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Certification
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Resolution: Answered
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Moderate
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None
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A valid QRDA I document with the Family History section cannot be validated.
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The schematron should be corrected. I find that the error appears in the cypress validator at healthit.gov, but I also find the error in the schematron released by CMS with the 2017 CMS IG
The CMS 2017 QRDA I schematron include the following rule:
<sch:rule id="Family_History_Observation_QDM_V2-may-code-translation-errors" context="cda:observation[cda:templateId[@root='2.16.840.1.113883.10.20.24.3.112'][@extension='2016-02-01']]/cda:code/cda:translation">
<sch:assert id="a-2228-27695-error" test="@sdtc:valueSet">The translation, if present, SHALL contain exactly one [1..1] @sdtc:valueSet (CONF:2228-27695).</sch:assert>
</sch:rule>
This rule is incorrectly being applied to the *code *element. The standard specifies conformance statement 2228-27695 as applying to the *value *element. The code element is not required to have a valueSet attribute. The rule should be something like:
<sch:rule id="Family_History_Observation_QDM_V2-may-code-translation-errors" context="cda:observation[cda:templateId[@root='2.16.840.1.113883.10.20.24.3.112'][@extension='2016-02-01']]/cda:value/cda:translation">
<sch:assert id="a-2228-27695-error" test="@sdtc:valueSet">The translation, if present, SHALL contain exactly one [1..1] @sdtc:valueSet (CONF:2228-27695).</sch:assert>
</sch:rule>
This is causing problems, since the translation of the code element is required and this rule is being incorrectly applied to that translation instead of the value/translation. If we don't send a translation of the code element, the tool correctly throws error for conf:1198-32847. If we do send that code/translation, we receive error conf:2228-27695 for the lack of valueSet. Also note that even if we send a valueSet for that code element (which is NOT required), the tool throws a reporting error since the valueSet used for that element is not recognized by the tool as a valid valueSet.