HL7 Pediatric Data Standards Special Interest Group Meeting Minutes
Tuesday, August 3, 2004
1:00 – 2:00 CT (11:00 – 12:00 PT; 12:00 – 1:00 MT; 2:00 – 3:00 ET)
Dial in number: 866-365-4406
Passcode: 1436132

Meeting Objectives:

Update on EHR project progress, issues and needs

Call Participants:

Cheri ThroopPaul Biondich, MDCarl Weigle, MDFeliciano Yu, MD

Hema BisaryaNoorullah Akhtar, MDKay FendtAileen Sedman, MD

Lorna DykSamuel WaltersTerese Finitzo, PhDLisa Horowitz

Cheri, acting administrative co-chair, called the meeting to order at 1:00 PM CT.

Introduction to new members:

Terese Finitzo, Ph.D., Vice President Performance Support Services, OZ Systems, and her colleague, Steve Montgomery, participated on our call. OZ Systems provides information management systems to public health arenas, particularly early detection systems to identify babies with potential hearing loss.

Wayne Brandes, DO MPH, Director of Healthcare Informatics, American Institutes for Research and Arpi Chalian, MD, FAAP, Healthcare Executive, Cerner Corporation were unable to participate on this call.

Lisa Horowitz, representing Lisa Simpson, NICHQ, also participated on this call.

Agenda Item #1: July 6 Meeting Minutes:

The July 6 Meeting Minutes were approved (see

Agenda Item #2:Development of HL7 PDSSIG “one pager”

The current draft was reviewed by participants with general consensus that content and design are appropriate. This document will be refined and updated, based on HL7 PDSSIG activities and participant feedback. This document is intended for use by PDSSIG members in communicating about our SIG, what we are about, and how other professionals and/or organizations can become involved, if interested.

Resolution: HL7 PDSSIG “one-pager” communication tool approved for use by SIG participants.

Agenda Item #3: PDSSIG Representation on SNOMED CT working group

Paul Biondich agreed to serve as PDSSIG representative to SNOMED CT. The following is a summary of the 7/20/04 conference call discussion with Kent Spackman, Stan Huff, David Classen, Andy Spooner, Paul Biondich, and Cheri Throop:

SNOMED is interested in having pediatric domain-specific representation for vocabulary development, and the Pediatric Data Standards SIG of HL7 could serve as a focal point for organization of this group, as we have a shared interested in vocabulary development/enrichment.

Paul is willing to help organize and establish this group. This same group can also serve the needs of other vocabulary standards that will be supported/promoted through the Connecting for Health Informatics Initiative (CHI). Paul will begin this process by attending the upcoming SNOMED meeting in Phoenix, AZ in September. Andy and Cheri will work on the funding needed to make this happen.

Aileen specifically asked about linkage of the various vocabularies including ICD-9 or ICD-10, LOINC, SNOMED CT and others. Paul explained that each of the various vocabularies is used for different purposes; use case will drive which data standard set is most appropriate and applicable. As we delve further into our current project, gaps in pediatric-specific vocabulary requirements will become more apparent.

Agenda Item #4: NHII Meeting Update

In his first major contribution as the new healthcare IT leader, David. J. Brailer, M.D., Ph.D. announced July 21 the federal government's strategy for developing electronic health records for all Americans in the next 10 years. Called a "framework" by Brailer, the big-picture report did not mandate any specific technology standards or a timeframe for compliance.

Paul led group discussion on this topic, explaining that the meeting, at a very high level, grappled with the issue of use of a unique identifier and also the concept of a large medical record system. Paul provided the following URL links as additional background to this work and also the meeting discussion of vocabularies.

This is a link to the Consolidated Health Informatics Initiative (CHI) executive summary. This document describes how the federal government sees existing vocabulary standards moving forward:

This next link is the NHII summary and long-term direction of the movement:

This link provides a balanced commentary on the pros and cons of each of the initial large decisions by the NHII:

Carl identified the need for input from a pediatric perspective reach David Brailer, as the new National Health Information Technology Coordinator for HHS (recent summary statement from Dr Brailer, see One person who has promoted this activity to Dr Brailer is Dale Nordenberg, a pediatrician in Atlanta, and the Associate Director for Informatics and the Chief Information Officer for the National Center for Infectious Diseases, at the National Centers for Disease Control. Carl suggested that contact be made with Dr. Nordenberg regarding our SIG and how we might coordinate efforts. A conference call with Dr. Nordenberg will be scheduled.

