LRI+IGs+Analysis+WG+Meeting+2011-08-18

include component="page" wikiName="siframework" page="LRI Header" =LRI IGs Analysis WG Meeting Minutes=  **Dial-in:** 1-408-600-3600 **| Passcode:** 660 071 157
 * Date: ** 08/18/2011
 * Time: ** 3:00PM – 4:00PM EDT

Attendance
Hans Buitendijk, David Burgess, Kathryn Calderone, Ernest Grove, Freida Hall, Rob Hausam, John King, Austin Kreisler, Ken McCaslin, Natalie Menser, Riki Merrick, Brian Pech, Zeshan Rajput, Scott Robertson, David Susanto, Bob Yencha

Action Items

 * **#** || **Date Initiated** || **Action** || **Owner** || **Status** || **Date Closed** ||
 * 1 || 08/18/2011 || Write a clarifying paragraph regarding the conformance statements for 'Observation Sub-ID' Element to be included in the IG || Hans Buitendijk || In Progress ||  ||
 * 2 || 08/18/2011 || Review the 'Units' Element marked for further follow up regarding conformance statements and prepare a paragraph for the discussion on Tuesday 8/23. || Riki Merrick & Ken McCaslin || In Progress ||  ||
 * 3 || 08/18/2011 || Wordsmith the conformance statements related to the parent/child micro relationship so that they meet the needs of the IG. || Need a volunteer || In Progress ||  ||

Agenda Items

 * 1) Related Placer Number & Units need to be addressed, and conformance statements need to be determined.
 * 2) Discuss next steps regarding Parent/Child Micro Relationship, referencing “Appendix A: HL7 Reporting of Cultures and Susceptibilities” of the ELR Document, and Austin Kreisler’s and Ken McCaslin’s proposals/recommendations.
 * 3) Continue to address any remaining conformance issues.

Meeting Notes

 * **Recap of last meeting and agenda **
 * **“Conditionality” discussion continued **
 * Proposal 714 is posted as a reference; it provides guidance on the new HL7 conformance requirements; Bob Yencha will reference this document in the Implementation Guide.
 * The following elements were discussed:
 * Parent Result under Observation Results: (C (R/RE)
 * Update “Parent”
 * Observation Sub-ID: C(R/RE) – need a clarifying paragraph around the related conformance statements- Hans Buitendijk will help write this paragraph to be included in the IG.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Units: still marked for further follow up; Riki Merrick & Ken McCaslin will review it in preparation for Tuesday; Ken McCaslin will review the work with Cindy Johns as well.


 * **<span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Parent/Child Micro Relationship Discussion **
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">The problem we are running into is determining when to use parent/child:
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">There is one condition the group has consensus on: if the specimen action code is equal to ‘G’, then you need to use parent/child. ‘G’ = Reflex Testing (Generated Order)/OBR 11 is the specimen action code.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">There is a concern that someone might declare that a test is not a reflex and consequently will not need to use parent/child.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Ultimately there is a need for more clear language so that more systems start to communicate the micros in a parent/child format.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">If you consider micro a reflex, then parent/child should be used.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Some may argue that a micro susceptibility relative to the culture is not a reflex test, therefore the results are not valued as ‘G’ and consequently not reported as parent/child, so the result comes across as a text blog.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">So, even if you do not consider it to be reflex, you still send as parent/child so that in practice, systems use it and in the validation it can be offered as a valid test.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Even if a Specimen Action Code is not ‘G’, but is a culture, then it shall be communicated as a parent/child.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Ken reached out to labs to inquire whether this would be an issue. It turns out labs do not flag reports as ‘G’, but that should not be a problem.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">All members were in agreement with the need for a paragraph that states that even if you do not consider susceptibility testing a reflex test, you still need to send it as a parent/child.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">The general comments were that people would like to see this tested and validated.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Two conformance statements need to be documented:
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">One for the sender demonstrating that they can populate the micro culture and susceptibility message using parent/child.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">The second, demonstrating that the receiver can receive the message, and processing it appropriately.


 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Back to “Conditionality” for Data Types **
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">‘Name of Coding System’ Component C(R/X)
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Name of Alternate Coding System Component C(R/X)
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Non Global Profile- Universal ID – C(R/RE)
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Universal ID Type- C(R/X)


 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Next Week **
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Group to start work at Hierarchical Designator- Universal ID
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Four ‘Cs’ left to finish up
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">David Burgess’s example of micro has been adequately covered with today’s discussion.
 * <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Data Values and vocabularies are the last items to review in order to make sure the group has not missed anything.

Next Meetin**g**

 * <span style="font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Date: **<span style="font-family: 'Arial','sans-serif'; font-size: 13.3333px;">08/23/2011
 * <span style="font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Time: **<span style="font-family: 'Arial','sans-serif'; font-size: 13.3333px;">3:00 PM-4:00 PM EDT
 * Dial in:**<span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;"> 1-408-600-3600

Reference Materials
>
 * 1) <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">[|Parent/Child Micro Relationship]
 * 2) [|Proposal714.doc]
 * 3) <span style="color: #000000; font-family: 'Arial','sans-serif'; font-size: 13.3333px;">Ken McCaslin's Notes on [|Parent/Child Micro Discussion]

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