1 CDA Open Issues: (DRAFT 1.05 May 21, 2002)

2 Non-CDA:

2.1 Conference planning

2.2 RIM harmonization

2.2.1 Merged R-MIM

2.3 FDA package inserts

2.4 Mixed content models:

1 CDA Open Issues: (DRAFT 1.05 May 21, 2002)

1. ITS(s): W3C Schema? DTD? RELAX NG? Decide normative status of each.

2. Templates joint proposal with Templates SIG, includes registry: DRAFT, under discussion on Templates SIG listserv

3. Identification of changes required due to current RIM and current data types

4. Retire the Patient_encounter.practice_setting_cd attribute; Indicate that the PracticeSetting vocabulary domain can be used for the Role.cd attribute; Re-map the current CDA <practice_setting_cd> to be derived from Role.cd, using the PracticeSetting vocabulary domain; add Practice_setting values. (change db #21)

5. Evaluate our use of RIM vocabulary

6. replace HMD with merged MRM/CDA HMD (change db #21)

7. Create body R-MIM

8. Link CDA: 3.3.2.4.3: need to add proposal for “link_CDA”; potentially other link types: inserted decision from minutes of 11-15-01. (Bob)

o Target is another CDA document. Primary document is not complete without the presence of the target. Use case: BMT with disease insert. Disease document is generated elsewhere. In the summary document, you have to reference the disease insert document. When you receive the summary document, you need to also have the referenced document in order to fully interpret the summary document.

o If this is a semantic link, what is the value of Act_relationship.type_cd?

o Must the target be a CDA document, or can it be any OID?

o see notes in DRAFT section 3.3.2.4.3

9. Coded_entry in Levels Two & Three? should we maintain the distinction between caption_cd and coded_entry?

10. Obs media: 3.3.2.4.5: do we want to change the policy on observation_media to allow inclusion within a CDA document?

11. Add XFRM to <document_relationship.type_cd> to indicate that document transforrmed from source (change db #17)

12. Organization as potential intended recipient should be added(change db #19)

13. Cardinality of <fulfills_order>, should be changed (change db #20)

14. consider change to MIME-packaging per Gunther’s suggestion

15. Role of participant: Should CDA convey the role or specialty of the author (attending, cardiology, …) (should we re-examine the use of the function_cd field?)

16. Referenced coordinates: Modeled as a discreet observation that refers to the referenced coordinate. (If so, need to add an Act_relationship in the R-MIM); Also needs relationship to linked images (e.g. for x-rays); Need AR from Observation to A_Ref_Coord

17. Validation: Make sure the ID/IDREF for originator, etc are correct.

18. Clarify use of confidentiality codes; (change db #21)

19. Update:

§ DTD comments

§ appendices

20. Add section on backward compatibility

21. Update section on when to use MDM vs. ORU (Scott)

2 Non-CDA:

2.1 Conference planning

Call for Abstracts

Final program

Brochure

2.2 RIM harmonization

· Technical Correction: Now that we've moved some new classes under Act, we need to create new ActClass values. In particular, we moved "Link_html", "Local_attr", and "Local_markup" under the Context_structure class, so we need to have new ActClass values placed under the CTXT value.

ActClass

CTXT

LINKHTML

LOCALATTR

LOCALMRKP

· Need to submit domain names for all type_cd / class_cd choices (Woody will let us know which ones)

· Gunther’s ballot comments on XFRM – only have it show up once, and with the correct definition.

· Gunther’s ballot comments on document relationships vs. revisions:

Before:

DocumentRelationship

APND

RPLC

XFRM

RPLC

SUCC

RVSN

APND

XFRM

After:

RVSN à (Change name that Gunther will propose)

APND

RPLC

SUCC

XFRM

2.2.1 Merged R-MIM

These are changes needing to be made to the merged R-MIM

· We still use “PracticeSetting” – need to revise since the name has changed (or is this a non-issue if we use the CMET?)

· New clone naming scheme

· Woody’s QA: in RCMR_HD000002 there is an Act.id with cardinality [1..]

2.3 FDA package inserts

· Create a structured document that represents a drug package insert.

· Need to figure out what the header is supposed to be.

· Need to get the list of sections they need (from Randy) and submit them to LOINC. (I already discussed this with Stan, who agrees).

2.4 Mixed content models:

· Allow multiple hyperlinks within a block of text (without necessarily saying the text block is of type HTML);

· Allow local markup within a block of text.

· Allow recursively nested “anchors” within a block of text (so that you can reference specific text passages).

· Ability to link out from a block of text to an image, meaning that the image should be rendered here.

· Ability to link out from a block of text to any clone, possibly meaning that this is where something in the referenced clone should be rendered?

· Proposal is to use this content model in Act.txt:

<!ELEMENT paragraph (caption?, content*) >

<!ELEMENT list (caption?, item+)>

<!ELEMENT item (caption?, (content | paragraph | list | table)*)>

<!ELEMENT table (caption?, (col*|colgroup*), thead?, tfoot?, (tbody+|tr+))>

<!ELEMENT caption (#PCDATA | link_html)*>

<!ELEMENT thead (tr)+>

<!ELEMENT tfoot (tr)+>

<!ELEMENT tbody (tr)+>

<!ELEMENT colgroup (col)*>

<!ELEMENT col EMPTY>

<!ELEMENT tr (th|td)+>

<!ELEMENT th (#PCDATA | link_html)*>

<!ELEMENT content (#PCDATA | content | link_html | local_markup)*>

<!ELEMENT link_html (#PCDATA) >

<!ELEMENT local_markup (#PCDATA | content | link_html | local_markup | local_attr)* >

2.5