Agenda Item #5: EHR Project Assignments:

The following is a brief overview of our project reported by each section leader. All SIG members are encouraged to engage in review of each section, offering feedback to the project section champions. Draft versions of each section are posted on the HL7 website () under documents. Project champions may be contacted via the following:

DIRECT CARE (DC1) - Aileen Sedman

Aileen Sedman

(239) 498-0185

  • Critical component is health information management. Age and gender should dictate what is targeted for completion (ie. growth chart; age-specific health maintenance; standardized charts)
  • Current issues include definition of a summary list versus a problem list (Cheri is contacting AHIMA to obtain official definitions of each)
  • Carl identified key issue of pre/post adoption records (need to be separated but with connection between the two without breaching confidentiality of the pre-adoption name, etc.)
  • Based on Lorna’s feedback, Eileen will incorporate a longitudinal view.

DIRECT CARE (DC2 and DC3) - Steve Lawless

Stephen Lawless

  • (Not available to provide update)

SUPPORTIVE CARE - Pele Yu

Feliciano (Pele) Yu

205-934-6838

  • Importance of including registries was identified (immunization; blood donor; organ donor, etc)
  • Potential issues include gaps between diagnosis and condition and how to incorporate parental issues
  • S.2.1.1/S.3.1.2 refers to the outcomes measures/analysis. Pele has added pediatric specific AHRQ indicators from the measures clearinghouse as a placeholder. Cheri recommended that a statement be added reflecting ability to monitor all nationally endorsed pediatric measures as a way to capture whatever is currently available and applicable.

INFORMATION INFRASTRUCTURE - Andy Spooner/Kay Fendt

Andy Spooner

(901) 572-3292

Kay Fendt

  • Andy and Kay have not had the opportunity to begin working on this component.

OVERVIEW OF DECISION SUPPORT/VOCABULARY NEEDS - Paul Biondich

Paul Biondich

(317) 630-7785

  • None at this time. Please keep Paul informed of gaps and identify these on the EHR-S model document (see column for this information)

Agenda Item #6: Possible grant funding for May 2005 HL7 meeting

AAP has received approval to proceed in applying for the AHRQ small conference grant. CHCA will manage this grant on behalf of AAP. Another update will be provided at the September 29 meeting as the deadline for grant proposal submission nears.

SIG ASSIGNMENTS (post August 3 conference call)

  1. Sign up to assist with DC1, DC2-DC3, Supportive Care, and Information Infrastructure project subgroups.
  2. Identify key functional requirements critical to pediatric care
  3. Integrate requirements from January WGM meeting (AAP position paper)
  4. Identify where these might fit in EHR-S model
  5. Identify functional gaps as these become evident
  6. Provide champions with all feedback on or before August 24; champions will provide any edits, issues for resolution, and additions to Cheri no later than Wednesday, September 1 in preparation for September 29 PDSSIG WGM in Atlanta.
  7. Please contact Cheri to set up conference calls for your subgroup if desired.

Next Conference Calls: Agenda item for September meeting

Please e-mail any documents you would like distributed to . Thank you!

Please mark your calendars!
September 26 — October 1, 2004
18th Plenary & Annual Working Group Meeting
Location: Sheraton Atlanta Hotel
165 Courtland Street
Atlanta, GA 30303
Hotel Phone: 404 659 6500
Rate is $159 per night
Contact: ()
Phone number: 800-833-8624
Early Bird Registration & Hotel Cutoffs: August 25, 2004
  • REGISTER for our Pediatric Data Standards SIG listerv at

Pediatric Data Standards Special Interest Group Tracking Log:

ITEM: / Responsible
Party: / Date
Initiated / Date
Closed / Additional Comments:
Finalize education day / Cheri Throop / November 14, 2003 /

