IDDate CreatedLast UpdatedCommentorGroupingExisting WordingProposed WordingProposed DispositionProposed Disposition CommentVote
16789/29/20189/29/2018Gaunt, SarahBlock Vote 201902211.1.1.2 recordTarget "...This patient SHALL contain exactly one [1..1] birthTime (CONF:1098-5298). SHALL be precise to year (CONF:1098-5299). b. SHOULD be precise to day (CONF:1098-5300). For cases where information about newborn's time of birth needs to be captured. c. MAY be precise to the minute (CONF:1098-32418)."Alignment needed - Seems inconsistent with 2015 ONC Requirement: date of birth constraint— (i) The year, month and day of birth must be present for a date of birth. The technology must include a null value when the date of birth is unknown. --- the spec indicates that day is not required, and there is no provision for unknown."Referred and tracked.SD has voted on this issue and the Schematron will be updated to allow nullFlavor. We will leave the constraint as it is in the NHCS IG, which further constrains the C-CDA by saying SHOULD be precise to month if day is not availableSarah/Craig 7-0-1
16779/29/20189/29/2018Gaunt, SarahBlock Vote 201902211.1.3.4 performer, 1.1.5.3 performer, 1.1.9.3 performer While NPI is indicated in all examples, there does not appear to be a requirement that the id is populated with NPINot persuasiveThere is a constraint on the C-CDA US Realm Header on performer/assignedEntity/id that says: "The performer, if present, SHALL contain exactly one [1..1] assignedEntity (CONF:1098-14841). a. This assignedEntity SHALL contain at least one [1..*] id (CONF:1098-14846). i. Such ids SHOULD contain zero or one [0..1] @root="2.16.840.1.113883.4.6" National Provider Identifier (CONF:1098-14847)." This constraint is inherited by the NHCS document-level templates and we consider it sufficient to keep aligned with C-CDA rather than further constraining this data element.Sarah/Craig 7-0-1
16769/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.41 Planned Immunization Activity Review any constraints to C-CDA - do we need any updates to better align?PersuasiveWill use Immunization Section as suggestedSarah/Craig 7-0-1
16759/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.42 Planned Medication Activity (V2) Look into using the C-CDA 3.20 Discharge Medication (V2) ?[act: identifier urn:hl7ii:2.16.840.1.113883.10.20.22.4.35:2014-06-09 (open)]PersuasiveWill add Discharge Medication to the Medications Section to use instead of Planned Medication Activity for the Discharge Rx data element. Planned Medication Activity will still be used for planned medications other than the Discharge Rx ones.Sarah/Craig 7-0-1
16749/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.51.3 Injury or Poisoning Observation (V2) It is possible to derive this from codes - review if modelled approach is needed for intentPersuasive with modRemove Injury or Poisoning Observation template and use the base template (Problem Observation) instead. Insert an informational note in the IG that NCHS is looking for coded values (ICD-10 or SNOMED-CT) to reflect injury or poisoning the in the problem list.Sarah/Craig 7-0-1
16739/29/20189/29/2018Gaunt, SarahBlock Vote 20190221Mapping Spreadsheet: Historical Labs //observation[templateId/@root="2.16.840.1.113883.10.20.22.4.2"][templateId/@extension="2014-06-09"]/code/@displayNameupdate mapping to reflect 'code' not the displayName (remove /@displayName)PersuasiveRemove displayName from mappingSarah/Craig 7-0-1
16729/29/20189/29/2018Gaunt, SarahEmail LF3.17.3 Current Outpatient Visit (V3) ...To indicate whether this is an initial or follow-up visit use the Episode of Care template. Information about follow-up after surgery is contained in the Procedure Follow-up Attempt Observation template.Is this similar to the New Patient Act question? If so, can find via various coding systems. Need to provide guidance in getting this out of the Services and Procedures Section Episode of Care is captured in C-CDA; the follow-up visit info can be found there
16719/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.9 Clinical Note and External Document Reference Verify that this approach is aligned with current C-CDA modeling - look into Notes.PersuasiveRoll back to External Document Reference (C-CDA template) and add Note Activity template.Sarah/Craig 7-0-1
