Orders & Observations Conference Call
19-August-2010
Attendees:
Name / OrganizationDeborah Bogert
Patrick Loyd / GP Informatics
Rob Savage /
NGC / CDC
Hans Buitendijk / Siemens HealthcareRob Hausam / Hausam Consulting
Riki Merrick / IConnect Consulting / APHL
Ken McCaslin / Quest Diagnostics
Scott Robertson / Kaiser Permanente
Jonathan Harber / Blood Systems
Note Takers: Riki Merrick, Hans Buitendijk
Minutes:
§ Minutes
o Approve July 22, August 12 Conference Call minutes:
§ Motion to approve July 22 – Ken McCaslin, Rob Savage.
· Against: 0; Abstain: 2; In Favor: 7
§ We’ll address August 12 next week.
o Rio WG minutes are still in progress.
§ Micro-Biology Project – Patrick Loyd
o The approval request had slipped through the cracks.
o SSSD vote is being finalized through e-vote in progress
o 6-8 weeks out before getting model back to OO.
o There are about 10-15 items that still need to be changed, including template and vocabulary harmonization
o Canada took generic model and roll it out for microbiology using normative micro results in order to register terminology and go through harmonization for this.
o Will bring up the topic during the October WGM in Cambridge
o Rob Hausam would like to be further involved in the team.
§ Immunizations – Rob Savage
o Started to review PID-OBX relationship with PHER.
o Main message form PHER was to clarify the purpose / use of POBX data specific for immunizations
o PHER will meet with patient care on the topic as well
o There was discussion on the use of the ROL segment, but that might be overkill for info we want to send
§ In case ROL discussion comes back up, the team should look at PRT, which in chapter 4 and 7 replaces ROL starting V2.7.
o Discussion on Heir of American Immunization registration association suggested using OBX under PV1
§ Patient level information OBX under PID is for patient related information
§ OBX under PV1 – would be for visit level information, not patient
§ Agreed it belongs more to PID rather than PV1.
§ Blood Bank V2 Update – Jonathan Harber
o
o Please review and send questions to Patrick or Jonathan or the listserve
§ Target is to review by September 2 so we can move a formal motion to accept these proposals for V2.8 and have them queued.
o Added HL7 introduction to blood bank working group
o Patrick and Jonathan still need to double check the data elements listings here
o Moved most items to the upcoming IG
o The document describes blood donation attempt in both arms as 2 procedures = so use 2 segments
o Workflow / activity diagram per blood bank WG
o Event discussion per activity diagram and covered each activity, though folks using the same system for multiple events obviously don’t need to exchange data, but wanted to include every event.
o We should mark clearly what codes or field positions should be “locked” as part of the work group vote so pre-adoption through the upcoming IG can be done with lower risk of change once the final ballot of V2.8 is over.
o Donor Eligibility Observation – at multiple times in the activity (eligible or deferred) – as long as you are not deferred, you can donate, no “ok to donate” flag used.
o OBX needs to be under PID for DEO (14/23) Patrick will fix after collection of comments.
o DON: Difference between field 1 – donation event itself and field 31 Donation sample ID is for samples attached to the donation identifier: Donation Identification ID = key field in the dB
o Do you need to provide information about the PID.3 and which information should go here instead?
§ Thinking that in this section for blood donation might be helpful for folks trying to understand how blood bank fits into the standard and relationship to PID.3 etc.
§ Patrick: Use this in the IG, not the standard. Hard to assess if proposal is valid, until you apply the elements until you produce the IG to make sure you have all the data elements you need to propose for the standard.
§ In chapter 7 we do give examples on how to message micro results, so could do something similar for blood bank.
§ Hans: For micro it’s only in chapter 7 and in the past we have mixed IG required information already added to the standard, so it’s still there. Chapter 4 has message on how to order newspaper- would probably not do that today.
§ As part of proposal it could be in the introduction to give explanation how it ties together
o The mapping document we hope could help provide clarity on how the new messages fit into the existing standard fields as well how to represent all data elements in the proposed IG.
o Big debate on how to pass reactions:
§ We may assign 3 letter codes for HL70561 – Jonathan is the king of 3 letter codes for this guide.
§ Has been reviewed by medical experts etc for completeness and accuracy.
§ BUI to identify units by weight and volume, additive type, concentration etc
§ ISBT part of IGBA keeps a dB of manufacturer and have data file available in their system to provide the data required for the data – want the system to calculate specs of the ISBT standard.
§ Extensible enough to be able to add stemcells and organs
o Where in chapter 4 would you like to insert? As part of transfusion services, next to it, combine with it?
§ Jonathan’s preference would be to have them in front of the transfusion.
§ Agreed that these sections should go into chapter 4 at the start of the transfusion section.
o BUI-12 = why not use UCUM or ISO for this?
o For pre-adoption of v2.8 vocabulary should need to lock in the event numbers, table numbers etc. How do you do that now – who has the master list of next table number? or event numbers for orders it’s OO, for query it’s INM etc.
o What process do we want for collecting comments?
§ Next step is to make it a formal v2.8 proposal that can be strong enough to be used for pre-adoption.
§ Submit comments to Patrick or Jonathan, might need to discuss some at OO
§ Ken: Request at least 2 weeks:
§ If there are blood bankers that make comments that something is missing – have them call Jonathan instead, so Ken will forward the contact info to them.
§ Composite Order Model – Patrick Loyd
o Not discussed – next week
§ October WGM Agenda
o Ken McCaslin would like to see the ballot review for the Test Compendium be on Tuesday Q3 or Q4.
o Will start to discuss the agenda for October next week.
Future Topics
· August
o Continue with Composite Order Ballot Reconciliation
§
o
· Next Year
o Clinical Event
o Lab Result Topic Update