ToC+Clinical+Information+Model+WG+Meeting+7-21-2011

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ToC CIM Vocab WG Meeting Minutes

 * Date:** 07-21-2011
 * Time:** 1:00-2:00pm EDT
 * Dial-in:** 1-408-600-3600 | **Passcode:** 661 213 377

Attendance
Robin Barnes, Amy Berk, Mark Braunstein, Amram Ewoo, Lindsey Hoggle, John King, Amy Knopp, Russell Leftwich MD, Natalie Menser, Erik Pupo, Dave Shevlin, Steven Waldren, Bob Yencha

Action Items

 * **#** || **Date Initiated** || **Action** || **Owner** || **Status** || **Date Closed** ||
 * 1 || 07-21-2011 || Verify “Patient State” is a data type component that is referenced for Vital Signs entity || Vassil Peytchev || Open ||  ||
 * 2 || 07-21-2011 || Develop Behavioral Health and Social work One- Pager || Lindsay Hoggle || Open ||  ||
 * 3 || 07-21-2011 || Verify if CDA sections are not mapped to CIM and make corrections; Review diagrams to validate mapping; Create introductory text for CIM and send out to group for consensus || Erik Pupo || Open ||  ||
 * 4 || 07-21-2011 || Post comments on latest version of the CIM Detailed Report to the Discussion board and incorporate clinical examples || All || Open ||  ||
 * 5 || 07-21-2011 || Make edits to CIM Detailed Report and post to Wiki || Adrienne Pugh || Open ||  ||

Agenda Items

 * 1) Welcome and Announcements (Adrienne)
 * 2) Review CIM Mappings (Russell)
 * 3) Next Steps (Adrienne & Erik)

Meeting Notes

 * Discussion of the CIM Detailed Report**
 * Incorporated addition of clinical examples and insights necessary to inform some of the data types, and formatting edits from Russell Leftwich.
 * Vassil Peytchev was not able to update some of the data types in the document thus far; he will work on it later today.
 * Holy Miller is currently out on vacation and will send her section in later.


 * Erik Pupo Update**
 * Listed relevant examples showing CIM alignment with CDA components; all template IDs have been inserted thus far; all scope and administrative elements have been included in the text and will be loaded into the report and ready for consensus.
 * CIM support materials have also been developed; some are specific to implementers who will want to use the CIM. CIM is currently aligned to CDA Headers
 * Alignment of CDA guide to CIM objects (8 objects).
 * Need to align CIM to the information exchange discussed in the summary for use cases.
 * Some CDA sections are not mapped to the CIM because we are reviewing them to make sure that mapping is correct (ex. Chief Complaint). Transitions of Care WG will be working on capturing additional alignments to CDA
 * Introductory text will be created and sent out to the group- once that is completed we will ask for consensus on the TOC CIM and allow for 7 days to capture consensus votes.


 * Discussion of Russell's Comments**
 * **Immunization History Entity**- trying to align it with what is captured in most immunization registries- Erik Pupo to make the change.
 * Decision was made that it is OK to take ‘skin test’ section out of the document in this section
 * **Patient Contact Information Entity**- changing this to email address rather than phone number
 * Storage of direct email address- data type is probably AD.
 * **Reason for Consults Request**: Change this name to “Reason for Referral” in order to capture both consultations and referrals. Consultation is one sub-type of the referral – needs to be updated in the table as a whole.
 * **Social History Entity:**(Social History Additional Details)
 * Behavioral Health and Social work realm- hold off until all appropriate members are present? – Lindsey Hoggle to do some work on this and prepare a one pager.
 * **Support Contacts Entity:**
 * Need to incorporate legal status(power of attorney/guardian etc.) as a data element for “Support Contacts” entity. Need to add section on legal rights.
 * Power of attorney or guardianship ( particularly a handicapped individual) An emergency contact may not have a legal status- and in most cases it would not be legal status; it could be of value to designate the legal status of the person.
 * We should clarify (yes or no- legal authority or power of attorney
 * Adding data element- “Legal right to speak?”- proposed by Susan Campbell
 * **Vital Signs Entity**
 * Device type: size of blood pressure cuff is a determinant of whether or not you get an accurate reading; normal size blood pressure cuff; Needs to go into implementation guide
 * Patient State: whether the patient is supine, standing or exercising is an important element; can’t have accurate blood pressure reading if you don’t know the state of the patient.
 * The group agreed that it would be helpful if the definition of patient state had some more depth/some clarity.
 * Patient State changed to a “B” Data Element
 * **List of Intolerances including Allergies Entity**
 * Clarifying the relationships
 * Do we have ways of measuring severity or symptoms vs. causes
 * There are scales for assessing the severity of a reaction but not a condition

Next Meeting

 * Date:** 07-28-2011
 * Time:**1:00-2:00pm EDT

Reference Materials

 * 1) ToC CIM Detailed Report

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