16709/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.34 New Patient Act Review data needs and assess impact (OPE)PersuasiveWill remove this template. Will add guidance to the services and procedures section to record/document if the encounter is a new patient intake. If CPT E&M codes are readily avaiable/used in the EHR, the code for new patient visit should/can be used. Will add a CPT E&M code New Patient example for clarification.Sarah/Craig 7-0-1
16699/29/20189/29/2018Gaunt, SarahBlock Vote 201902212.7 Services and Procedures Section The templates in this section are based on C-CDA templates. Consider removing these templates and using the base C-CDA templates instead.PersuasiveWill roll-back to the base C-CDA templates. The main reason for creating further constrained templates in the previous version of the IG was to give guidance on using local codes, we consider that a few years down the track, the need to use local codes is not so important due to the wider use of standard terminologies. (Rolling back to the base C-CDA templates will not preclude the use of local codes, this guidance just won't be in the actual template). Will add guidance in the mapping document.Sarah/Craig 7-0-1
16689/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.69 Vital Sign Observation (V2) Table 298: Vital Sign Result Align with ONC 2015 requirements: (A) The patient’s diastolic blood pressure, systolic blood pressure, body height, body weight, heart rate, respiratory rate, body temperature, pulse oximetry, and inhaled oxygen concentration must be exchanged in numerical values only; Add Inhaled Oxygen ConcentrationPersuasive with modWe cannot change the description in the C-CDA template (which has a list of common vital signs) but we will add guidance that align with the ONC 2015 requirements list in Volume 1. We will also ensure that all the data elements from the ONC requirements are listed in the mapping table with the correct mapping.Sarah/Craig 7-0-1
16679/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.48 Pregnancy Observation Update pregnancy modelling to reflect new approaches specified by the new Supplemental C-CDA Templates for Pregnancy IG when it is published.Persuasive3.48 Pregnancy Observation Update pregnancy modelling to reflect new approaches specified by the new Supplemental C-CDA Templates for Pregnancy IG when it is published. (Will be published in time for this IG to go to ballot in May).Sarah/Craig 7-0-1
16669/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.48 Pregnancy Observation Update pregnancy modelling to reflect new approaches specified by the new Supplemental C-CDA Templates for Pregnancy IG when it is published.Not persuasive with modRemove the Present on Admission Observation. Present on admission can be found by checking the date of the Problem against the admission dateSarah/Craig 7-0-1
16659/29/20189/29/2018Gaunt, SarahEmail LF3.51.2 Adverse Effect of Medical Treatment Review modelling - is there a place in CCDA that already covers this concept? (e.g. Allergies and Intolerances Section (entries required) (V3) [section: identifier urn:hl7ii:2.16.840.1.113883.10.20.22.2.6.1:2015-08-01 (open)])
16649/29/20189/29/2018Gaunt, SarahEmail LF3.51.5 Primary Diagnosis Observation (V2) This template represents the primary diagnosis. If no other means of determination is possible, use first listed diagnosis as the primary diagnosis.Add better guidance for how to determine 'primary': review HL7 perspective on primary diagnosis; align with HL7 approach(es) if already in use (priority preference?) Add better guidance for how to determine 'primary' want to give guidance on getting the diagnoses from Reason For Visit if the primary dx is not available.Persuasive with mod (still working on)Consulted with SD/PC about this issue. They were of the opinion that the modeling is currect, but that the LOINC code was incorrect and that we should request a new code from LOINC for "Primary Diagnosis" (currently using "Principal Diagnosis" code). We will: 1. Request a new code from LOINC for "Primary Diagnosis" and use this code instead in the template 2. Insert an infomational note stating that if the primary diagnosis is available (for example from an HIM professional from a finalized encounter), that should be used. If not, use NULL for primary diagnosis and get full list of diagnoses. The 1st listed diagnosis is only acceptable IF it is ordered using Dx Priority (sequence number). (Question for LF: Where is this sequenceNumber coming from? There isn't a sequenceNumber used around problems/diagnoses in C-CDA that I'm aware of...)
