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The team could only stay on for 30 minutes so we provided an orieintation to the design approaches within HackMD and requested that the ONC Team members review the design approaches beore the WGM next week
Some key design issues to review:
Medication Adherance - is an extension with Medication Adherence Observable Entity Code 418633004 at code and SNOMED finding codes at value, correspondingly in C-CDA will be an Observation with the "answer" value set at observation.value. We believe we may get pushback from pharmacy for not bringing in MedicationStatement
Facility Location: It looks like the approach in FHIR and C-CDA may be different given the historical use of SDLOC Location template within the document context and not historically always going through encounter first which is what US Core vendors are currently asking for
Will discuss the C-CDA approach with the C-CDA to FHIR mapping folks and the SDWG, C-CDA vendors
Treatment Intervention Preference and Care Experience Preference US Core will closely align with PACIO ADI Work, but will create a profile based on US Core Simple Observation, with compatible vocabulary bindings and emphasis on using Observation.value.string to capture the narrative text, as opposed to requiring the text element as PACIO currently does (US Core Vendors' request). We believe we may get some pushback from PACIO, but hoping we can work with them and that someday PACIO can derive from US Core. C-CDA will align with the C-CDA Advance directives work update about to be published and determine if simplification is needed for the USCDI data elements.
US Core and C-CDA alignment Heuristics
We reviewed the US Core and C-CDA alignment heursitics and asked for feed or concerns. None were expressed and Carmela agreed that this was a worthwhile effort.
The heuristics will be voted on this week on SDWG weekly call thursday
Lab Result Specimen Condition Acceptability and Lab Result Interpretationvocabulary discrepency issue