Coordinated Registry Network (CRN) HL7 Implementation Guide (IG) Workgroup (WG)

Meeting Date & Time

Tuesday, June 4, 2019 at 2:00 pm ET

Attendees

Attendees

Present/Absent

Attendees

Present/Absent

Becky Angeles

P

Behnaz  Minaei

 

Nagesh Bashyam (Dragon)

P

JaWanna Henry

P

Gayathri Jayawardena

P

Myron Finseth

 

Richard Ballew

P

Vaishnavi Rao

P

Rob Samples

 

Ioana Singureanu

 

Terrie Reed

 

Marti Velezis

P

Lisa Lang

 

Patrick McLaughlin

 

Abdullah Rafiqi

P

Robin Taylor

 

Christina Nguyen

 

Lindsey Hoggle

 

Craig Newman

 

Mary Ann Hantakas

 

Yanyan Hu

P

Mike Flanigan

P

Liz Amos

P

Clem McDonald

P

Discussion                                                                    

AUGS FHIR App—UDI Discussion

  • Collen from AUGS had a conflict and will be unable to join today’s call, we will pick this discussion up next week after confirming her availability
    • Marti reminded group of UDI Conference next week

 

CRN Implementation Guide (IG) Ballot Comment Reconciliation

  • Comment resolutions from last week’s call were added to the tracker
  • Block voting will occur during the bi-weekly BR&R WG calls
  • Comment Review
    • 21073 - Terminology value sets should point to specific OIDs, coding systems
      • Clem McDonald suggested specificity is needed, included specific examples using the value sets and codes for the various resources.     
      • Dragon noted specific examples can be provided along with a specific list of value sets which are required for implementation curated by NLM. 
      • Resolution:
        • List each value set for the IG along with the URL
        • Create examples
          • Basic Questionnaire/QuestionnaireResponse
          • Populated Questionnaire/QuestionnaireResponse
          • Extractable Questionnaire/QuestionnaireResponse
            • Clem suggested it would be useful to start with the resource and then show how this might look as a questionnaire.  He noted that the value sets are vague and difficult to conceptualize.  These can be answer lists, list of drugs, measurements, etc., which is why it is best to start with the Resource (e.g., Drug Resource). 
            • Dragon will include the FHIR Resource that would be created using the mapping.
          • Dragon displayed an example of a form
            • Clem asked if these can be specific to the procedure.
            • No, all questions are yes/no and if yes, appropriate series of questions follows
            • Clem suggested this is too labor-intensive.  Why not first ask what is the procedure and then display relevant questions?
            • Yanyan agreed in terms of efficiency this approach is preferable.
            • Dragon will take this feedback back to the registry.
          • Clem suggested it would be helpful to anchor the variables in relation to the event.  For example, is weight tied to a time? 
            • Richard suggested the data elements are not fully in the context of when the question is asked.  The questions are asked at different times.  
            • Richard explained primary procedures (intended) were identified.  The WG created specific VSAC value sets with OIDs to identify the relevant procedures.  The WG did not intend to build in too much logic for this filtering, but instead identified a list of relevant procedures across the women’s health domains.  The class of procedures is in a VSAC value set.  These are not exclusively device-related. 
            • Resolution: Add details on frequency and timing of questionnaires.
    • 21076 - Explicit narrative needed for what is coming out of EHR
      • Resolved by resolution proposed for #21073
      • One or more specific code systems would be helpful
        • Instance codes and answer list class of codes
        • Clem suggested CBT is best for surgical procedures.  The physician in the hospital will record CBT for billing purposes.  Yanyan suggested this may be ICD10.  Clem suggested CBT is granular and at the very least should explore with clinicians what is best to use.
      • Will include specific value set which includes codes from multiple code systems into the IG.
    • 21210 - Mapping of CDEs to FHIR Table
      • Resolution: Will add a definition or description of the data element into the IG as a column and add links to the FHIR data elements.
    • 21211 - Change mapping of Hospital Discharge
      • Definition is not clear.  Hospital Discharge should be mapped to the Hospital Discharge Date data element (date patient discharged following the procedure).  Will still be mapped to Encounter.period. This is the end of the Encounter.period. 
      • Resolution: Rename the data element as Hospital Discharge Date.  The mapping should be Encounter.period.end.

 

Next Steps

  • Comment resolution will continue on next week’s call.