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Attendees

Attendee

Name

Affiliation

x (last 15 mins)

Alex Kontur

ASTP Public Health Analyst (COR)

x

Brett Marquard 

HL7 US Realm Senior Advisor


Matthew Rahn 

Director, Standards Division

x

Gay Dolin 

HL7 US Realm PM


Carmela Minicucci Couderc 

ASTP - Senior Terminology Adviser

x

Albert W. Taylor 

ASTP - Medical Informatics Officer

x

Jackie Baldaro 

ASTP - Branch Chief, Terminology and Content Delivery


Sara Armson 

ASTP - Health IT Specialist

The team completed the review of the US Core Profiles and C-CDA Templates that represent new USCDI V5 data elements. All represntations have now been reviewed and approved See USCDI V5: Review of Pre-ballot Profile and Template designs going to January 2025 ballot.

Gay and Brett notes that if the ASTP team would like to review further individually and they note simple areas of improvement, we can likely make those changes. In addition, ballot comments can be logged when the ballot opens.

Next Steps:

  • The ASTP is invited to do additional independent review of changes within the next week.
    • Small guidance changes (e.g. grammatical corrections or improvements) can likley be implemented if identified within the next week (deadline December 5th)
    • More substantial comments will need to placed as trackers against the ballots during the ballot period
  • Please sign up for ballot!: HL7 Ballot Sign-Up

Summary

C-CDA Notes

Interpreter Needed

  • Interpreter Needed Observation:

    • LOINC 54588-9 Interpreter needed
    • Answer Set with Yes, No, and Unknowns (SNOMED CT and DAR values)
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Pronouns

  • Individual Pronoun Observation:

    • LOINC 90779-2 Personal pronouns reported
    • Answer Set: LOINC THO Set: Personal Pronouns
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Name to use

  • US Realm Patient Name (PTN.US.FIELDED):

    • Represented by callMe in EntityPersonNamePartQualifier
    • Gay highlighted differences between CDA and FHIR name part qualifier concepts/terms, with FHIR trackers (PA WG) placed to address future alignment.
    • Currently, "Name to use" is adequately represented in both standards.
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Provenance

  • Provenance - Author Participation:

    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

  • Provenance - Author Participation (author.code):

    • CDA Role Code (HL7 V3 RoleCode System)
    • Additional Bindings:
      • Providers: Healthcare Provider Taxonomy (HealthcareProvider Taxonomy code system)
      • Non-Clinicians: PersonalAndLegalRelationshipRoleType (HL7 Role Code code system)
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

US Core Notes

Clinical Notes

  • US Core DocumentReference Profile:

    • Includes 2 LOINC codes added to the minimum set servers.
    • Declared in the Clinical Notes Guidance page.
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Lot Number

  • US Core Immunization Profile:

    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Advance Directive observation

  • US Core Observation ADI Documentation Profile:

    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

  • US Core ADI DocumentReference Profile:

    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Sex Parameter for Clinical use

  • Sex Parameter for Clinical Use (SPCU):

    • Extension value URL aligns with LOINC 99501-9 and its value set.
    • See guidance in the US Core Patient Profile.
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Orders

  • US Core MedicationRequest Profile:

    • Uses RxNorm for MedicationRequest.medication with reference to Medication Clinical Drug.
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

  • US Core ServiceRequest Profile:

    • Reviewed the additional bindings table for common lab codes, radiology procedures, clinical tests, and US Core Procedure Codes.
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Interpreter Needed

  • US Core Interpreter Needed Extension:

    • LOINC 54588-9 Interpreter needed, with guidance aligning URL meaning to the LOINC code.
    • Answer Set with Yes, No, and Unknowns (SNOMED CT and DAR values).
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Pronouns

  • Individual Pronouns in US Core Patient Profile:

    • Answer Set: LOINC THO Set: Personal Pronouns
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Name to Use

  • Guidance present in US Core Patient Profile:

    • "Name to use" represented by setting Patient.name.use to "usual."
    • Gay noted CDA and FHIR naming concepts differ, trackers placed for future alignment. HL7 PA WG owns the value set
    • Currently adequately represented.
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

Provenance

  • Healthcare Provider Taxonomy in Practitioner Role:

    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.

  • Provenance Guidance:

    • ASTP team was advised to review new Provenance approach and provide feedback.
    • 28-Nov-24: Yes - ASTP agrees the design covers the USCDI definition.
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