Orders & Observations Conference Call



Orders & Observations Conference Call

24 January 2013

+1 770 657 9270, Passcode: 653212#

Attendees:

|Name |Organization |

|Rob Savage |NGC / CDC |

|Elaine Ayers (first couple minutes) |NIH |

|Brian Pech |Kaiser Permanente |

|Sumesh Sundareswaran |Lantana Group |

|Debbie Bogert |Canada Health Infoway |

|Freida Hall |Quest Diagnostics |

|Ken McCaslin |Quest Diagnostics |

|Eric Haas |APHL |

|Riki Merrick |iConnect / APHL |

|Rob Hausam |Hausam Consulting |

|Austin Kreisler |SAIC / CDC |

|Margaret Dittloff |The CBORD Group |

|Yan Heras |Lantana Group |

|Ashley Swain |Lantana Group |

|Saunya Williams |Accenture |

|Lorraine Constable |Constable Consulting |

|David Burgess |LabCorp |

|Rita Altamore |Washington State Department of Health |

|Ron van Duyne |CDC |

|Hans Buitendijk |Siemens Healthcare |

Co-Chair:Hans Buitendijk

Scribe: Riki Merrick, Hans Buitendijk

Agenda/Minutes:

Agenda Review

Minutes

• January 3 – Motion to accept as distributed. Ken McCaslin, Riki Merrick

o Against: 0; Abstain: 0; In Favor: 18

• January 10 – Motion to accept as distributed. Ken McCaslin, Margaret Dittloff

o Removed the ? after “Ken” in second topic.

o Clarified Work Group Health that we did not discuss.

o Against: 0; Abstain: 0; In Favor: 18

• January 14-18 (WGM) – Next week

Project Statements

• BMI (PHER)

o [pic]

o Project with American Academy of pediatrics and CDC to develop v2.x IG; Lantana to bring to May 2013 ballot, limited to height, weight, gender, DOB, date of measurement

o Issue is that states are not consistent in how they are collecting this info

o Concern that this message is too specific, BMI only. Akin to creating an IG for CBC in a lab context.

o Hope we are not using a separate message for this, just how to. It is not intended to create a new message, but using ORU.

o Need to clarify universal/US Realm and why this is this specific. Expected to be raised. That was because it is aimed at US regulations - IHE profiles are universal, but we are open;

▪ For universal realm may need to drop vocab – need to have the rationale well described - list the reasons for making this a separate IG for US realm for BMI for SC

o Not any different than other IGs for example newborn screening.

▪ Is this for a separate message, or just guidance on how to communicate on an underlying standard? Or instructions on how to use the EHRsystem results to PH – IIS using ELR, LRI, base standard?

o Is this more of a profile or IG – very narrow topic; what should be the approach?

▪ Suggest to pursue profile to keep the guide thin.

o This is the first step to – would it be better to define the project as the larger goal and then phase it, starting with BMI instead?

o Not clear why it is a bad idea to be this specific.

o Based on V2.5.1, modeled after LRI IG. Working with Bob Yencha, so will include the pre-adopted stuff – will be using LRI; need to sync up with ELR R2 as well

o Material in password protected dropbox is a little concerning – normally make this public domain – open to recommendations – can use HL7 PHER wiki services for this. Before going to TSC you need to declare that. We want to keep it open/accessible. Will be addressed.

o Motion to accept co-sponsorship and work with PHER to address the various issues raised. Lorraine Constable, Rob Savage

▪ Need to clarify which IG it will be based on.

▪ Against: 0; Abstain: 0; In Favor: 16

• Nutrition

o [pic]

o Had completed DAM and successfully balloted, but using DAM for artifact creation we found several issues;

o Also addressing preference tracking that we thought would come from other group, so taking over some patient care use cases, as well as medication preference etc;

▪ Pharmacy will co-sponsor to help address medication preferences.

o Need to adjust the opening to make clear this is a continuation of existing work. Develop vocabulary and include as test case, since it does include

o Will also request to publish errata to DAM in the meanwhile

o Need to update the dates to current dates from original DAM – may be the older version

o Need to fix name to DAM phase II

o Phrase correctly to focus input on new work, not existing work (can you still do revision tracking in v3?

▪ Hard to do in model – will highlight those in the introduction

o Going for Normative, which pushes the boundaries.

o Status 1 year DSTU to normative

o Motion to approve with the changes discussed for clarity/completeness. Freida Hall, Margaret Dittloff

▪ Lorraine to send to Pat van Dyke/Calvin Beebe/Dave Hamill by Sunday.

▪ Against: 0; Abstain: 0; In Favor: 16

• eDOS

o [pic]

o Electronic lab test compendium electronic Directory Of Service) – first phase sponsored by ACLA – now sponsored by ONC and CHCF (Patrick Lloyd is doing pilot PM)

o There are some folks that have implemented- have some change requests from that and in order to align with LOI / LRI;

o Intent is for 6 month DSTU in order to go normative with LRI and LOI

o Use case has been required by ONC work group

o Balloting as universal, as this seems to not be restricted to US

o This is based on masterfile messages in chapter 8 – very lab specific – no other HL7 WG as co-sponsor

o Do we have joint copyright considerations to consider? ACLA gave this to HL7, so shouldn’t be. Freida will double-check.

▪ CHCF is not developing this externally, they are funding.

o If IHE was going to do anything further, they would publish LOI, LRI and eDOS together for Connectathon

o Motion to accept as proposed. Freida Hall, Eric Haas

▪ Against: 0; Abstain: 0; In Favor: 16

V2.8 Ballot Reconciliation – Hans Buitendijk

• One item remaining

• Please look at #91 for next week to make sure whether the red highlighted rows in the message below (end of minutes) indeed can be removed and resolve the item.

