Patient Administration and Financial Management (PAFM)
Technical Committee Meeting Minutes
HL7’s Winter Working Group Meeting
January 25 - 29, 1999
Orlando Marriott Downtown
Orlando, FL
Addendum to minutes
HL7 v2.3.1 Membership Ballot Outcome (Chapters 3, 6, and 8)
Chapter 3 Ballot Issues and resulting edits:
Item # / Vote / Issue / Resolution /Ballot: CDC – Daniel Pollock, M.D.
3.3.2.10
3.3.2.22
3.3.5.28
3.3.5.35 / Affirm / RE: definitions of the Race and Ethnic Group data elements should be corrected: 1) The phrase "second couplet (alternate identifier, alternate text, and name of alternate coding system)" should be changed to "second triplet (alternative identifier, alternate text, and name of alternative coding system)." The CE data type is comprised of two triplets, not two couplets. / In chapter 3, this impacts the “race” and “ethnic group” fields in the PID and NK1 segments. Changed “couplet” to “triplet” in 4 references listed in first column.
3.3.2.10
3.3.2.22
3.3.5.28
3.3.5.35 / The sentence "In the United States, these codes are assigned by the Office of Management and Budget" also needs editing. OMB does not assign codes for race or ethnicity; rather, it designates minimum race and ethnicity categories for federal statistical reporting purposes. The US Bureau of the Census provides an expanded set of categories, but Census, like OMB, does not assign codes to its race and ethnicity categories. CDC is developing a code set based on the Census race and ethnicity categories. This code set will need to be updated !
over time as the Census categories evolve and as the OMB standard is revised. Instead of stating that the race or ethnic group codes are assigned by the Office of Management and Budget, it would be more accurate to state that minimum race or ethnic group categories are designated by the Office of Management and Budget. Alternatively, the sentence "In the United States, these codes are assigned by the Office of Management and Budget" could be dropped altogether. This appears to have been done in the IN2-42 version of the Ethnic Group data element, which states simply "The second couplet of the CE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes." / Accepted. Drop the sentencing referencing to OMB. This impacts the fields listed in the first column.
Ballot: Pathology Associates Medical Laboratories – Ann Hueber
3.5.2.1.7 / Suggest / In the second scenario, the last three elements "Q", "R", and "S" are not effected and their value remains as if no association had been made.
SUGGEST: affected Page 3-88 / Accepted. Change “effected” to “affected.”
3.5.2.1.7 / Suggest / In the third scenario, the last three elements "D", "E", and "F" are not effected and their value remains the same as if no association had been made.
In this scenario, the three elements which do not have corresponding identifier type and assigning authority "D^t4^a1", "E^t5^a1", and "F^t6^a1" are not effected and their value remains the same as if no association had been made.
SUGGEST: affected Page 3-89 / Accepted. Change “effected” to “affected.”
3.5.2.1.8 / Suggest / In the second scenario, the three elements which do not have corresponding identifier type and assigning authority "X^t4^a1", "R^t5^a1", and "S^t6^a1" are not effected and their value remains the same as if no association had been made.
SUGGEST: affected Page 3-90 / Accepted. Change “effected” to “affected.” (two occurrences in this section.)
Note: Same issue with the following text was corrected: In this scenario, the three elements which do not have corresponding identifier type and assigning authority “D^t4^a1”, “E^t5^a1”, and “F^t6^a1” are not effected and their value remains the same as if no association had been made.
3.5.2.1.6 / Typo / The “PID-4-alternate patient ID with MRG-2-prior alternate patient ID” row in the table graphic belongs under the “Patient” heading, not the “Account” heading / Accepted. Moved PID-4 row from “account” to “patient”.
3.5.2.1.7 / Typo / For the third scenario, the second sentence should read “As in the list example above, elements “A”, B”, “C”, “D”, “E” and “F” in the first list would “pair up” with elements “X”, “Y” and “Z” in the second list.”… the lists changed, but this sentence appears to have been copied from the second scenario / Accepted. Edit sentence to match graphic, e.g., add D,E, and F in the first list and remove Q, R, and S from the second list (in text.)
Ballot: McKessonHBOC – Richard Ohlmann
3.2.46
3.2.48 / Query / The style for dealing with messages being “retained for backward compatibility” is not consistent. For example, compare these two messages (A46 and A48) with 3.2.39 (A39)… bolded verbiage for the A39 only; but recommended replacement message for only A46 and A48. While the verbiage under A46 and A48 is good, should all deprecated messages be itemized as a new section under 3.5.2.2 for consistency? / Accepted. Bold first sentence (backward compatible) for Trigger Events A46 and A48.
Add A39, A46, and A48 to Section 3.5.2.2 (Trigger events) as retained for backward compatibility.
In 3.5.2.2, beginning with 3.5.2.2.1, remove reverence to A39, A46, and A48 trigger events retained for backward compatibility.