16639/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.49 Present on Admission Observation This template represents whether or not the containing diagnosis was present on admission (POA). If this fact is unknown use nullFlavor="UNK".Inpatient is the only setting that needs this - add language Required for IP (NA for OPE, EDE)Not persuasive with modNo longer an issue - we will remove the Present on Admission Observation. Present on admission can be found by checking the date of the Problem against the admission dateSarah/Craig 7-0-1
16629/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.51.6 Problem/Diagnosis/Symptom/Condition Observation (V2) This template is based on C-CDA Problem Observation. Review to make sure that the implied template is still needed. Reason for new template is the presence of the Present on Admission template - can this data be collected using dates? If this template is kept, need to update the wording/Schematron to reflect that Present on Admission is only required for Inpatient document type.PersuasiveRoll-back to base template (C-CDA Problem Observation). The only reason this template was further constrained was to explicitly add the Present on Admission template. We are removing the Present on Admission template and getting this information from dates, thus can roll this template back to the base.Sarah/Craig 7-0-1
16619/29/20189/29/2018Gaunt, SarahBlock Vote 201902213.51.1 Admission Diagnosis Observation Why not use the CCDA Admission diagnosis: (see Hospital Admission Diagnosis (V3) [act: identifier urn:hl7ii:2.16.840.1.113883.10.20.22.4.34:2015-08-01 (open)])?PersuasiveWill use the C-CDA Admission Diagnosis template as suggested.Sarah/Craig 7-0-1
16609/29/20189/29/2018Gaunt, SarahBlock Vote 201902216 VALUE SETS IN THIS GUIDE There are multiple value sets used for discharge disposition for the different document types - NCHS will review and possibly update these.PersuasiveThe current value set for discharge disposition (NCHS) in the IG is a subset of a larger value set. We will update to the larger value set for discharge disposition. PHINVADS: value set: 2.16.840.1.114222.4.11.915 https://phinvads.cdc.gov/vads/ViewValueSet.action?id=29D34BBC-617F-DD11-B38D-00188B398520 Sarah/Craig 7-0-1
16599/29/20189/29/2018Gaunt, SarahBlock Vote 201902212.2.2 Inpatient Encounters Section (V2) "MAY contain zero or more [0..*] entry (CONF:3256-1064) such that it a. SHALL contain exactly one [1..1] Specialty Unit Stay Encounter (identifier: urn:hl7ii:2.16.840.1.113883.10.20.34.3.38:2015-04-01) (CONF:3256-1065).""SHOULD contain zero or more [0..*] entry (CONF:3256-1064) such that it a. SHALL contain exactly one [1..1] Specialty Unit Stay Encounter (identifier: urn:hl7ii:2.16.840.1.113883.10.20.34.3.38:2015-04-01) (CONF:3256-1065)."PersuasiveWill update as suggestedSarah/Craig 7-0-1
16589/29/20189/29/2018Gaunt, SarahEmail LF3.1 Admission Priority Observation Review modelling of this concept. There may be a concept of admission priority that supports these concept codes.
16579/29/201843372.53296Gaunt, SarahBlock Vote 201902213.45 Point of Origin Observation Review modelling of this concept. There should be a concept of admission source that supports these concept codes (there is one in FHIR - what about CDA?)Not persuasiveC-CDA does not contain this concept.Sarah/Craig 7-0-1
165643372.5315543372.53155Gaunt, SarahBlock Vote 20190221Rename "Encounter Id" to "Encounter Number" in the IG and mapping table.PersuasiveWill rename as suggestedSarah/Craig 7-0-1
165543372.5295243372.52951Gaunt, SarahBlock Vote 201902211.1.9.4 componentOf Consider adding Episode of Care as a data elementNot persuasiveThere is nowhere in componentOf/encompassingEncounter to record this information (follow-up, initial, or unknown)Sarah/Craig 7-0-1
165443372.5268443372.52684Gaunt, SarahBlock Vote 201902211.1.9.4 componentOf Upgrade from MAY to SHALL Ensure that there is an issuing authority to make sure the encounter number is uniquePersuasiveWill update as suggestedSarah/Craig 7-0-1
165343372.5254643372.52619Gaunt, SarahBlock Vote 201902211.1.9.3 performer This is fixed to Primary Care for ambulatory document-type, this needs review and likely needs changing; also review provider taxonomy and consider a smaller subset.PersuasiveThis performer is only SHOULD and it's saying that there SHOULD be one performer that is the Patient's Primary Care provider. It's not saying that there HAS to be one of these, only that one of the performers (and there can be more than one) SHOULD be a Primary Care Provider. We will add another constraint for other types of performer (i.e. the "Primary" performer) to clarify that the Primary Care Provider isn't necessarily the Primary provider in the encounter. Update function code. Will also use "Healthcare Provider Taxonomy" that is in VSAC: https://vsac.nlm.nih.gov/valueset/2.16.840.1.114222.4.11.1066/expansionSarah/Craig 7-0-1