V2.9 Proposal

• Proposal 743 – Freida Hall

• Next week

Paired Titers – Eric Haas

• Next week

CWE or CNE – Eric Haas

• Next week

Project updates – No time left to address.

• Table 0078 – Rob Hausam

o No time left to address.

• Composite/Lab Order – Lorraine Constable / Patrick Loyd

o No time left to address.

• Nutrition – Margaret Dittloff / Lorraine Constable

o No time left to address.

• LOI/LRI – Hans Buitendijk / Ken McCaslin

o No time left to address.

• Specimen – Lorraine Constable / Hans Buitendijk

o No time left to address.

• Implantable Devices – Hans Buitendijk

o No time left to address.

• FHIR – Lorraine Constable / Patrick Loyd

o No time left to address.

• Blood Bank – Patrick Loyd

o No time left to address.

• Lab Status Analysis – Jay Lyle

o No time left to address.

• LCC – Jim Harrison

o No time left to address.

Lab Order Ballot Reconciliation

• No time left to address.

• Time Boxed – Lorraine Constable / Patrick Loyd

• Targeted for 30 minutes max next week.

OMQ^O42^OMQ_O42: General Order Message with Document Payload

|Segments |Description |Status |Chapter |

|MSH |Message Header | |2 |

|[{SFT}] |Software | |2 |

| [UAC] |User Authentication Credential | |2 |

|[{NTE}] |Notes and Comments (for Header) | |2 |

|[ |--- PATIENT begin | | |

| PID |Patient Identification | |3 |

| [PD1] |Additional Demographics | |3 |

| [{PRT}] |Participation (for Patient) | |7 |

| [{NTE}] |Notes and Comments (for Patient ID) | |2 |

| [{NK1}] |Next of Kin/Associated Parties | |3 |

| [{ARV}] |Access Restrictions | |3 |

| [ |--- PATIENT_VISIT begin | | |

| PV1 |Patient Visit | |3 |

| [PV2] |Patient Visit- Additional Info | |3 |

| [{PRT}] |Participation (for Patient Visit) | |7 |

| ] |--- PATIENT_VISIT end | | |

| [{ |--- INSURANCE begin | | |

| IN1 |Insurance | |6 |

| [ IN2 ] |Insurance Additional Information | |6 |

| [ IN3 ] |Insurance Additional Information, Certification | |6 |

| }] |--- INSURANCE end | | |

| [GT1] |Guarantor | |6 |

| [{AL1}] |Allergy Information | |3 |

|] |--- PATIENT end | | |

|{ |--- ORDER begin | | |

| ORC |Common Order | |4 |

| [{PRT}] |Participation (for Common Order) | |7 |

| OBX |Observation containing document | |7 |

| [{PRT}] |Participation (for document) | |7 |

| TXA |Transcription Document Header | | 9 |

| [CTD] |Contact Data | |11 |

| [{DG1}] |Diagnosis | |6 |

| [{ |---OBSERVATION begin | | |

| SGH | | | |

| OBX |Observation containing document | |7 |

| [{PRT}] |Participation | |7 |

| [TXA] |Transcription Document Header | |9 |

| [{NTE}] |Notes and comments | |2 |

| SGT | | | |

| }] | | | |

| [{ |--- OBSERVATION begin | | |

| OBX |Observation/Result | |7 |

| [{PRT}] |Participation (for Observation) | |7 |

| [{NTE}] |Notes and Comments (for Results) | |2 |

| }] |--- OBSERVATION end | | |

| [{ |--- PRIOR_RESULT begin | | |

| [ |--- PATIENT_PRIOR begin | | |

| PID |Patient Identification – previous result | |3 |

| [PD1] |Additional Demographics – previous result | |3 |

| [{PRT}] |Participation (for Patient Prior) | |7 |

| [{ARV}] |Access Restrictions | |3 |

| ] |--- PATIENT_PRIOR end | | |

| [ |--- PATIENT_VISIT_PRIOR begin | | |

| PV1 |Patient Visit – previous result | |3 |

| [ PV2 ] |Patient Visit Add. Info – previous result | |3 |

| [{PRT}] |Participation (for Patient Visit Prior) | |7 |

| ] |--- PATIENT_VISIT_PRIOR end | | |

| [{AL1}] |Allergy Information - previous result | |3 |

| { |--- ORDER_PRIOR begin | | |

| ORC |Common Order - previous result | |4 |

| [{PRT}] |Participation | |7 |

| OBR |Order Detail - previous result | |4 |

| [{ |--- TIMING_PRIOR begin | | |

| TQ1 |Timing/Quantity | |4 |

| [{TQ2}] |Timing/Quantity Order Sequence | |4 |

| }] |--- TIMING_PRIOR end | | |

| [{NTE}] |Notes and Comments - previous result | |2 |

| [{PRT}] |Participation (for Order Prior) - previous result | |7 |

| [ CTD ] |Contact Data - previous result | |10 |

| { |--- OBSERVATION_PRIOR begin | | |

| OBX |Observation/Result - previous result | |7 |

| [{PRT}] |Participation (for Oservation Prior) | |7 |

| [{NTE}] |Notes and Comments - previous result | |2 |

| } |--- OBSERVATION_PRIOR end | | |

| } |--- ORDER_PRIOR end | | |

| }] |--- PRIOR_RESULT end | | |

| [{FT1}] |Financial Transaction | |6 |

| [{CTI}] |Clinical Trial Identification | |7 |

| [ BLG ] |Billing Segment | |4 |

|} |--- ORDER end | | |

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