General / Query / With the elimination of “external ID” and “internal ID” from the definitions of both PID.2 and PID.3 fields, respectively, should the use of this old terminology (“internal” and “external”) be eliminated throughout the chapter and replaced with the newer “patient identifier list” term? / Defer to v2.3.2
General / Query / Similarly, with the designation of these messages as “retained for backward compatibility” (A39, A46 and A48) should we continue to promote their use by recommendation (see verbiage in sections 3.5.2.2.1 through 3.5.2.2.5) and sample messages (see examples 3.5.2.2.6, 3.5.2.2.16 and 3.5.2.2.18), or should these references be eliminated? / Defer to v2.3.2 (rewrite of sample message section.) As interim step, added the sentence: This event is retained for backward compatibility prior to the table in the sample message section for A39, A46, and A48 (now renumbered 3.5.2.2.9, 3.5.2.2.19, and 3.5.2.2.21.)
Cleanup of verbiage in 3.5.2.2.1 corrected with prior issue (see prior section on 3.2.46 and 3.2. 48.)
3.5.2.2.12
renumbered to 3.5.2.2.15
(A43) / Query / Should the original example message simply be replaced with the newly added example? Or, is the implication of “retained for backward compatibility” that both methods are equally acceptable and both should be supported? / Defer to v2.3.2
3.3.8.2
3.3.8.4 / Query / Aren’t both of these MRG fields also “retained for backward compatibility” now, similar to PID.4 and PID.2, respectively? / Added to 3.3.8.2 and 3.3.8.4: This field has been retained for backward compatibility only. It is recommended to use MRG-1 prior patient identifier list for all patient identifiers.
Ballot: HL7 Finland
3.5 / Query / We think that it is confusing to talk about PID-2-patient ID, because PID-2 is no more used. Of course the main hierarchy person-patient-account-visit still remains. / Defer to v2.3.2
Ballot: IDX Systems Corporation – Al Figler
3.2.4.6 / Suggest / Section 3.2.4.6 (page 33) states that A46 is obsolete, but this is not reflected in the example in Section 3.5.2.2.16 (page 103). Suggest either remove example or mention status of A46 there also. / Accepted (duplicate). Added backward compatible sentence to message example in 3.5…
3.2.4.8 / Suggest / Section 3.2.4.8 (page 33) states that A48 is obsolete, but this is not reflected in the example in Section 3.5.2.2.18 (page 105). Suggest either remove example or mention status of A48 there also. / Accepted (duplicate). Added backward compatible sentence to message example in 3.5…
Ballot: LAB-Interlink, Incorporated
3.3.3.3 / Affirm / I am a bit confused about the need for the "Ordering Facility" at the component/test level in the ORC (4.3.1.21). Will that be in conflict with the "Patient Location Facility in the PV1 (3.3.3.3)? I'm sure the rationale is sound and was well thought out. If someone could briefly explain, I would appreciate his or her effort. / No edits needed. The patient’s assigned location in PV1-3 represents their census, or other assigned location. A patient may be transferred to a different facility for treatment. For example, Hospital A does not have a CAT scan and transports patients to Hospital B for treatment. In this example the Ordering Facility for items related tot he CAT scan would be Hospital B.
Ballot: SMS – John Molina
3.5.2.1.2 / Typo / There is a reference to a graphic depiction of the merge event following the paragraph, but the illustration is missing.
3.5.2.1.7 / Typo / Objects of the both sets are incorrect in the paragraph description. / Accepted. (Duplicate). Text updated to match graphic.
Kaiser Permanente – Joanne Larsen
3.2.19 / Query / Question the addition of the QAK segment as an optional field in the ADR message. To be consistent with the QAK description in section 2.24.22, it seems like it should be required. The initiating system is required to identify the query because the QRD-4 is a required field in the QRY^19. / No edit to Chapter 3. Resolved with edit to Chapter 2 (per email from Mark Shafarman 2/28/99):
Re: 2.24.22.1, the field note for query tag in the qak segment, as agreed to in the Jan. CQ WG meeting for v 2.3.1 edit:
QAK-1-Query tag is not conditional on the presence of the QRD-1-Query ID field in the original mode queries: in the original mode queries QAK-1-Query tag is not used.
Reported after the Meeting – technical correction
3.3.2.5
3.3.2.6
3.3.2.9
3.3.5.2
3.3.5.26
3.3.5.30
3.3.8.7 / Typo / Components of XPN (family name, given name, etc.) were erroneously changed from ST to IS. / Change first six components (through Prefix) of XPN from IS to ST.
Chapter 6 Ballot Issues and resulting edits:
Item # / Vote / Issue / resolutoin /Chapter Authors / N/A / Reverse order to list Freida Hall first (for inquiry routing) and change HBO & Company to McKessonHBOC.