165243372.5231643372.52315Gaunt, SarahBlock Vote 201902213.8 Characteristics of Home Environment This template represents the patient's home environment including, but not limited to, type of residence (trailer, single family home, assisted living), living arrangement (e.g., alone, with parents), and housing status (e.g., evicted, homeless, home owner). ... SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHOULD be selected from ValueSet Residence and Accommodation Type urn:oid:2.16.840.1.113883.11.20.9.49 DYNAMIC (CONF:1098-28823)."The description indicates 3 sets of concepts (type of residence, living arrangement, housing status), but only one concept is reflected as a coded value. The value set (residence and accomodation type 2.16.840.1.113883.11.20.9.49) associated with this value does not reflect these concepts (e.g. cluttered living space, stairs in house, etc) NCHS would like these values: https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.7730"Persuasive with modWill update the value set for the Patient Residence Observation to https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.7730 (is currently https://phinvads.cdc.gov/vads/ViewValueSet.action?oid=2.16.840.1.114222.4.11.7402). Will base the Patient Residence Observation template on the C-CDA template Characteristics of Home Environment.Sarah/Craig 7-0-1
165143372.5227443372.52273Gaunt, SarahBlock Vote 201902211.1.1.2 recordTarget Gender identity is included in ONC 2015 requirements - if this is available for CCDA, we would like to add thisPersuasiveWill add new template (have discussed with SD and PC and there is no current model for this). Will use ONC value set. NOTE: There is some new harmonization work being done around this topic - need to research and reference and alignSarah/Craig 7-0-1
165043372.5223343372.52233Gaunt, SarahBlock Vote 201902211.1.1.2 recordTarget Align with ONC 2015 requirements: Sex is M, F and null unknown; OTH is not allowable for the ONC 2015 latest requirementsPersuasiveUpdate constraint in the National Health Care Surveys (V2) document template on administrativeGender to only allow nullFlavor="UNK"Sarah/Craig 7-0-1
135242873.6605442921.40403Jones, EmmaBlock Vote 20190221Relates to STU Comment 800 – was marked persuasive to relax the constraint from a shall to a should. See - (CONF:3256-1187) - The text, if present, SHALL contain exactly one [1..1] @mediaTypeThis change was not made in the IG found here - http://www.hl7.org/implement/standards/product_brief.cfm?product_id=385Not PersuasiveThe original comment 800 says nothing about conformance statement 3256-1187. The text of the comment seeks additional guidance and clarification for the External Document Reference template. The disposition of comment 800 is Persuasive (changed from Considered on 7/14/2016), with disposition comments “Create a new template that will accept both CDA and other types (such as PDF) of document. Add guidance to template with examples of document types that would be useful.” Additional guidance was added, and an example of including a non-CDA PDF document (using the existing template) was also added. Since it was found that the existing template was usable to fulfill the needs, there was no need to develop an additional template. The complete set of conformance statements relevant to this comment are made within the Implementation Guide release 1.2 on pg 169-170, items 3.9.5 through 3.9.6.a. Prefacing item 3.9.5, the conformance states, “The code represents the type of document. Either a code and/or text description should be used to describe the external document.” The specific statements then go on to state, “ 5. MAY contain zero or one [0..1] code (CONF:3256-1179). 6. MAY contain zero or one [0..1] text (CONF:3256-1185). a. The text, if present, SHALL contain exactly one [1..1] @mediaType (CONF:3256-1187).” In that the prefacing statement carries only a “should” degree of requirement for “either a code and/or a text description”, the concern is already addressed. It is only when a Text description is used to describe the external document that it must contain a @mediaType.Sarah/Craig 7-0-1
