LRI+IG+Analysis+&+Vocab+SWG+Meeting+2011-6-15

include component="page" wikiName="siframework" page="LRI Header" Date: 6/15/2011 Time: 4:00PM-5:00PM EDT
 * F2F LRI Implementation Guide Analysis WG/ Vocab WG Meeting Minutes **

Tom Boal, Hans Buitendijk, David Burgess, Kathryn Calderone, Steve Carter, Donna Carter, Bill Coli, Robert Dieterle, Frieda Hall, James Harrison, Joyce Hunter, Hal Jiang, Cindy Johns, Wes Kennemore, Austin Kreisler, Ken McCaslin, Riki Merrick, Nam Nguyen, Bill Omrod, Brian Pech, Kurt Schmeer, Dave Shevlin, Robert Snelick, James Sorace, Virginia Sturmfels, Jonathan Tadese, Merideth Vida, Cindy Vinion, Roniqua Watkins, Bob Yencha
 * Attendance **

, talk about the purpose of the RI demo and pilots and what perspective the architecture team is taking for LRI (HL7 v2.messaging, etc.) || IG Analysis WG ||
 * Next Steps/Action Items: **
 * = # ||= Action ||= Owner ||
 * 1 || Determine next steps for UCUM if pilot testing is unsuccessful. || Vocab WG ||
 * 2 || Research the requirement that CWE 9 is needed to be used for SPM 4 to return what was originally submitted. || Virginia Sturmfels ||
 * 3 || Species Code Element: There is a concern on how to manage the rabies use case. This requires a linkage as well as a separate profile. Follow up with Public Health || IG Analysis Group ||
 * 4 || Parent Element: Check to see if the Rule Out can either be addressed through another value of the Universal Service Class (USC) or Specimen Action Code, or another clearly available value || IG Analysis Group ||
 * 5 || Start/End Date/Time Element: Ken McCaslin to check with Jim regarding 0..* || Ken McCaslin ||
 * 6 || <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Decide which implementation guide between HITSP and ELINCS will be used. || <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">IG Analysis WG ||
 * 7 || <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Next monthly meeting
 * 8 || <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Check the group logic on conformance use, and whether or not we are using “C”. || <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Rob Snelick ||


 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">UCUM is a viable option, however:
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">There are still questions regarding UCUM adoption.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">A successful pilot is necessary to feel comfortable recommending UCUM. There were issues and questions that needed to be addressed.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">How many people need to adopt UCUM in order for it to be determined a success?
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">WG used In-Scope test list from LOINC as a starting point.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Access to UCUM tables is not easy. There needs to be a table of Regenstrief-approved UCUM codes that anyone can easily access and understand so that they know what codes need to be incorporated into messaging.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Need a transition plan on roadmap so that organizations can get used to UCUM and adopt.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">UCUM is not widely used.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Concerns in terms of UCUM units being used where UOM (unit of measure) might be different from what labs report. UOM does not match, even if it has the same units of measure. Needs to be addressed.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">There are issues with characters used such as [, { and * and character length issues. This needs to be tested.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">In UCUM document, there are some duplicates. Process to remove is to submit a request and somebody will look at it and take it out. It shouldn’t be up to the user to find flaws; should be up to the owners to resolve duplicates and inconsistencies.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">UOM is being recorded as a string in the wrong field creating problems. There should be a requirement for Meaningful Use stage 2 that senders must communicate UCUM units in the proper field.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">UCUM pilot will provide evidence of some success even if these issues extend beyond this initiative.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">UCUM pilot testing must include dimensionless tests.

<span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Both message structure and usage/cardinality between the user and the sender are identical.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">SNOMED
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">SNOMED is widely used, but need pilot testing to determine weaknesses.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">CWE 9 can be used to communicate information but we need to ensure that it is tested.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Successful Pilot Testing:
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">SNOMED CT is included in the OBX.5 for CWE data types and in SPM 4.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">SNOMED CT is successfully received, displayed, and incorporated as structured data.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Valid SNOMED CT codes are used from the appropriate hierarchies.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Sender and receiver application performance for print text match on both sides in content of the laboratory results to qualify report of record.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">With regards to OBX.5: when data type is CWE (Coded With Exceptions), SNOMED CT should be used to:
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Identify organisms using codes from the organism hierarchy.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">We will need further evaluation for genomics- refer to genomics implementation guide for vocabulary
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Consider other CWE test types where other vocab outside of SNOMED might apply- check if genomics or other test uses CWE data type for results.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Use SNOMED CT as preferred terminology with the understanding that for an interim period HL7 will be allowed, but HL7 will be phased out in the long term (year?) in SPM 4, 5, 7, 8 and 9.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">SPM 4 – specimen type – Required (R).
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Use specimen hierarchy for SNOMED CT, or
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">HL7 table 0487.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">SPM 5 – specimen type modifier – need to know what the message guide is, then we can decide usage.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Use qualifier hierarchy for SNOMED CT.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">HL7 table 0541.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">SPM 7 – Collection method.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Use procedure hierarchy (sub-root specimen collection in ELR is not big enough for all needed terms at this point) for SNOMED CT.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">HL7 table 0488.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">SPM 8 – Site of collection – need to know what the message guide is, then we can decide usage.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Use body site hierarchy for SNOMED CT.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">No HL7 table, in v2.3.1 we used HL7 table 0070.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">SPM 9 – Modifier for the site (left/right/upper/lower) – need to know what the message guide is, then we can decide usage.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Use qualifier hierarchy for SNOMED CT.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">HL7 table 0542.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">If all SPMs are RE than that means all labs have to support it.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">R for SPM 4 and Optional for SPM 5–SPM 9.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">LOINC Code
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Widely used, but certain aspects of LOINC code needs to be tested.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Vocab WG reviewed the In-Scope Test list.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Pilot testing strategy has been devised.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">WG felt good about LOINC, but wanted to test some vocabulary.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Alignment with LRI In-Scope Test List.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">A1-A4 identified what format would be.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Created a list of most commonly used tests in an ambulatory care setting.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">For pilot testing, each test has to be tested but not all by the same pilot group. The volunteer site for the same site does not have to oversee all tests.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">If we decide to go with ELINCS, Ken McCaslin would be willing to go to California to discuss.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Hans Buitendijk does not want to factor that into the decision between the ELINCS guide or the HITSP guide.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">RI produces reusable code incorporated into guide. Meets all requirements. But not something a commercial entity would use.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">IG Analysis
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">IG Analysis Matrix Spreadsheet Progress
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">The WG reviewed EP EHR Receiver perspective as well as the EP EHR Sender perspective.
 * <span style="color: black; font-family: 'Verdana','sans-serif'; font-size: 13px;">Reviewed ORU (results availability) and sending of ACK (acknowledgement).

include component="page" wikiName="siframework" page="space.template.inc_contentleft_end"