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Date
Attendees
Attendee | Name | Affiliation |
X | ONC Public Health Analyst (COR) | |
X | HL7 US Realm Senior Advisor | |
Acting Director, Standards Division | ||
X | HL7 US Realm PM | |
X | ONC - Branch Chief, Terminology and Content Delivery | |
X | ONC - Medical Informatics Officer |
Goals
- Discuss and agree on path forward with respect to vocabulary discrepancies
Discussion items
Item | Notes | Acknowledgements of understanding ofcurrent design approach or public design approachdiscussion plans (attendee names) |
---|---|---|
Treatment Intervention Preference | LOINC is the USCDI recommended vocabulary. We discussed that pre-existing work also leverages SNOMED finding and procedure codes and even CPT. The group confirmed that other code systems are allowed to communicate the complete meaning within the profile and that LOINC is intended to be the vocabulary/tool the supports queries to see if such preferences were assessed within an EHR | Received agreement from Albert W. Taylor and Carmela Minicucci Couderc that the recommendation of LOINC is associated with the category or question. Other codes systems are allowed (for example) SNOMED as the answers |
Care Experience Preference | LOINC is the USCDI recommended vocabulary. We discussed that pre-existing work also leverages SNOMED finding and procedure codes and even CPT. The group confirmed that other code systems are allowed to communicate the complete meaning within the profile and that LOINC is intended to be the vocabulary/tool the supports queries to see if such preferences were assessed within an EHR
| Received agreement from Albert W. Taylor and Carmela Minicucci Couderc that the recommendation of LOINC is associated with the category or question. Other codes systems are allowed (for example) SNOMED as the answers |
Alcohol Use (evaluation/questions) | LOINC is the USCDI recommended vocabulary. We discussed that pre-existing work also leverages SNOMED finding and procedure codes and even CPT. The group confirmed that other code systems are allowed to communicate the complete meaning within the profile and that LOINC is intended to be the vocabulary/tool the supports queries to see if alcohol use was assessed within an EHR
| Received agreement from Albert W. Taylor and Carmela Minicucci Couderc that the recommendation of LOINC is associated with the category or question. Other codes systems are allowed (for example) SNOMED as the answers |
Substance Use (evaluation/questions) | LOINC is the USCDI recommended vocabulary. We discussed that pre-existing work also leverages SNOMED finding and procedure codes and even CPT. The group confirmed that other code systems are allowed to communicate the complete meaning within the profile and that LOINC is intended to be the vocabulary/tool the supports queries to see if substance use was assessed within an EHR
| Received agreement from Albert W. Taylor and Carmela Minicucci Couderc that the recommendation of LOINC is associated with the category or question. Other codes systems are allowed (for example) SNOMED as the answers |
Physical Activity (evaluation/questions) | LOINC is the USCDI recommended vocabulary. The group confirmed that other code systems are allowed to communicate the complete meaning within the profile and that LOINC is intended to be the vocabulary/tool the supports queries to see if physical activity assessed within an EHR
| Received agreement from Albert W. Taylor and Carmela Minicucci Couderc that the recommendation of LOINC is associated with the category or question. Other codes systems are allowed (for example) SNOMED as the answers |
Lab values/results | SNOMED the USCDI recommended vocabulary. Confirmed that "If encoded" SNOMED is the USCDI recommended vocabulary. (Result may be a Physical Quantity which would be a number plus UCUM to identify the unit) | Received agreement from Albert W. Taylor and Carmela Minicucci Couderc that the recommendation of SNOMED is for when the value is encoded and not a PQ |
Medication Adherence | Brett discussed the approaches proposed in Argonaut recognizing a design has not yet been decided on:
Brett explained the history of MedicationStatement within US Core and the complexity of all of the HL7 FHIR Medication Resources C-CDA will likely create a Medication Observation template/profile that can be used inside a Medication Activity template/profile We discussed the vocabularies used in the R5 MedicationStatement.adherance. Both MedicationStatement.adherance and MedicationStatement.adherance.reason use example experimental codes HL7 Codes at adherence.code: MedicationStatement Adherence Codes (Example) SNOMED CT codes at adherence.reason: SNOMED CT Drug Therapy Status codes (Example) Vocabulary design is still open and use of SNOMED is likely not a problem to design in, but Gay mentioned that for the "high-level" adherance type of codes, SNOMED uses "compliance" concept names which may be considered offensive to some groups. Carmela mentioned that other words could be used in EHR UIs. | Received agreement from Albert W. Taylor and Carmela Minicucci Couderc that the Medication Adherence design approach in US Core has not been determined yet. They recognized that the high level SNOMED codes concept names may present challenges during ballot and reconciliation. TEAM: PLEASE CONFIRM THAT IT IS UNDERSTOOD THAT IN C-CDA THE DESIGN WILL PROBABLY BE A LOINC CODE AT OBSERVATION.VALUE, WITH SNOMED AT OBSERVATION.VALUE POINT NOT DISCUSSED: CONSIDER ONC REACHING OUT TO SNOMED TO REQUEST CONCEPT NAME CHANGES FROM USING THE WORK "COMPLIANCE" TO "ADHERANCE" See children of 414059009 | Drug therapy compliance observations (finding) | Note that some of the terms have "Adherence" as acceptable synonyms |
Lab Result Specimen Condition Acceptability | ONC is not finished discussing these two items. internally. We will resume discussion at the next meeting. Questions was asked as to why the observation.interpretation discrepancy was more severe than specifmen condition given both HL7 Vocabs have been used in V2 for a very long time. GD reviewed after and it appeasr both are equally problematic
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