CLOSED

2/15/04 / April 13, 2004 in San Antonio
Recruitment / All SIG members / November 14, 2003 / Formal letter to FDA (David/Andy)
-See 1/19/04 minutes for specialty members still needed.
2/27/04: Efforts to enroll international pediatrician participant underway
3/31: Andy/Cheri develop draft brochure (COMPLETED)
5/3: Recruitment continues; need for international representation.
Request Liora Alshuler to attend May 3, 2004 meeting / Cheri Throop / January 19, 2004 / CLOSED
5/3/04 / 2/27: Liora has agreed to present
4/20/04: Follow up with Liora
Request Clem McDonald to attend May 3, 2004 meeting / Paul Biondich / January 19, 2004 / CLOSED
5/3/04 / 4/20/04: Communication to Paul regarding Clem’s availability.
4/25/04: Paul contacted Stan Huff who will be presenting at our meeting.
Request Clinical Decision Support SIG presentation at May 3, 2004 meeting / Cheri Throop / December 22, 2003 / CLOSED
4/21/04 / 2/27: Request made and DCS S:IG representative plans to attend
4/21: Matt Sailor to present
Growth Chart Project Update / Aileen Sedman / January 19, 2004 / OPEN / 2/27: See minutes
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Prenatal to Perinatal Care Project / Andy Spooner / January 19, 2004 / OPEN / 2/27: See minutes
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Developmental Care Project / Paul Biondich / January 19, 2004 / OPEN / 4/13: Update provided for education day
5/3: Update provided for WGM
5/3/04: integrate in to PIR-EHR
WIC documentation form project / Cheri Throop
Ellen Schwalenstocker / January 19, 2004 / OPEN / 2/27: See minutes
3/31: Hema Bisarya will assist with this project.
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Pediatric Electronic Health Record Project / Feliciano Yu / February 27, 2004 / OPEN / 3/31: David Milov will assist wit this project.
4/13: Update provided for education day
4/13: Noorullah Akhtar will assist with this project
5/3: Update at WGM
5/3/04: integrate in to PIR-HER
7/6/04: Accountability for specific sections assigned
Asthma Core Measures / Cheri Throop
Ellen Schwalenstocker / January 19, 2004 / OPEN / 2/27: see minutes
3/31: Hema Bisarya will assist with this project.
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Strawman proxy ballot process / Andy Spooner
David Classen / January 19, 2004 / CLOSED 5/3/04 / 2/27: See minutes
3/31: Draft document will be sent to SIG members prior to May meeting
4/26: PDSSIG Decision Making document to SIG members for approval
5/3: Agenda item for WGM
IOM Electronic Health Record framework –distribution to SIG members / David Classen / January 19, 2004 / CLOSED2/9/04 / 2/9/04: Distributed
Invite Helga Ripen to PDSSIG conference call / Cheri Throop / May 3, 2004 / OPEN / 5/3/04: member of NHII group
Form PDSSIG Vocabularies subgroup (Paul Biondich; Clem McDonald; Stan Huff) / Andy Spooner / May 3, 2004 / OPEN / 5/3/04: See minutes
Recruit and recommend pediatric representation on SNOMED CT working group (Kent Spackman)
  • Funding for representative
/ Andy Spooner/David Classen / May 3, 2004
June 1, 2004 / CLOSED6/1/04
OPEN / 5/3/04: See minutes
6/1/04: See minutes. Paul Biondich is willing to serve in this role.
6/1/04: SIG Co-chairs to work on this issue.
Conference call with Kent Spackman (SNOMED CT)
Discussion with Ed Hammond: Coordination efforts – our SIG and SNOMED CT
Funding inquiries: NLM and AAP / Andy Spooner/David Classen
David Classen
Andy Spooner / June 1, 2004 / CLOSED7/20/04
CLOSED
6/29/04
OPEN / Pediatric Representation
David had conversation with Ed Hammond on June 29 2004. He advised that we proceed with conference call as planned.
PDSSIG “one-pager” as communication tool / Andy Spooner/David Classen/ Cheri Throop / July 6, 2004 / CLOSED7/20/04 / (Due July 21 for upcoming AAP and NHII meeting)
Conference call with Dr. Dale Nordenberg / Andy Spooner/David Classen/Cheri Throop/ Carl Weigle / August 3, 2004 / OPEN

Parking Lot Issues:

ISSUE / Date Identified / Date Resolved:
Aileen asked how we prevent redundant work across HL7 groups as well as across national entities / January 19, 2004
Aileen asked for further guidance on what format our SIG projects need to be for delivery to other HL7 groups. / February 27, 2004
Aileen asked how HL7 work is kept up to date. / May 3, 2004
PDSSIG Logo model under review by HL7 for their approval / May 18, 2004 /
July 6, 2004

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HL7 Pediatric Data Standards Special Interest Group Meeting Minutes

August 3, 2004