135142873.659642873.65959Jones, EmmaWaiting on LF (1660 dispo)STU Comment 924 disposition was persuasive per the NHCS R1.2 Comments. The comments was: Primary Diagnosis Observation (V2) template: - Remove the wording “If no other means of determination is possible, use first listed diagnosis as the primary diagnosis." from the description. - Remove the XML comment "" from the template example and sample files Problems Section (V3) template: - Add the wording “If a primary diagnosis is available, it must be recorded in the Primary Diagnosis Observation. All problems, diagnoses, symptoms and conditions, including the primary diagnosis, must be recorded in the Problem/Diagnosis/Symptom/Condition Observation.” to the description". - Update constraint 3256-74 from “SHALL contain exactly [1..1]” to “SHOULD contain zero or one [0..1]” as follows:These changes were not made in the version of the IG found here - http://www.hl7.org/implement/standards/product_brief.cfm?product_id=385Persuasive with mod (still working on)The disposition of comment 924 was Not Persuasive with Mod. The disposition comment for #924 is “We need to maintain the SHALL since we must have a primary diagnosis. However, for instances when a primary diagnosis is not determined or available, we suggest adding the following guidance text in the IG: If no other means of determination are possible, use first listed Dx as Primary. 8-0-0” and the Version Implemented states “Not Done”. Comment #924 was last updated 5/12/2016. Also see comment about Primary Diagnosis (comment 1664) above. Add extra wording if needed
130342809.6988842809.69888Eckerson, KristiBlock Vote 20190221pg 252, Table 160: Problem Type, Code ... Print Name 3rd entry 75324-4 Diagnosis 6th entry 29308-4 Complaint HL7.CCDAR2 7th entry 75322-8 Functional performance HL7.CCDAR2 Code 75324-4 is a deprecated code signifying Functional Performance. 29308-4 signifies Diagnosis, and 75322-8 signifies Complaint.Code ... Print Name 3rd entry 29308-4 Diagnosis 6th entry 75322-8 Complaint HL7.CCDAR2 7th entry 75276-6 Functional StatusNot relatedThese codes are in a value set that is part of the C-CDA published IG - we cannot change these. Consider making a comment against the C-CDA IGSarah/Craig 7-0-1
17482/12/20192/12/2019Gaunt, SarahBlock Vote 20190221Current IG is based on C-CDA R2.0Update next release of IG to be based on C-CDA R2.1PersuasiveWill update to C-CDA R2.1 as suggestedSarah/Craig 7-0-1
17472/11/20192/11/2019Clifton, MichaelBlock Vote 20190221This section contains medications (other than immunizations) that were ordered, supplied, administered, or continued during this visit. It includes Rx and OTC drugs, allergy shots, oxygen, anesthetics, chemotherapy, and dietary supplements.While systems can record oxygen as medications, under some circumstances oxygen is recorded as a procedure instead. The guidance associated with the NHCS template shouldn't necessarily specify that this needs to be included in this section, but rather that oxygen information should be included generally in the document.PersuasiveWill change wording to "It includes Rx and OTC drugs, allergy shots, oxygen (if recorded as a medication), anesthetics, chemotherapy, and dietary supplements." and also add wording to state that Oxygen can be recorded as a service/procedure.Sarah/Craig 7-0-1
17462/11/20192/11/2019Clifton, MichaelEmail BG/RAThis section contains immunizations that were ordered, supplied, administered, or continued during this visit. A continued immunization has an effectiveTime/low that is less than the encompassingEncounter/effectiveTime/low (date/time of admission/visit/arrival) and a new immunization has an effectiveTime/low that is equal to or greater than the encompassingEncounter/effectiveTime/low.What is the definition of a continued immunization in this context? The IG references "continued" data elements a number of times, but there is no context for what this means in relation to the data.Persuasive (working on this)
17452/11/20192/11/2019Clifton, MichaelSG ResearchThis section contains medications (other than immunizations) that were ordered, supplied, administered, or continued during this visit. It includes Rx and OTC drugs, allergy shots, oxygen, anesthetics, chemotherapy, and dietary supplements.This implementation guide relies on C-CDA templates in a number of areas, but then doesn't leverage it to the degree that it could. For example, the definition of the new Medications section to act as a catch-all medications section diverges from the paradigm of separating out the administered and prescribed medications into specialized medications sections in C-CDA. Considering implementers currently have implementations that separate out medications into the individual sections, the solution for the NHCS template should have an option for recording medication information that more closely aligns to the existing solutions.
