Orders & Observations Conference Call
9-July-2009
Attendees:
Name / OrganizationRob Hausam / Theradoc
Rob Savage / NGC/CDC
Austin Kreisler / SAIC/CDC
Patrick Loyd / GP Informatics
Mead Walker / Health Data and Interoperability Inc.
Hans Buitendijk / Siemens Healthcare
Cindy Vinion / APHL
Ruth Berge / GE Healthcare
Note Takers: Hans Buitendijk
Agenda:
· Approve July 2 Meeting Minutes
o Move to accept. Patrick, Austin.
§ Against: 0; Abstain: 0; In Favor: 6
· Document/Messages
o John Quinn will join July 23 to further discuss approach that IHE/HITSP/NCPDP are taking and how we need to address our concerns.
o Board is discussing the general issue as well.
o We would like to get Struc Doc to weigh in as well.
· Project Scope Statements
o Blood Bank project statement was forwarded to Steering Division for review/sign-off. No date set yet.
o Patrick Loyd working on project statements for SAEAF and Templates relative to orders prototype in this space.
§ John Koisch is working on an initial version to reflect a Lab fulfillment process.
o Specimen Process Steps still to be re-cast.
· CPM Status
o Ballot Reconciliation is complete. Gunther to withdraw item #27. Hans to post on ballot site.
o We had an earlier vote to progress with another ballot round and would withdraw if not needed.
§ Initial content are due this weekend and the final ~ Aug 2.
§ Updates are in progress which should make it in time.
o Question is whether to withdraw (and immediately request DSTU status – upon completing the updates).
§ Tom de Jong (Rx) requested to go through another ballot round and enable sync with Rx.
§ Mead Walker indicated that new content is being added (slight scope enhancement).
§ Consequently we’ll have to go back to ballot and there is no need to withdraw the ballot submissions.
§ We do need to get the NIB updated with the enhanced scope.
· Structured Doc Recap
o While OO-StrucDoc was on the agenda, it got squeezed out. Will be on the agenda next week.
o OO will host the phone number for the calls. Tuesday 11:00 – 12:00, weekly. We’re hopeful that Thursday Struc Doc call will only be used for summary.
· Grouper Discussion
o The harmonization proposal was not withdrawn, but proposals on how to deal with the issue. One proposal is to push it out of the current ballot cycle (option 3).
o There was substantial confusion around what was normative and when.
o Austin/Woody found old proposal to move Battery to Observation and leave Cluster where it was. Suggests to re-submit.
§ Battery can then be ordered.
§ Can reflect both information and structure.
o OO Proposal to MnM
§ Grouper
· Stay under Organizer
· Agreed with proposed definition: This context represents the information acquired and recorded for an observation, a clinical statement such as a portion of the patient's history or an inference or assertion, or an action that might be intended or has actually been performed. This class may represent both the actual data describing the observation, inference, or action, and optionally the details supporting the clinical reasoning process such as a reference to an electronic guideline, decision support system, or other knowledge reference.
§ Battery
· Move to Observation (per old proposal)
· Ensure the definition is clearly a refinement of the observation.
o A battery specifies a set of observations. These observations typically have a logical or practical grouping for generally accepted clinical or functional purposes, such as observations that are run together because of automation. A battery can define required and optional components and, in some cases, will define complex rules that determine whether or not a particular observation is made.
o Replace blood pressure with vital signs.
· Need to ensure Observation covers atomic and group.
· Does not seem to break anything else.
§ Cluster
· A group of entries within a composition, topic or category that have a logical association with one another.
The representation of a single observation or action might itself be multi-part. The data might need to be represented as a nested set of values, as a table, list, or as a time series. The Cluster class permits such aggregation within an entry for such compound data.
Examples include "Haematology investigations" which might include two or more distinct batteries.
A cluster may contain batteries and/or individual entries
· Would need better clarification between Grouper and Cluster if we keep it.
· Requires review of requirement to determine whether it specializes Grouper, or whether it should sit above Battery in Observation. If the latter, Battery can only have atomic content and we need atomic.
· Battery can group batteries.
· Consequently, suggest Option 3 only applies to Cluster so we can resolve that.
§ Motion to accept Group re-definition, move Battery to Observation with some definitional tweaks (to be provided between now and MnM meeting), and Cluster exercise Option 3 to resolve completely at a later date (i.e., keep as-is for now with issue logged). Austin, Rob Hausam
· Against: 0; Abstain: 0; In Favor: 7.
§ Austin will circulate proposal as quickly as possible, but may not leave a lot of time for review. We’ll go with the best we have into MnM discussion.
Future Topics
· HITSP / OO – As needed
· Date TBD
o Continue with Composite Order Ballot Reconciliation
§
o Specimen Segment Usage – Ruth Berge
o Clinical Event
o Lab Result Topic Update
o Decision Making Document
§
V2.8 Proposal Status
·