Ballot: McKessonHBOC - Patricia Grey,
6.4.6.31 / TYPO / “Value” and “Description”, the headings for the table, should be underlined. / Accepted. (Style guide issue)
6.4.6.47 / TYPO / “Value” and “Description”, the headings for the table, should be underlined. / Accepted. (Style guide issue)
6.4.7 / TYPO / IN2:42 (Ethnic Group) was marked in the Committee Ballot # 1 of Chapter 6, which was handed out at the 9/98 PAFM meeting, with RP/# as “Y”. I could find no verbiage saying that we removed the repetition of the field. Should this be a repeating field? / Accepted. Technical correction. Note: Ethnic group should repeat in all four “person” segments, e.g., PID, NK1, GT1, and IN2. The other segments already have Ethnic Group as repeating.
6.4.10.12 / TYPO / Should the table name match the name of the field? “Special” rather than “Spec”? / Accepted. Changed “Spec” to “Special” in text and table header.
Karen: Appendix A reference to Table 0348 should be changed to match Chapter 6, e.g., from Spec program indicator to Special program indicator.
6.4.10.16 / TYPO / The word “code” in the table name should be italicized.
The quotes should be removed from the end of the fourth sentence. / Accepted.
6.4.11.7 / TYPO / “user-defined table 0352 - Occurrence code - UB2” should read “user-defined table 0350 - Occurrence code” and should be italicized. / Accepted. Also removed – UB2, which was the original name for table 0352 (e.g., Occurrence code – UB2.) Originally, we had separate tables for Occurrence Code in the UB1 and UB2 segments because the values were different. We agreed to pull the table examples from the UB1 segment (since the UB92 table values are currently in use), which meant we could use a single table reference (0350).
6.4.11.8 / TYPO / Should the last entry in table 0351 read “PSRO/UR Approved Stay Dates” rather than “PRO/UR Approved Stay Dates”? / Not accepted. Verified in UB92 manual that the code is “PRO/UR Approved Stay Dates”
Ballot: McKessonHBOC – Freida Hall
6.4.2.15 / Major / Remove 0-Admitting Diagnosis from the Diagnosis Priority table. “Admitting” is a diagnosis type, which is defined in field 6, Diagnosis Type Field. There can be multiple admitting diagnosis, therefore sequential number (1, 2, 3…) of admitting diagnosis is necessary. / Accepted. Change description for “0” from “the admitting diagnosis” to “not included in diagnosis ranking”. (This wording was discussed with Mead Walker [ARB Chair] and John Quinn [TSC Chair]), and does not require a re-ballot.
Ballot: CDC – Daniel Pollock, M.D.
6.4.5.44
6.4.5.55
6.4.7.42
6.4.7.71 / Affirm / RE: definitions of the Race and Ethnic Group data elements should be corrected: 1) The phrase "second couplet (alternate identifier, alternate text, and name of alternate coding system)" should be changed to "second triplet (alternative identifier, alternate text, and name of alternative coding system)." The CE data type is comprised of two triplets, not two couplets. / Accepted. In chapter 6, this impacts the “race” and “ethnic group” fields in the IN2 and GT1 segments. Changed “couplet” to “triplet” in 4 references listed in first column.
6.4.7.71 / The sentence "In the United States, these codes are assigned by the Office of Management and Budget" also needs editing. OMB does not assign codes for race or ethnicity; rather, it designates minimum race and ethnicity categories for federal statistical reporting purposes. The US Bureau of the Census provides an expanded set of categories, but Census, like OMB, does not assign codes to its race and ethnicity categories. CDC is developing a code set based on the Census race and ethnicity categories. This code set will need to be updated !
over time as the Census categories evolve and as the OMB standard is revised. Instead of stating that the race or ethnic group codes are assigned by the Office of Management and Budget, it would be more accurate to state that minimum race or ethnic group categories are designated by the Office of Management and Budget. Alternatively, the sentence "In the United States, these codes are assigned by the Office of Management and Budget" could be dropped altogether. This appears to have been done in the IN2-42 version of the Ethnic Group data element, which states simply "The second couplet of the CE data type for ethnic group (alternate identifier, alternate text, and name of alternate coding system) is reserved for governmentally assigned codes." / Accepted. Drop the sentencing referencing to OMB. This impacts the fields listed in the first column.
Reported after the Meeting – technical correction
6.4.5.3
6.4.5.4
6.4.5.16
6.4.5.42
6.4.5.45
6.4.6.6
6.4.6.16
6.4.7.7
6.4.7.9
6.4.7.22
6.4.7.40
6.4.7.49
6.4.7.52 / Typo / Components of XPN (family name, given name, etc.) were erroneously changed from ST to IS. / Change first six components (through Prefix) of XPN from IS to ST.
Chapter 8 Ballot Issues and resulting edits: