PCC TF-1/PHLAB/XDSLAB Harmonization

Back to: PCC_TF-1/PHLAB

Intro

The use of content modules in XDS-Lab helps lab remain consistent with what other domains have accomplished as well as insures that the lab domain provides guidance to the other domains as they incorporate relevant laboratory data into their own content profiles.

Benefits:

• Consistency with work done in other domains (example annotation comment)
• Provide guidance to other domains incorporating laboratory data (example PCC)
• Provide context to section of CDA (example intended recipient)

CDA Document Content Modules

• XDS Laboratory Report Specification 1.3.6.1.4.1.19376.1.3.3

CDA Header Content Modules

• Human Patient (1.3.6.1.4.1.19376.1.3.3.1.1)
• Non-Human Subject (1.3.6.1.4.1.19376.1.3.3.1.2)
• Human Patient with Non-Human Subject (1.3.6.1.4.1.19376.1.3.3.1.3)
• Intended Recipient (1.3.6.1.4.1.19376.1.3.3.1.4)
• Referral Ordering Physician (1.3.6.1.4.1.19376.1.3.3.1.5)
• Laboratory Summary Date/Time Duration(1.3.6.1.4.1.19376.1.3.3.1.6)
• Primary Performer(1.3.6.1.4.1.19376.1.3.3.1.7)

CDA Section Content Modules

• Laboratory Specialty Section (1.3.6.1.4.1.19376.1.3.3.2.1)
• Laboratory Reported Item Section (1.3.6.1.4.1.19376.1.3.3.2.2)

CDA and HL7 Version 3 Entry Content Modules

• Lab Report Data Processing Entry (1.3.6.1.4.1.19376.1.3.1)
• Notifiable Condition (1.3.6.1.4.1.19376.1.3.1.1)
• Specimen Collection Date Time (1.3.6.1.4.1.19376.1.3.1.2)
• Specimen Received Date Time (1.3.6.1.4.1.19376.1.3.1.3)
• Non-Human Subject(tbd)
• laboratory performer? (same as header??)
• laboratory equipment instance?
• laboratory result verifier? (same as header??)
• Laboratory Organizer (1.3.6.1.4.1.19376.1.3.1.4)
• Laboratory Organizer - Isolate Organizer (1.3.6.1.4.1.19376.1.3.1.5)
• Laboratory Observation (1.3.6.1.4.1.19376.1.3.1.6)
• Annotation Comment (PCC) (1.3.6.1.4.1.19376.1.5.3.1.4.2)

OPEN ISSUES

• alignment with CCD? CRS?
• missing codes (LOINC)
• end result documentation - in PCC, in XDS-Lab?

Differed for later discussion

Specimen

XDS-Lab Current Specification: <specimen> block

Proposed Specification: no change

Reason for template: re-usability

<ClinicalDocument
  ...
  <component typeCode="COMP">
    <structuredBody classCode="DOCBODY" moodCode="EVN">
      <component typeCode="COMP">
        <section classCode="DOCSECT">
          ...
          <entry typeCode="DRIV">
            <templateId extension="Lab.Report.Data.Processing.Entry" root="1.3.6.1.4.1.19376.1.3"/>
            <act classCode="ACT" moodCode="EVN">
              ...
              <specimen typeCode="SPC">
                <templateId root='TBD'/>
                <specimenRole classCode="SPEC">
                  <id extension="555847" root="1.19.6.11.13"/>

Annotation Comment (PCC)

We would like XDS-Lab to adopt the Annotation Comment content module for comments.

Reason for template: consistency with existing content module

Change Proposals: PCC Change Proposal Wiki List

<ClinicalDocument
  ...
  <component typeCode="COMP">
    <structuredBody classCode="DOCBODY" moodCode="EVN">
      <component typeCode="COMP">
        <section classCode="DOCSECT">
          ...
          <text>
            <table>
              <thead ID="rabiesTest">
                <tr>
                  <th>Rabies Virus</th>
                  <th>Subject</th>
                  <th>Comments</th>
                </tr>
              </thead>
              <tfoot ID="rabiesTestComment">
                <tr>
                  <td>Repeat confirmed negative</td>
                </tr>
              </tfoot>
              <tbody>
                <tr>
                  <td>Rabies virus not found.</td>
                  <td>ferret</td>
                  <td ID="rabiestTestR1Comment">Reagent lot 34</td>
                </tr>
              </tbody>
            </table>
            <paragraph ID="sComment">Report level comment goes here.</paragraph>
          </text>
          ...
          <entry typeCode="DRIV">
            <templateId extension="Lab.Report.Data.Processing.Entry" root="1.3.6.1.4.1.19376.1.3"/>
            <act classCode="ACT" moodCode="EVN">
              ...
              <entryRelationship typeCode="COMP">
                <observation classCode="OBS" moodCode="EVN">
                  <code code="C58990" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Rabies Test">
                    <originalText><reference value="rabiesTest"/></originalText>
                  </code>
                  <statusCode code="completed"/>
                  <effectiveTime value="20071108000000.0000-0500"/>
                  <value xsi:type="CE" code="59881000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED" 
                                       displayName="Rabies Virus"/>
                  <entryRelationship typeCode="COMP">
                    <act classCode="ACT" moodCode="EVN">
                      <templateId root='2.16.840.1.113883.10.20.1.40'/>
                      <templateId root='1.3.6.1.4.1.19376.1.5.3.1.4.2'/>
                      <code code="48767-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Annotation Comment"/>
                      <text><reference value="rabiestTestR1Comment"/></text>
                      <statusCode code='completed'/>
                    </act>
                  </entryRelationship>
                  <entryRelationship typeCode="COMP">
                    <act classCode="ACT" moodCode="EVN">
                      <templateId root='2.16.840.1.113883.10.20.1.40'/>
                      <templateId root='1.3.6.1.4.1.19376.1.5.3.1.4.2'/>
                      <code code="48767-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Annotation Comment"/>
                      <text><reference value="rabiestTestTComment"/></text>
                      <statusCode code='completed'/>
                    </act>
                  </entryRelationship>
                </observation>
              </entryRelationship>
              ...
              <entryRelationship typeCode="COMP">
                <act classCode="ACT" moodCode="EVN">
                  <templateId root='2.16.840.1.113883.10.20.1.40'/>
                  <templateId root='1.3.6.1.4.1.19376.1.5.3.1.4.2'/>
                  <code code="48767-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Annotation Comment"/>
                  <text><reference value="sComment"/></text>
                  <statusCode code='completed'/>
                </act>
              </entryRelationship>