Card Tech Minutes 2016.12.07-08

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Attendees

  • Chris Melo, Philips, Co-Chair
  • Nick Gawrit, Heartbase, Co-Chair
  • Paul Dow, ACC, Secretary
  • Antje Schroeder, Healthineers
  • Dan Murphy, Epic
  • Rebecca Baker, ACC
  • Nakano Shinichi, Toshiba and IHE-Japan
  • Takeshi Oozeki, Toshba and IHE-Japan
  • Charles Thomas, University of Washington
  • James Tcheng MD, Duke University
  • AbdulMalik Shakir, Hi3 Solutions
  • Denise Downing, PCC Domain
  • Serafina Versaggi, PCC Domain
  • Ioana Singureanu, PCC Domain

Minutes

Wednesday, December 7, 2016

Consolidated Cardiology Report Content Profile Planning
Four profiles were initially submitted for consideration in the 2016-2017 cycle. As the process developed, two profiles were removed, and the remaining two profiles, CRC and CIRC, were considered to blend into one structured reporting profile to address diagnostic and therapeutic procedures. The implementation of the separate profiles has been limited, so the thought was to make the profile more applicable to a wider audience. This would also leverage the work done with EPRC-IE which strengthens all of the profiles, and will harmonize all three profiles in the long run.
Project Goals: 1. Update CRC to ver 2.1 2. CIRC update to CRC and EPRC and base it on CCDA templates
The harmonizes with the ACC Registry, and industry approaches of one way to submit data to any registry. One consideration is the planning for bandwidth to complete the work.This will further encourage the standardization of terminology. It make help the NCDR to have a recommendation from IHE regarding this process. The Cath PCI 5.0 Update, from 4.4, is vital to make this profile a success as vendors will not spend the time and money to implement a version that has a brief lifespan.Any ACC comment from would need to be provided by the end of Jan 2017 for inclusion in this release.
AbdulMalik shared a presentation regarding the work process for Consolidating the RCS-C and RCS-EP. Including description of the primary template containment structures and codes. Oozeki-san shared the IHE-Japan experience and how the national extensions differ from the CV registry submission process.
Consolidated CRC, Part 1
Chris Melo presented the CIRC Templates and reviewed the details regarding the three base use cases and areas to be considered for update in 2016, and the document level data elements to assess where probable work objects would be needed. Some are CCDA and some are not. This may led to developing a common set of templates for cardiology, could be an asset to the Radiology Domain, though some variances exist in workflows between areas. Chris has developed a spread sheet with the details that will be posted in the FTP folder.
Nick Gawrit shared the EPRC-IE [2014] and CRC [2016] Templates side-by-side to compare and contrast their structures. Both of which were modeled off the HL7 C-CDA Procedure Note. Procedure Description is where the changes begin to appear. As well as Lesion Description and Leads Description and other Procedure Notes. It is mostly similar content.
IHE-Japan Update
The Japanese Circulatory Society [JCS] has created a guideline document for Standard Export Data Format [SEAMAT] including Nuclear Medicine, ECG, Echo, and Cath reports. They have also used the HL7 and DICOM standards for storing medical information, with an extension to store ECG data, similar to CRC. There may be an opportunity to validate this against the IHE CRC Profile. THe Nuclear Medicine Report was added in 2016. This includes the Nuclear Medicine Report and Myocardial Perfusion Imaging [MPI] report. A brief review of the list of codes assigned to various elements. Several items have been submitted to LOINC for the provision of new codes to be created: Ultrasound close to 200 terms were submitted, Cath had about 400, ECG had about 20.
Connectathon Japan results: 13 cardiology systems provided by 6 vendors tested 5 profiles. CATH, ED-CARD, IVI, ECG, and ECHO. There are still some questions still exist for the IVI profile around testing in two regions. As the profile will primarily used in Japan, is the two region requirement still enforced? This may be changed per the Planning Committee after discussion.
PCC Use Case Co-Development
PCC has reached out to the CARD TC to develop use cases that meet Cardiology clinical needs for two profiles.This includes the Point-of-Care Procedures and for Medical Device Registries. There are other database options might useful to Cardiology for device surveillance, and patient safety. We are invited to join the bi-weekly calls to support the development/feedback for use cases. How the UDI gets into the system is out of scope for this project. The Vol 1 needs to be completed by 12/20/2016, to allow for review prior to the PCC meeting in early Feb 2016.
PCC, ITI, and RAD Domain Updates
PCC has accepted seven projects, including several CDA implementation guides, for this cycle. ITI will assist. Their current agenda does not overlap with Cardiology very well this year, but if you are interested in update, Chris Melo can provide more details.
ITI has fewer items for consideration this cycle including style sheets for CDA documents. Deleting documents from XDS repository.
DCC Publication dates have been updated for the CARD domain. Art Decor will be considered across the domains as the tool of choice for development.
RAD The original Scheduled Workflow, Version A, is not tested at Connectathons anymore. Once it becomes Final Text, it will be retired. The new version, Version B, will be impact 4 to 5 CARD profiles. Version A could become Final Text this cycle, which may need to be discussed during our Summer TC F2F meeting. They have three work profiles. 1. Including storage of CT Protocols. 2. Management of follow up of non-critical, incidental findings. 3. Standardized Log of Events dealing with wait times and other administrative issues, approximately 20-30, to allow for dashboard functionality and analysis. There has also been a sub-group for accession based imaging, e.g. dermatology photos, and associating them with DICOM standards to import them into PACS.
Consolidated CRC, Part 2
Work Items for Consideration
  1. NCDR EP Suite ICD 2.2 Compared to EPRC-IE
  2. Final Text Jimmy Tcheng CathPCI Procedure Note Document versus CRC
  3. RSC-C Impact to CRC
  4. RSC-EP Impact on EPRC-IE
  5. Comparison of CRC with EPRC-IE
    1. Identify Gaps
    2. Address Gaps
    3. Document Resolutions/Incorporate Changes
  6. Comparison of C-CDA 2.1 vs C-CDA 1.1
    1. Identify Gaps
    2. Address Gaps
    3. Document Resolutions/Incorporate Changes
  7. Comparison of CIRC with CRC
  8. Header Structure
  9. Value Sets
    1. Document Types
    2. Versioning
  10. Comparison of CRC with IHE Japan Work Products
  11. NCDR CathPCI version 5.0 [document end of January 2017]
  12. Open Issues Reconciliation
  13. Clinical Decision Support Impacts, like AUC Criteria
  14. ACC template ID structure review in relation to CRC

