LRI+Validation+Suite+WG+2011-10-11

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 * LRI Validation Suite Meeting Minutes**
 * Date:** 10/11/2011
 * Time:** 1:00-2:00 pm EDT

Robert Allen, Neeli Bajaj, Tom Boal, Joan DuHaime, Freida Hall, Cynthia Levy, James Littlejohn, Scott Robertson, Rob Snelick, Sheryl Taylor
 * Attendance**

Note: If you attended this meeting and are not listed above, please contact Ingrid Williams(Ingrid.K.Williams@lmco.com or (443-348-2606) to be added to the list.

**Agenda **

 * **Discuss Validation Suite**
 * **Next Steps**
 * **Q and A**


 * Agenda**
 * Action Item List
 * Test Data Update
 * Review Policy Proposal for Validating Receiver Processing of Terminology
 * Review ELINCS Test Plan and Test Tool
 * Update on LIS Test Plan Template
 * Update on EHR Test Plan Template
 * Spreadsheet Analysis/Juror Document
 * Tooling Update
 * Face-to-Face Meeting Plans
 * Planning
 * Next Steps
 * Q and A

Sheryl Taylor has started creating some sample Core Test Messages and tabs. She has also started putting in various data elements. • We have started creating the documentation.
 * Action Item List (Updates)**

Completed the draft test messages for the following six medical categories:Hermatology, Chemistry, Microbiology, Special Chemistry, Susceptibility, and Other. Review Policy Proposal for Validating Receiver Processing of Terminology Background: The Logical Observation Identifiers Names and Code (LOINC) was developed to provide a definitive standard for identifying clinical information. Some of the Issues: The main question is "How do we test this scenario and test the universe of possible LOINCs?" • Would like to have feedback from the LRI Validation Suite workgroup on the Receiver Requirements for Processing Terminology, Assessment of Terminology, Equivalent Terminology, and Questions slides concepts, in the ToC RI 20110927.doc PowerPoint slides presented during this meeting.
 * Test Data Update**
 * Still working on the draft test messages for the Routine Urinalysis and Complete Urinanlysis categories.
 * We currently have an initial recommended list of 140 to 144 categories and reporting formats.
 * Default values are being identified.
 * We will use the Lab Codes the vendor wants us to use.
 * Starting to develop the test cases for, and the mapping to, the identified test categories. We will start a smaller number for an initial review.
 * It was mentioned we should start with a "starter" message and minimally populate the message, as a starting point for the testing.
 * The plan is to have the Laboratory Information System (LIS) test harness send a test message to the Electronic Health Record (EHR), containing a specific LOINC.
 * One of the LOINC laboratory test results criterion (§170.302 [h]) states, among other criterion:
 * (Have to be able to) Electronically receive clinical laboratory test results in a structured format and display such results in human readable format.
 * Will the EHR translate or map a LOINC to some type of internal EHR code but will display something different, e.g. in a readble-format translation of the code?
 * Will both the LOINC and readable format have to be transmitted to, and from, the EHR?
 * What happens if the EHR uses codes other than LOINCs?
 * Key Notes**
 * There was a question of whether or not the terminology challenges being addressed would be issues for the Department of Human Resources (DHR) vendors.
 * Rob Snelick asked if anyone disagreed with the following draft requirements:
 * The receiver shall persist (store) the original standardized code and the original standardized code text as recieved in exact representation.
 * The receiver may perform a translation/mapping to locally defined representations.
 * There were no disagreements.
 * Rob Snelick asked if anyone disagreed with the proposed procedures for assessing the receiver for incorporation of terminology on the Assessment of Terminology slide. There were no disagreements.
 * Rob Snelick indicated the workgroup would need input and guidance from medical experts and the medical community on addressing the proposed requirement: "For translated/mapped local code text, an equivalent representation, as determined by clinical terminology expert."
 * The following will have to be analyzed and addressed: Whether or not a general code or a LOINC would be displayed alone or the general code, or LOINC, and the "longer" text name would have to be displayed to satisfy the healthcare community needs. One of the issues would be, if both are displayed, then more information would be displayed than is required, which could be problematic. Or, not.
 * The following will also have to be analyzed and addressed: As a standard rule, we would some form of standardized healthcare terminology or would we have to incorporate translating general codes, or LOINCs, into some "equivalent" form of standardized readable format.
 * If we are required to send a LOINC, should we also send the longer text name or equivalent, even if the longer text data is not displayed on the other end in one of the EHR systems?
 * Some in the workgroup mentioned this may be something they would have more to comment on, once they were able to see some of these scenarios in action.
 * Rob Snelick will look into the possibility of creating a white paper and sending it out to the healthcare community, at large, in order to get members of the healthcare community's feedback and suggestions.
 * Rob Snelick pointed out on the Questions slide that one of the significant questions, which will have to be addressed and determined "What is acceptable and what is not acceptable?" For example, what is an acceptable loss of data? Is it valid to display a representation that has less specificity? Is it valid to display a representation that has less specificity, as long as the original data is persisted in the system? Etc.
 * Rob Snelick said we will have to determine what will be included in a valid message we send to an EHR system and when an error code will be generated.
 * Rob Snelick, mentioned in closing, "We need to know exactly what we need to test."

Continue discussions on questions and issues raised in today's meeting.
 * Next Steps**

Next Meeting ** WebEx link: [|siframework2.webex.com] ** ** Dial-in: 1-408-600-600-3600 Passcode: 665 819 504 **
 * Date: Tuesday, 10/25/2011 (N.B.: no meeting during F2F)**
 * Time: 1****:00 p.m. EDT**

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