PHRI+Consensus

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=Archived Consensus, votes and comments on Results of Consensus Review for PHRI Framework Document =  ITEM #1: The Consensus on the PHRI Reference Implementation Framework document is now CLOSED - Thank you for the vote - we will review the comments and provide updated documents with resolutions on the 4/24/2013 call

Any questions, comments, or concerns with the documents or the consensus process can be sent to Anna Orlova ( aorlova@jhsph.edu ). LLC || Yes with comments || Have sent comments with improvements for clarity, to Lead Team ||
 * **Member Name** || **Affiliated Organization** || **Endorsement (Vote = "Yes" or "No with comments")** || **Comments (e.g., "if 'no' then what can be done to make your vote a yes?")** ||
 * Noam Arzt || HLN Consulting, LLC || Yes, with a comment || Last paragraph on p. 9 is still very misleading with respect to Immunization reporting, MU, and CDA. A reader could make the //wrong// conclusion that CDA is acceptable for MU for immunization when we know that is not the case. ||
 * Dina Dickerson || Oregon Health Authority || Yes || My comment is that this is a very useful document as a guide for harmonizing data and workflow in the realm of public health practice and also as a starting point for that work. ||
 * Riki Merrick || iConnect Consulting || Yes ||  ||
 * Anna Orlova || PHDSC || Yes ||  ||
 * Seth Foldy || sethfoldy.com
 * Nikolay Lipskiy || CDC/OSELS || Yes ||  ||
 * Hetty Khan || CDC/NCHS || Yes || Minor edit:page 16. Section 3. Next Steps for PHRI Phase 1: change "Trila" to "Trial" ||
 * Kerry Souza || CDC/NIOSH || Yes with minor edits || [[file:NIOSH consensus vote comments on PHRI Reference IG.docx]] ||
 * Wendy Scharber || Registry Widgets || Yes, with minor edits || confirm with CDC- Cancer whether the IHE PRPH-Ca Profile or the Meaningful Use Implementation Guide should be listed in Table 1 and in Appendix A. ||
 * Kathy Walsh || LabCorp || Yes, with comments || Spelling Error. In the “Public Health Reporting Reference Implementation Framework” document, Public is misspelled as Pubic in three places on page 4, one place on page 6, one place on page 8, and one place on page 9.

Question?

Both of the documents have “ Public Health Reporting Specification - CDA ” in the header but I would think only the “Guide to Constrain the CDA R2 Specification to support PH Reporting with two Examples of Document Level Constraints (Communicable Disease and Adverse Events)” would have CDA in the header. Actually what I would have expected is the title of each in the header instead of “ Public Health Reporting Specification - CDA ”. ||
 * Mark Marostica || Atlas || Yes || I am not sure if you need my approval as I was not an active participant in the development of these documents but rather an occasional contributor from a vendor perspective but you can count me as approving all the documents up for balloting. ||

ITEM #2: The Consensus on the PHRI CDA Implementation Guide document is now CLOSED - Thank you for the vote - we will review the comments and provide updated documents with resolutions on the 4/24/2013 call

Any questions, comments, or concerns with the documents or the consensus process can be sent to Riki Merrick (rmerrick@iconnectconsulting.com ).

=Archived Consensus, votes and comments on Consensus Review for PHRI CDA guide document = Under Order/Diagnostic Test it has "The only vocabulary constraints currently applied is use of LOINC for laboratory order codes and use of CPT to supporting diagnostic tests." but I do not think all laboratory order codes have LOINC and I thought CPT were going away.
 * **Member Name** || **Affiliated Organization** || **Endorsement (Vote = "Yes" or "No with comments")** || **Comments (e.g., "if 'no' then what can be done to make your vote a yes?")** ||
 * Kerry Souza || NIOSH || "Yes" with comments || A document with several minor edits submitted.[[file:NIOSH concensus vote comments on PHRI CDA.docx]] ||
 * Dina Dickerson || Oregon Health Authority || Yes ||  ||
 * Riki Merrick || iConnect Consulting || Yes ||  ||
 * Anna Orlova || PHDSC || Yes ||  ||
 * Nikolay Lipskiy || CDC/OSELS || Yes ||  ||
 * Hetty Khan || CDC/NCHS || Yes || Page 20 Section 1.4.1 [link to be added once posted]. Please remember to add link here. ||
 * Wendy Scharber || Registry Widgets || Yes ||  ||
 * Kathy Walsh || LabCorp || No, with comments || Concern!

Concern! In Table 70- Result - Detailed Example, the status codes and the interpretation codes do not match HL7 2.5.1. Actually I am not sure which field statuses codes should be but I can not find all of them in HL7 2.5.1 and the interpretation codes seem to be HL7 0078 but the codes are not the same and even when the code is the same the description is different. Maybe we could say these are examples of what could be used? Or maybe say it is a partial list?

