TOC+Implementation+Guidance+SWG+Meeting+Minutes+12-16-2011

include component="page" wikiName="siframework" page="TOC Header" =ToC Implementation Guidance SWG Meeting Minutes=
 * Date:** 12-16-2011
 * Time:** 3:00-4:00pm EDT

Attendance
Rich Kernan, Russell Leftwich, Holly Miller, Russ Ott, David Tao, Bob Yencha

Action Items

 * **#** || **Date Initiated** || **Action** || **Owner** || **Status** || **Date Closed** ||
 * 1 || 12-16-2011 || Provide comments to the visual example provided by Erik || Volunteers || Open ||  ||
 * 2 || 12-16-2011 || Review discharge instructions and discharge summary and compare how the documents are covered by Consolidated CDA and CEDD || David Tao || Open ||  ||
 * 3 || 12-16-2011 || Create a sample allergy section on specific data that is typically captured by allergists- (This will be used as a basis for determining how to code information) || Dr. Russell Leftwich || Open ||  ||

Agenda Items

 * 1) Welcome and Announcements
 * 2) Implementation Guidance Discussion (Volunteers)
 * 3) Next Steps

Meeting Notes

 * There is a need to determine how to provide contextual guidance with examples of patient centric examples- i.g in the patient narrative which explains the vital signs or the discrete observations grouped according to the organizer and then provide an explanation of what the section is, the required components and how the data works together
 * I.G. The example provided on the call was as follows, "Patient X has a BP of over 120/80 at rest" and then the implementation guidance would be on how to code this statement and ultimately provide implementers with an understanding of how to use CDA.
 * There was a caution that the detailed clinical scenarios and patient examples run a risk of lacking utility for implementers/consumers of the guides
 * The following comments were provided for the Implementation Guidance visual
 * D. Tao made the comment that more patient-centric clinical examples were needed
 * The implementation guidance data format needs to stay within the grouping of sections as defined by the five within MU and then those required by TOC and later by those optional in TOC
 * The table is similar to the tables in the new consolidated CDA templates
 * The CEDD table names are similar to C83 reference names
 * The point was raised that the XML files and examples could serve as companion documents that explains how to use CDA for representing "Discharge Summary"
 * The community could see the value of the information and would be more likely to participate and provide other CDA examples
 * The explanation of the data elements/fragments from CDA could be built to determine what is required along with supporting language of what the WG is trying to accomplish
 * There will need to be explanation around coding data elements, narrative block (what will it contain? and how should it be formatted?)
 * Narrative block is required everytime and its important to explain how it used, and why its required
 * Dr. Leftwich raised the following question on if what the vendors implemented for Stage 1 products has any relevance to what the Standards Committee is now proposing?
 * The answer was raised that sometimes the implementation guidance around TOC discharge and baseline consolidated guide have been lacking with regard to the level of insight as needed by implementers
 * Implementer workshops and the Connect-athon can help capture the issues that implementers face as well as to recruit key industry players to provide advice on relevant issues and needs as well as resources to learn from.
 * The quick-start guide (document-centric) needs to have the right amount of balance with regard to balance & sections as identified by MU and then begin to marshal resources to CDA with the hope that implementers can be pointed to particular sections to use as references
 * Alternatively, the SWG could approach HL7 to re-use an implementation guide to recreate a quick-start guide for the TOC IG
 * The question was raised on whether the SWG needs to provide guidance on general topics around architectural principles?
 * Implementers might need more context around IDs as well as structural explanations
 * Implementers struggle with relating informational pieces with one another (i.e. Problem List vs. Allergies)
 * Allergies, Reactions and Active Problem List Examples discussion
 * Allergies are not listed on Problem Lists
 * Asthma could be listed as a condition but not as an active problem
 * A reaction is an episode that has a time frame- whereas a condition doesn't need a time frame
 * A medical record has an Active Problem List with your medical condition with an allergy list
 * David Tao to take a look at Consolidated CDA and CEDD with regards to discharge instruction and discharge summary
 * The allergy section that Russ develops can be reviewed by Arien Malec
 * The are two Lantana quick-start guides on CDA & CCD can serve as references for the SWG in providing a general framework for on which clinical examples to incorporate

Next Meeting

 * Date:** 1-6-2011
 * Time:** 3:00-4:00pm EDT

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