SDWG Clinical Oncology Treatment Plan CDA IG Ballot development meetings

Purpose Team Weekly Conference Call

Date February 5, 2013

Time 5:30 pm – 6:30 pm EST

Agenda

1. New Introductions 5 minutes

2. Review IG Updates 10 minutes

3. This week’s templates 40 minutes

4. Wrap Up/Conclusion 5 minutes

Attendees

· Ed Ambinder, ASCO Standards Subgroup

· John Krauss, ASCO Standards Subgroup

· Grant Wood, Intermountain Health Care, Genetics Institute

· Joshua Mann, Jeff Kan and Suzanne Maddux from ASCO

· Gaye Dolin, Zabrina Gonzaga, Yan Heras, Beau Bannerman from Lantana

· Mark Shafarman – Interested party, HL7 member

· Steven Chu – Interested party, Co-chair Patient Care, HL7 Pharmacy

· Wendy Scharber, CDC consultant

· Mark Roche

Meeting Minutes

Overview of Project and heuristics

Assuming publishing of Spring ballot, can’t guarantee, but this is a DSTU with less rigor than a normative standard.

Steve Chu: Is there a use case where we send exclusion statement to explicitly indicate that data is important, but the data is missing or not present?

· Gaye: Do have templates where allow for explicitly negation, but not for every template. Clinical statements use negationInd and Null Flavors used to communicate the absence of information.

Completion of last week’s review of Problem Section and Entries:

· Starting with Breast Cancer Concern Act

· John Krauss – what about bilateral breast cancer?

· Gaye: Verified that should allow to contain more than 1. Action: Change CONF 19456 to SHALL contain [1...*] entry for Breast Cancer Concern Act to accommodate more than one instance Explanation of Concern Act

o Steven Chu - Container for related problems or diagnosis where provider can track progress of condition or related conditions

o Wendy – is this operationally what EHR’s do?

§ Weak area of existing EHR’s. Not all EHRs are designed to contain a concern tracker.

· Breast Cancer Diagnosis Observation

o Post Treatment Disease Status

o Additional vocabulary tasks still in process

§ May allow several types of vocabularies, or recommend SNOMED as required in MU for problems

§ Wendy from CDC offered to help with terminology

§ Need for fuzzy dates? Example: Patient reports event happening “5 years ago”. . Currently not a way in C-CDA to represent “Spring” or “ 5 years ago”. Will look at CDA conventions, May be able to use “OTH” and add a description.

o –

o #7 CONF 19287: this represents a temp value set for problem codes

o #8 targetsite CONF 21925:

§ Evaluate need to record if this is a primary target site and to describe here is there was metastasis. Collecting behavior (invasive or non-invasive) will help distinguish if this is a primary target site.Evaluate if capturing metastasis as a separate entry is more appropriate or if out of scope.

§ Reviewed OVERALL STAGING

· TNM Breast CA Staging/Clinical Staging – represents overall stage

o Pointed out CONF 24918: put AJCC reference in Method

o TNM Tumor

o TNM Node

o TNM Metastases

· Last menstrual period

o Last Menstrual Period - actually capture the month (i.e. May 2011 or year like 2012).

o CONF:21965 add the display name for menstrual period code

·

· Post Treatment Disease Status

o CONF 21938 add display name

·

Procedures Section and Entries:

· Will begin next week

ACTION ITEMS

· Post to HL7 Project wiki:

o Source documents for ASCO Treatment forms

o These meeting minutes and this week’s slide deck

· Connect Zabrina Gonzaga (Lantana Information Analyst) with Wendy Scharber from CDC for terminology input

· Evaluate potential need/capability to capture fuzzy or partial dates

o e.g., patient reports that event occurred “5 years ago”

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