Card Tech Minutes 2012.04.11

Attendees

• Jason Kreuter (ACC)
• Dr. James E Tcheng (ACC) - absent
• Barry Brown (Mortara) - absent
• Anthony Scinicariello ( St. Jude)
• Bryan Jennings (Medical Micrographics)
• Duncan Wood (Medical Micrographics)
• Harry Solomon (GE)
• Nick Gawrit (heartbase)
• Paul Seifert (Agfa)
• Tom Dolan (Philips)
• Antje Schroeder (Siemens)
• Chris Melo (Philips)

Agenda

• Review supplement documentation conventions from a TF documentation alignment viewpoint
  • The editorial team have taken up some elements from the new IHE TF documentation groups WIP restructuring effort - particularly in Vol 1. As the overall IHE TF documentation work is still under construction, particularly regarding new mechanisms to document CDA-content, we are still using the existing (old) Vol 2 format for our CDA-content.
  • The editorial team have been working with Mary Jungers from the IHE Documentation workgroup and have her agreement on this approach for the Cath/EP reporting supplements.
  • From an cardiology-domain perspective, the new supplement is NOT-consistent with the existing TF and CIRC-TI-supplement. It has duplicated some vol 2 sections numbering from CIRC, and has also changed the mechanisms for organizing CDA-content to align with C-CDA conventions.
  • This inconsistency is by design based on the new direction we chose for CDA-content, and the fact that the new IHE-TF work is not finalized and we have not looked at aligning cardiology with that, including re-documenting the existing CIRC-profile .
  • in order to explain the inconsistency for supplement readers who may be familiar with CIRC implementation the request was made to align with CIRC.
  • During the discussion the comittee was divided on whether correcting this inconsistency was important to meeting the obvjectives of public comment and hence should be addressed BEFORE public comment.
  • a motion was made to - clearly document this inconsistency, but leave the section numbering as is and proceed with the current-draft documentation-convention for public comment.
  • quorum was achieved and the vote was as follows:
    • Siemens - against
    • Philips - for
    • GE - for
    • Agfa - for
    • Medical Micrographics - for
    • Heartbase - for
    • St. Jude - Observer/abstain
  • The motion was approved
  • NOTE - in the mean time - the editor of the cath-supplement increased the section counter ( 7) to NOT overlap with CIRC, which mitigates some of the issues.
• Cath content review
  • In terms of content the editors indicated their recent changes.
  • A question arose on documenting the overview of the procedure with discrete data and coronary tree data being captured together. this was explained satisfactorily.
    • The editors also called attention to the open issue where they indicate that providing xml-samples would help understanding how to use the various document constructs available. This is in line with CDA-practice and may be addressed before TI, CIRC would also benefit from this during it's eventual refactoring to align with the new TF.
  • the organization of procedure-related findings being clustered for presentation was also raised. The editors indicated that the flexibility was there to do that with the extensive value-set table and their dynamic property.
    • DECISION - The editor will provide an example of how current constructs can be used to document a procedure-related findings grouping as an illustration - both at the section/entry definition and at the vocabulary constraint/value set level.
• EP report content review
  • This leverages almost all of cath and EP-related specializations ( mainly value-sets) have been indicated/labelled as different. there may be some legacy "PCI"references which have not been caught, reviewers should provide those to Bryan ASAP so he can correct/remove those by Friday morning.
  • Bryan indicated the new implant procedure section added beyond cath.
    • the current proposal has this as unstructured content (narrative text). It was agreed by the editor and other members that this needed to be codified using either the product instance construct from cath ( extended/specialized with the attribute modelling done in IDCO), or from the CDA implanted device construct.
    • DECISION - There needs to be structured content in place for this section before release for public comment (i.e. Friday)

ACTION

• Chris - put in clarification-text on documentation-convention inconsistency in Vol 2 section 6 of Cath supplement - DUE - Friday april 13 - DONE
• Bryan - ditto for EP, and try to replace section 6 with section 8 - as Nick has done - DUE - Friday April 13.
• Nick - add an example illustrating the ability to cluster findings by procedure-type - DUE Friday April 13.
• Bryan - add codification-structure proposal for describing implanted devices in the implant procedure section - DUE Friday april 13.