Card Tech Minutes 2012.02.08

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Attendees

  • Dan Roman (ACC)
  • Jason Kreuter (ACC)
  • Barry Brown (Mortara)
  • Bryan Jennings (Medical Micrographics)
  • Duncan Wood (Medical Micrographics)
  • Harry Solomon (GE)
  • Nick Gawrit (heartbase)
  • Paul Seifert (Agfa)
  • Tom Dolan (Philips)
  • Chris Melo ( Philips)
  • Bijoy Sundersingh (Philips)

Meeting Notes

  • Cath Report Content (CDA-CATH) Vol 3 review - Complications section and general C-CDA approach
    • Chris Melo presented a draft vol 3 per the consolidated-CDA template.
    • This was an example - other Feb 8 material needs to follow the guidelines we discussed below and be provided by Nick to co-authors next week)
    • Review of documentation style/format
      • There is no need to duplicate the constraints from the base C-CDA definitions. Some of this is included for the analysis phase of this profile development to determine if a new specialization of the existing C-CDA template is to be defined.
      • New templates shall be created if the cardinality of the specific elements of the template are changed (further constrained).
      • The existing template shall be used if only the vocabulary used is constrained.
    • Review of content
      • The scope of this profile includes the cath lab and the step down unit but does not include the discharge of the patient, unless the patient is discharged from the cath lab.
      • The key issue to remember is that this is primarily a way to structure and codify the Physician's report of the cath procedure. The structure and codification eases the collection of data for Registry purposes. but it is NOT a codification of the NCDR registry - so not all required Registry data will be organized or even included in this report.
      • There were 19 “complications” identified by Nick based on the ACC-NCDR CathPCI 4.4 specification. The report may include any number of these, but it is not required to include all of these as this report is not for registry submission.
        • These “complications” need to be reviewed by domain experts (Dr. Tcheng) to confirm that they are cath-report “complications” or some other category - e.g. cath report "procedures".
        • Once we have the content medically correct if there are still elements for which we have no SNOMED code, Harry will request codes from SNOMED.
      • The following elements have been allocated to "Procedures"
        • Referral for Dialysis – since this is this for dialysis during the cath procedure, this should be included in the Cardiac Procedure Description Section using a Procedure Entry
        • RBC/Whole Blood Transfusion – likewise, since this is during the cath procedure, this should be included in the Cardiac Procedure Description section as a Procedure Entry. And the measurement can be associated with it.
        • Hemagloblin prior to transfusion
      • An initial mapping to SNOMED CT concepts was made and these mappings have been verified by Harry (after the call).
      • Some of the “complications” are not “Yes/No” valued. These may be supporting data elements for other “complication” indicators. How are these represented in this section? This needs further analysis
        • e.g. what do we do with Hematoma size
      • The “problem type” for each of these “complications” needs to be determined. Are they a finding, condition, symptom, problem?
        • These should probably be “finding” or “condition” in context of the Cath procedure. The problem type is dependent on the context of the specific complication.
        • A “problem” is something that is intended to be kept on the patient’s problem list
      • The “Age observation“ is not applicable and should not be present for each “complication”.
      • The “Health Status” is not applicable and should not be present for each “complication”.
      • The “Problem Status” entry shall be included and shall be valued if the “complications” value is “Yes”.
      • We can still have additional concepts included in the Complications section:
        • “Renal Failure” 42399005
        • “anemia due to blood loss” 413532003
  • Dan Roman
    • Dan is leaving the ACC. We all thanked Dan for his service and wish him well. Dan has transitioned to Jason Kreuter who will support the domain until a replacement for Dan has been identified. Welcome Jason !!
  • ACTION- See the action list doc on the Wiki - File:IHE Card ActionItemsAndPlanning.docx
    • Nick - Contact Dr. Tcheng to have him evaluate the physician view of our allocations decisions and open-issues - DUE Feb 15
    • Chris - distribute updated Complications C-CDA section to key authors group and the EP authors - DUE Feb 10
    • Nick - Distribute other Feb 8 sections (historys, assessment and plan, allergies, vitals) in C-CDA format for offline cath/EP author review - DUE Feb 16
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