Question? Both of the documents have “ Public Health Reporting Specification - CDA ” in the header but I would think only the “Guide to Constrain the CDA R2 Specification to support PH Reporting with two Examples of Document Level Constraints (Communicable Disease and Adverse Events)” would have CDA in the header. Actually what I would have expected is the title of each in the header instead of “ Public Health Reporting Specification - CDA ”. || =Archived Consensus, votes and comments on Data Harmonization Profile= The general consensus of the Public Health Reporting Initiative is that the is complete and correct in its representation of the common corer data elements for a Public Health report (within the constraints of the scope of the Initiative). All comments we incorporated into the final document.
 * Mark Marostica || Atlas || Yes || I am not sure if you need my approval as I was not an active participant in the development of these documents but rather an occasional contributor from a vendor perspective but you can count me as approving all the documents up for balloting. ||
 * Seth Foldy || sethfoldy.com || Yes ||  ||
 * Member Name || Affiliated Organization || Endorsement (Vote = "Yes" or "No with comments") || Comments (e.g., "if 'no' then what can be done to make your vote a yes?") ||
 * NIkolay LIpskiy || CDC || Yes ||  ||
 * Wendy Scharber || Registry Widgets || Yes || In the Patient section: medical record number is declared as an integer data type. ||
 * ^  ||^   ||^   || Will that datatype allow a medical record number with dashes? ||
 * ^  ||^   ||^   || Example MR# with a check digit: 12343-8? ||
 * ^  ||^   ||^   || Also, some systems may include a letter designation. Not very often, but it probably happens. ||
 * ^  ||^   ||^   || Please evaluate. Whatever decision you reach is fine by me and my vote changes to a yes. ||
 * ^  ||^   ||^   || Riki Merrick comment: Suggest to change data type to ST - has been applied. ||
 * Riki Merrick || iConnect Consulting, contractor to APHL || Yes ||  ||
 * Seth Foldy || sethfoldy.com, former team co-lead || Yes with comments || I have submitted a list of suggestions for change that I believe clarify the intent of the group, rather than change it. However, some (e.g. possible confusion of "elements" with "entities" in last pages, and mislabelling of tables) definitely need attention. The list is too bulky to mount here in full but the lead team has it. However, I could live with the document unchanged if necessary to move forward. ||
 * Lura Daussat || OZ Systems || Yes with comments || After reviewing with Nikolay, the following changes will be made. My vote is now yes, with comments. ||
 * ^  ||^   ||^   || On Page 71, Table 52, there is no intersection between Newborn Hearing and Provider Information and we believe this should be indicated. Provider information is provided to public health when a newborn hearing screening is performed. The public health report back to the OP EHR may also include health care providers. ||
 * ^  ||^   ||^   || On Page 57, Table 39, in the Vocabulary section, it appears that some vocabulary may be missing, that is related to the ||
 * ^  ||^   ||^   || Outpatient EHR – Initial Hearing Screening Follow-up Report that is mentioned in the Newborn Hearing User Story. The vocabulary that is not included, that is included in the IHE Profile on the Early Hearing Care Plan, which is the OP EHR, Initial Hearing Screening Follow-up Report, is: ||
 * ^  ||^   ||^   || Physical Examination ||
 * ^  ||^   ||^   || Review of Systems ||
 * ^  ||^   ||^   || Coded Care Plan ||
 * ^  ||^   ||^   || JCIH_EHDI Hearing Screen Left Value Set ||
 * ^  ||^   ||^   || JCIH-EHDI Hearing Screening Right Value Set ||
 * ^  ||^   ||^   || JCIH-EHDI Newborn Hearing Procedure Value Set ||
 * ^  ||^   ||^   || Joint Commission Medical Reason Value Set ||
 * Anna Orlova || PHDSC || Yes ||  ||
 * Rob Savage || CDC/AIRA || Yes with comments || This document does not reference/acknowledge the ongoing success of the HL7 V2.5.1 Implementation Guide for Immunization Messaging. I references the Immunization DAM and FHIM, both of which were influenced by the Implementation Guide. There should be alignment with that IG as well as the other documents. For instance there are guidelines and vocabulary in the IG that could be referenced. V2 messaging of immunization content has a long history of success and widespread implementation. This document should acknowledge this and include it as a reference and influence. ||
 * ^  ||^   ||^   || I agree with Wendy Scharber, MR# should be a string type and should also include assigning authority. ||
 * Lise Stevens || FDA/CBER || Yes with Comments || Minor comments forwarded to N. Lipskiy 1/10/13 ||
 * Kerry Souza || CDC/NIOSH || Yes with Comments || Comments are attached in a file below ||
 * John Abellera || CDC || Yes ||  ||

=Archived Consensus on Use Case and Functional Requirements= The general consensus of the Public Health Reporting Initiative is that the and documents are complete and correct in their representation of a provider-initiated report from an EHR system to a public health agency system (within the constraints of the scope of the Initiative).
 * **Submitter** || **Comment** ||
 * Kerry Souza || [[file:Kerry Souza NIOSH comments 011613.docx]] ||
 * Seth Foldy || [[file:Seth Foldy comments.docx]] ||

On September 25, 2012, the Public Health Reporting Initiative indicated agreement with the above consensus statement and accepted the edits described below.