17442/11/20192/11/2019Reed-Fourquet, LoriBlock Vote 2019022111. MAY contain zero or more [0..*] reference (CONF:3256-1155). a. The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:3256-1156). b. The reference, if present, SHALL contain exactly one [1..1] Clinical Note and External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.34.3.44:2016-07-01) (CONF:3256-1157).11. SHOULD contain zero or more [0..*] reference (CONF:3256-1155). a. The reference, if present, SHALL contain exactly one [1..1] @typeCode="REFR" Refers to (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:3256-1156). b. The reference, if present, SHALL contain exactly one [1..1] Clinical Note and External Document Reference (identifier: urn:hl7ii:2.16.840.1.113883.10.20.34.3.44:2016-07-01) (CONF:3256-1157). *** comment: often missing in implementation. Consider possible alternate locationsPersuasiveSee comment 1671 regarding the Clinical Note and External Document reference: "Roll back to External Document Reference (C-CDA template) and add Note Activity template."Sarah/Craig 7-0-1
17432/11/20192/11/2019Reed-Fourquet, LoriEmail LF7. MAY contain zero or one [0..1] entryRelationship (CONF:1106-640). a. The entryRelationship, if present, SHALL contain exactly one [1..1] @typeCode="CAUS" (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1106-641). b. The entryRelationship, if present, SHALL contain exactly one [1..1] Cause of Injury, Poisoning, or Adverse Effect (identifier: urn:oid:2.16.840.1.113883.10.20.34.3.27) (CONF:1106-642).7. SHOULD contain zero or one [0..1] entryRelationship (CONF:1106-640). a. The entryRelationship, if present, SHALL contain exactly one [1..1] @typeCode="CAUS" (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:1106-641). b. The entryRelationship, if present, SHALL contain exactly one [1..1] Cause of Injury, Poisoning, or Adverse Effect (identifier: urn:oid:2.16.840.1.113883.10.20.34.3.27) (CONF:1106-642). ***** comment: consider whether there are alternate approaches for collecting this information
17422/11/20192/11/2019Reed-Fourquet, LoriEmail BG/RASHOULD contain zero or one [0..1] sdtc:dischargeDispositionCode, which SHALL be selected from ValueSet Disposition (NCHS) urn:oid:2.16.840.1.114222.4.11.7436 DYNAMIC (CONF:1106-548). Note: Form Element: Hospital discharge disposition*** comment: Implementations do not consistently document this information in this location. While multiple implementations do not include disposition as specified, all have the concept of dischargedispositioncode in encompassingEncounter.Persuasive (still working on)See comment 1660 which consolidates all the dischargeDisposition value sets in the header. We will remove the dicharge disposition code from the Hospital Admission Encounter template.
