Change Proposal TF-PCC-CP-0025
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- Patient Care Coordination
- Change Proposal Number
- Last Updated
- Kboone 10:50, 19 May 2008 (CDT)
Change Proposal Summary
- Incompatible CCD Parents for Health Status
- Submission Date
- 09:47, 4 March 2008 (CST)
- Profile Affected
- TF Version
- Volume and Section
Health Status (188.8.131.52.4.1.193184.108.40.206.220.127.116.11) lists two CCD template IDs as parents (2.16.840.1.113818.104.22.168.57 and 2.16.840.1.113822.214.171.124.51). However, when running the provided example through CCD schematron rules, this entry fails. This is because the two CCD templates are not compatible.
From CCD CONF-508, CONF-512 and CONF-513 (page 85 of CCD) we can see that a status observation (2.16.840.1.1138126.96.36.199.57) shall have exactly one code which is "33999-4".
However CCD CONF-166 (page 31) states: "A problem healthstatus observation (templateId 2.16.840.1.1138188.8.131.52.51) SHALL be a conformant status observation (templateId 2.16.840.1.1138184.108.40.206.57) (as defined in section 5.1 "Type" and "Status" values), except that the value for "Observation / code" in a problem healthstatus observation SHALL be "11323-3" "Health status" 2.16.840.1.113883.6.1 LOINC STATIC." The code value cannot be both "33999-4" and "11323-3".
It appears that 2.16.840.1.1138220.127.116.11.51 is very similar to 2.16.840.1.113818.104.22.168.57, but strictly speaking it does not inherit from that observation.
The correction would be to remove the requirement that an IHE Health Status (22.214.171.124.4.1.193126.96.36.199.188.8.131.52) include both template IDs. My guess is that the intention would be that the only true parent is a problem healthstatus observation (templateId 2.16.840.1.1138184.108.40.206.51) as this shares the LOINC code (11323-3) used by Health Status (220.127.116.11.4.1.19318.104.22.168.22.214.171.124). In other words, remove 2.16.840.1.1138126.96.36.199.57. Once this restriction is removed, the CCD schematron rules pass this entry.