Thursday, December 8, 2016

Use of Art Decor for CDA
Dr. Kai Heitmann presented the Art Decor tool as an improvement over the current use of Microsoft Word as an editor for IHE profiles. Art Decor is a open source platform that supports team collaboration and supports creation and maintenance of data and value sets. Art is the user interface, Decor is the modeling tool. Art-Decor has a web site that provides detailed information. This is a tool that will replace the Excel spreadsheet for the management of datasets with concepts and proper descriptions, including use cases.
CP Discussion / Pamela Heller
The changes and enhancements of RCS PCI were discussed. Much of the conversation revolved around conditionality and reducing ambiguity. In the future it could be useful to handle these types of questions with a template library. As well as in depth discussion of the pros and cons of the segment numbering system that is preferred by the ACC, but may be technically difficult to execute.
Action Items | Person Responsible | Target Completion Date
  1. Create FTP folders for current work items | Chris Melo | Completed
  2. Review CP Maintenance Items in the FTP Folder for archive or deletion | TBD | TBD
  3. Add upcoming F2F to IHE Global Calendar | Paul Dow | Completed
  4. Post all PPT from F2F Meeting to FTP Site | Chris Melo | Completed
  5. Schedule a call with IHE-Japan RE: IHE NA CTA Testing | Paul Dow | 12/16/2016
  6. Work with Kai Heitmann for Art-Decor access | Chris Melo | 12/31/2016
  7. Planning for International Board Report Presentation | David Slotwiner and Jerry Serwer | 1/2/2017
  8. Update the Profile List | Antje Schroeder | 1/15/2017
  9. Update the broken or out of date links for the Technical Frameworks web page | Antje Schroeder | 1/15/2017
  10. Develop plan for resolving existing RCS-EP CPs | Nick Gawrit | 1/31/2017


Cardiology Technical Committee

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