Accepted Updates:

 * Add to introductory section in both documents the following statement "Some of the user stories submitted for this initiative represent current workflow and information flows, but others represent a proposed future state." (Consensus to add this language reached on preliminary consensus review call 9/12/12)
 * Remove the word 'representative' from the document backgrounds to reflect that all user stories (e.g., injury) may not be completely included in these versions
 * Add a future activity detailing the updating of these document to include additional or expanded public health domains (e.g., injury)
 * Minor formatting updates
 * Caveat that the data elements have not yet been released for consensus approval; will be removed once data elements are finalized

Review Submitted Votes (Use Case and Functional Requirements)
Updated 9/25/12 at 12PM ET. Vote changed to a 'yes' with accepted resolutions (above) || Yes with comments: Use case document: page 6/32 - 3.0 -last sentnece in first paragraph: delete 'to create' after 'pharmacy, etc.)': (e.g demographic, clinincal, laboratory, pharmacy, etc) .. and send a report... page 18/32 - 11.1.4 - 3rd sentence: add 'is' in front of 'determined': When an adverse event occurs and .. determined ... page 20/32 - bottom of page delete lone table header page 23/32 - 12.0 first paragraph, last sentence: add 'and/' in fron of 'or': ...requirements and may vary from condition-to-condition .. or jurisdiction-to-jurisdiction. Functional Requiremetns document: page 22/26 - las sentence before 6.0 remove second period at the end page 24/26 - table first row (reporting criteria) column description - 4th row: add 't' to 'definiions': definitions and add space after the comma It is my assumption, that the dataelements document referenced in the Functional Reguirements document will be voted on separately. Otherwise, I cannot apporve the Functional Requirements document until that task has been completed. || Vote changed to a 'yes' with accepted resolutions (above) || NIOSH votes ‘no’ to the statement “The Use Case and Functional Requirements documents are complete and correct in their representation of a provider-initiated report from and (sic) EHR system to a public health agency system (within the constraints of the scope of the Initiative)”, in acknowledgment of the absence of public health reporting of injuries and related acute health conditions from the Use Case. Public health reporting of injuries encompasses unintentional and intentional trauma, acute poisonings, and “medical misadventures” i.e., injuries arising from medical procedures. These outcomes may be either occupational or non-occupational in nature. While injury stakeholders (including occupational health) did not submit user stories describing the reporting of injuries for the PHRI process, public health reporting of injuries is within the scope of the Initiative. Generally, the Use Case document should note this limitation and suggest that future use case development by non-represented domains is appropriate. To communicate to the public health community that this initiative aims to represent the full range of public health reporting, injury should be mentioned specifically as a missing domain. Therefore, we recommend the following modifications to the Use Case document: • To page 5, following the sentence beginning with “Future Use Cases that could be developed include..”, add: “As additional public health stakeholders become engaged in Standards and Interoperability Framework activities, use cases for domains not represented in this effort (e.g., injury) should be developed and incorporated into future public health reporting documents.” • To page 15, under “11.1 User Story”, after the sentence beginning with “These user stories have been generalized..”, add: “PHRI acknowledges that not all domains were represented in this recent process, and that future efforts are needed to ensure that public health reporting standards also reflect the requirements of significant missing domains (e.g., injury). We also recommend the following modification to the Functional Requirements document: • On page 3, strike the word “representative” from the sentence beginning “The PHRI use case was derived using a representative sample..” In that sentence, the meaning of the word “representative” is unclear and may suggest a process of selection among candidate domains or scenarios. As an alternative, the sentence could be re-written : “The PHRI use case was derived from current public health reporting scenarios submitted by participating public health domains.” Thank you for the opportunity to participate in the PHRI process and to comment on these documents. ||
 * **Member Name** || **Affiliated Organization** || **Endorsement (Vote = Yes, No)** || **Comments (e.g., if no, what can be done to make it a yes?)** ||
 * Michelle Williamson || CDC / National Center for Health Statistics (NCHS) || Yes, with comments || We agree with the above statement; however, we do suggest providing some clarification in the introduction paragraph to the user stories to indicate that these stories represent current process and proposed future flows. Readers may misinterpret the stories as representing current processes. This distinction is noted in Appendix A in the user story names. For example, in the Chronic Disease #1, it indicates 'future flow for NCHS'. ||
 * Wendy Scharber || Registry Widgets || Yes || No Response ||
 * Eric Jamoom || National Center for Health Statistics (NCHS) || Yes || No Response ||
 * Nikolay Lipskiy || CDC/OSELS || Yes || No Response ||
 * Riki Merrick || iConnect Consulting || No, with comments
 * Steven Wagner || FHA || Yes || No Response ||
 * Kerry Souza || CDC-NIOSH || No, with comments
 * Dina Dickerson || Oregon Health Authority || Yes || No Response ||
 * Anna Orlova || PHDSC || Yes || *Vote cast on 9/17/12 Co-lead call ||
 * Lise Stevens || FDA || Yes || *Vote cast on 9/17/12 Co-lead call ||

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