the standard C-CDA Author Participation template to reference an author already defined elsewhere in the document:

      The assignedAuthor/id may be set equal to (a pointer to) an id on a participant elsewhere in the document (header or entries) or a new author participant can be described here.

      That is, that it's okay to do this:

      <assignedAuthor>
      <id extension="1386639318" root="2.16.840.1.113883.4.6" />
      </assignedAuthor>

      assuming the document actually contains a full entry for the author with that id somewhere else.

      But when an author containing the Provenance - Author Participation templateId does this, it raises a handful of schematron errors that still enforce the SHALL constraint on the representedOrganization (CONF:4440-4 and children):

       

      The following unimplemented constraints use the expression "not(.)" throughout the main Companion Guide schematron file:

      CONF:3250-16902
      CONF:3250-16912
      CONF:3250-16914
      CONF:4435-133
      CONF:3250-16942

      Typically unimplemented constraints use a dummy expression like "not(tested)" that always returns false (since the current element doesn't have a child named "tested"), but in this case, we're asserting that the current node is null, which returns false, makes the assertion fail, and triggers a false positive schematron error.


11:00am EST

  1. Value Set Updates
  2. Value Set STU Comments
    1. STU Comments #2014 and #2015 (LNelson)
      1. http://www.hl7.org/dstucomments/showdetail_comment.cfm?commentid=2014
      2. http://www.hl7.org/dstucomments/showdetail_comment.cfm?commentid=2015
  3. Adjournment


Notes/Minutes:


  1. Call to order 
    1. Call for Attendance

  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Approve minutes from, committee approved minutes below.

      2020-07-16 Agenda and Minutes 

    3. HL7
  3. External Updates - ONC and others - Matt the Tech Forum 10-11 Aug. come if you can. Go to https://www.onctechforum.com/ 
  4. Project Updates
    1. Value Set Issues

      1. see 11:00am
    2. Provenance - n/a
    3. PACP Publication Package (Lisa R. Nelson)  Lisa ran through the materials in the publication package materials.  Lisa shared some materials from the Personal Advanced Care Plan document. It was published as an STU release 2, as there were some substantive changes needed in the reconciliation work. She highlighted some of the substantive changes, i.e. Assembler Participant, restricting of the value sets for entry templates.  Higher expectations for narrative text linking. New templates for priorities. The value sets have been revised to account for work occurring within the industry.  There is a tight coupling between narrative the entries. Other revisions were also reviewed.
    4. Procedure STU Comment 1997 Proposal (Gay Dolin Nick Radov) There is an issues that has been found in the Narrative related to Procedure Effective time.  The narrative including historical and current ...
      1. Gay shared the solution (STU Comment #1997) and revised the disposition to ensure historical and current procedures could be modeled
      2. Gay made a motion to do "all of the above outlined in Disposition  in #1997".  Second by Calvin - Vote approve: 25  opposed: 0 Abstain: 0 
      3. Motion to reopen #1997 was approved by the committee.
      4. Gay moved to add the '@ value  reference to the previous item, second by Ben. 
  5. Additional Items
    1. Sept. WGM Meeting Scheduling - Discussion by Austin about the working group meeting - Monday 21 Sept - Friday 25 Sept - 2 hour blocks across the week over the 24 hour period.
      1. Thursday 10 AM
      2. Thursday 12 Noon
      3. 2 hours at other times,
      4. Patient Care, Vocabulary , PIE and FM have interest for meetings
  6. STU Comments
    1.  Matt Szczepankiewicz(25min) (expand HL7 CDA® R2 Implementation Guide: C-CDA Templates for Clinical Notes Companion Guide, Release 2 STU - US Realm 

    2. STU

      Last Update

      Commenter

      Comment

      1983   

       

      Order fulfillment conformance statement that are contradictory

      Matt - Orders Fulfilled in the InfullfillmentOf area of the header.   We will look at this next week.

       

      Appendix C has a constraint with root, extension and NULL of UNK

       

      The Provenance entry in the Appendix C is inconsistent with the author entry in the C-CDAr2.1 IG in terms of allowable values and it is misleading.

       

      For the UDI information, can we get clarification on whether it is possible to send other information when we do not have the DI information?

       

      Appendix B UDI
      1.1 UDI Organizer 

      Figure 1: Unique Device Identifier (UDI) Organizer Template ID root is incorrect

       

      (Vocab issue)
      Table 9 of the Companion Guide recommends the LOINC codes 11502-2 for Laboratory Narrative notes and 11526-1 for Pathology Narrative notes. However, these codes aren't actually included in the Note Types value set (urn:oid:2.16.840.1.113883.11.20.9.68) as required by the Notes Section and Note Activity templates in Appendix A. Likewise, although no specific LOINC code is recommended for Imaging Narrative notes, the value set doesn't include any codes from the value set recommended for imaging notes in Table 8 (urn:oid:1.3.6.1.4.1.12009.10.2.5).

       

      In Appendix C, I read the Provenance - Author Participation template as saying you can use the same trick as in the standard C-CDA Author Participation template to reference an author already defined elsewhere in the document:

      The assignedAuthor/id may be set equal to (a pointer to) an id on a participant elsewhere in the document (header or entries) or a new author participant can be described here.

      That is, that it's okay to do this:

      <assignedAuthor>
      <id extension="1386639318" root="2.16.840.1.113883.4.6" />
      </assignedAuthor>

      assuming the document actually contains a full entry for the author with that id somewhere else.

      But when an author containing the Provenance - Author Participation templateId does this, it raises a handful of schematron errors that still enforce the SHALL constraint on the representedOrganization (CONF:4440-4 and children):

       

      The following unimplemented constraints use the expression "not(.)" throughout the main Companion Guide schematron file:

      CONF:3250-16902
      CONF:3250-16912
      CONF:3250-16914
      CONF:4435-133
      CONF:3250-16942

      Typically unimplemented constraints use a dummy expression like "not(tested)" that always returns false (since the current element doesn't have a child named "tested"), but in this case, we're asserting that the current node is null, which returns false, makes the assertion fail, and triggers a false positive schematron error.


11:00am EST

  1. Value Set Updates
  2. Value Set STU Comments
    1. STU Comments #2014 and #2015 (LNelson)
      1. http://www.hl7.org/dstucomments/showdetail_comment.cfm?commentid=2014
      2. http://www.hl7.org/dstucomments/showdetail_comment.cfm?commentid=2015
    2. Message

      Re: #2014 The C-CDA R2.1 Companion Guide identifies 2.16.840.1.113883.11.20.9.68 as the value set to reference for clinical note types at the section and activity level. However, some of the codes referenced in the Companion Guide are not included in this value set. ? Laboratory (11502-2) ? Pathology (11526-1) ? Diagnostic Imaging (18748-4) Can you please confirm that these are the correct codes to use for the note types identified by USCDI? We need to discuss with Rob M on why the exclusion criteria is needed.  It seems to exclude these codes.
    3. Re: 2015 - add a dynamic binding for Notes Section codes.   Motion to approve Lisa to accept disposition #2015 , Second Matt  Opposed: 0 Abstain: 0 Approve: 13 Motion passed
  3. Adjournment

 


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