17412/11/20192/11/2019Reed-Fourquet, LoriBlock Vote 2019022111. MAY contain zero or more [0..*] entryRelationship (CONF:1098-15492) such that it a. SHALL contain exactly one [1..1] Encounter Diagnosis (V2) (identifier: urn:hl7ii:2.16.840.1.113883.10.20.22.4.80:2014-06-09) (CONF:1098-15973).This is not generally implemented as modelled, but the information is commonly reflected in diagnoses and problems. Consider allowing for these alternate locations and adding additional guidancePersuasiveWill update as suggestedSarah/Craig 7-0-1
17402/11/20192/11/2019Reed-Fourquet, LoriBlock Vote 20190221MAY contain zero or more [0..*] entry (CONF:3256-1111) such that it a. SHALL contain exactly one [1..1] Hospital Admission Encounter (identifier: urn:oid:2.16.840.1.113883.10.20.34.3.18) (CONF:3256-1113).SHOULD contain zero or more [0..*] entry (CONF:3256-1111) such that it a. SHALL contain exactly one [1..1] Hospital Admission Encounter (identifier: urn:oid:2.16.840.1.113883.10.20.34.3.18) (CONF:3256-1113). *** comment: inconsistently implemented and often missingPersuasiveWill update to SHOULD as suggested (same comment as 1737)Sarah/Craig 7-0-1
17392/11/20192/11/2019Reed-Fourquet, LoriEmail BG/RAMAY contain zero or one [0..1] entryRelationship (CONF:3256-471) such that it a. SHALL contain exactly one [1..1] @typeCode="RSON" Has Reason (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:3256-475). b. SHALL contain exactly one [1..1] Major Reason for Visit (identifier: urn:oid:2.16.840.1.113883.10.20.34.3.7) (CONF:3256-472). Note: Major Reason for This Visit ... 6. SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHALL be selected from ValueSet Major Reason for Visit (NCHS) urn:oid:2.16.840.1.114222.4.11.7404 DYNAMIC (CONF:1106-412).SHOULD contain zero or one [0..1] entryRelationship (CONF:3256-471) such that it a. SHALL contain exactly one [1..1] @typeCode="RSON" Has Reason (CodeSystem: HL7ActRelationshipType urn:oid:2.16.840.1.113883.5.1002) (CONF:3256-475). b. SHALL contain exactly one [1..1] Major Reason for Visit (identifier: urn:oid:2.16.840.1.113883.10.20.34.3.7) (CONF:3256-472). Note: Major Reason for This Visit **** comment: consider whether there are other locations or value sets for this concept.
17382/11/20192/11/2019Reed-Fourquet, LoriBlock Vote 20190221viii. This structuredBody SHALL contain exactly one [1..1] component (CONF:3256-581) such that it 1. SHALL contain exactly one [1..1] Triage Section (identifier: urn:oid:2.16.840.1.113883.10.20.34.2.10) (CONF:3256-591).Please add guidance on how to reflect whether or not the patient was triaged as a null flavor.PersuasiveWill update template and add guidance as suggested.Sarah/Craig 7-0-1
17372/11/20192/11/2019Reed-Fourquet, LoriBlock Vote 201902214. MAY contain zero or more [0..*] entry (CONF:3256-1111) such that it a. SHALL contain exactly one [1..1] Hospital Admission Encounter (identifier: urn:oid:2.16.840.1.113883.10.20.34.3.18) (CONF:3256-1113).4. SHOULD contain zero or more [0..*] entry (CONF:3256-1111) such that it a. SHALL contain exactly one [1..1] Hospital Admission Encounter (identifier: urn:oid:2.16.840.1.113883.10.20.34.3.18) (CONF:3256-1113). *** comment not part of proposed wording: the Hospital Admission Encounter section is optional and not consistently implementedPersuasiveWill update to SHOULD as suggested (same comment as 1740)Sarah/Craig 7-0-1
17362/11/20192/11/2019Reed-Fourquet, LoriEmail LF1.1.5.3 performer See National Health Care Surveys template for other performer elements. This serviceEvent SHOULD contain zero or more [0..*] performer (CONF:3256-669) such that it Note: Type of care provider seen 1. SHALL contain exactly one [1..1] time (CONF:3256-670). a. This time SHALL contain exactly one [1..1] low (CONF:3256-1170). Note: Date/Time of provider contactImplementations do not consistently represent the date/time of provider contact in this location. Some implement in documentationOf/serviceEvent/effectiveTime Consider updating the modelling of this concept.Not persuasive (still working on)serviceEvent/performer/time is the correct place to model date/time of provider contact. serviceEvent/effectiveTime is the time the event started. It doesn't allow for multiple providers each with a different time.
17352/11/20192/11/2019Reed-Fourquet, LoriEmail LF7. SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHOULD be selected from ValueSet Patient Residence (NCHS) urn:oid:2.16.840.1.114222.4.11.7402 DYNAMIC (CONF:1106-608).7. SHALL contain exactly one [1..1] value with @xsi:type="CD", where the code SHALL be selected from one of: ValueSet Patient Residence (NCHS) urn:oid:2.16.840.1.114222.4.11.7402 DYNAMIC (CONF:1106-608). ***consider listing alternate value sets that may be routinely used in the industry.