Card Tech Minutes 2016.11.09

Attendees

• Chris Melo, Philips, Co-chair
• Nick Gawrit, Heartbase, Co-chair
• Paul Dow, ACC, Secretary
• Antje Schroeder, Siemens
• Rebecca Baker, ACC
• Charles Thomas, University of Washington
• Dan Murphy, Epic
• Jerry Serwer, University of Michigan, PC Co-Chair
• Andrea Price, Indiana University
• Denise Downing, AORN, 'PCC Domain Co-Chair

Minutes

CRC, CIRC, and EPRC-IE Harmonization

• An initial discussion and preliminary analysis led to the conclusion that we could bring the CIRC profile, into CRC and possibly EPRC-IE to create one larger profile that covers the entirety of cardiology clinical reporting. The benefit is that this brings three profiles into one streamlined cardiology procedure and diagnostic exam clinical summary profile that folds into the framework using a common set of CDA-based templates. The steps to achieve this include:
  • 1. Update CRC to leverage C-CDA ver 2.1. This would begin with the latest published version CRC that includes the Structural Heart Interventions work. It would also include addressing some issues raised during recent implementation experience.
  • 2. Harmonize with EPRC-IE to leverage the learnings and enhancements for support for EP procedures. There were some changes made to the templates to address specific EP needs. We should be able to fold these back in to create a common set of templates for both CRC and EP.
  • 3. Include support for diagnostic imaging exams that is currently the purpose of the CIRC profile. This would result in using the common templates for these exams as well but would eliminate the need for the separate CIRC profile. There would be options defined for CR profile for specific document types - e.g. diagnostic, cath, EP, etc.
    • This will include non-invasive imaging like echo in the CIRC profile. This profile will not replace the registry content submission reports.
• We would also like to begin to use a tool to define these CDA templates and we will look to use ART-DECOR for this purpose. We will check with IHE DCC for support for this activity, including mentoring on the use of the tool.
• A question was raised regarding the complexity of pulling the information from the templates and it was noted that this does require extra effort. The RCS-xxx profile templates were specifically designed to meet the needs of the NCDR registries, and were intentionally different from the procedure summary templates from the CRC and EPRC profiles.
  • Q: We'll need to ask Dino about clarifying the complexity he mentioned: is it pulling the procedure report into the CDA or pulling the CDA into the Registry? It is believed that he meant using the RCS-xxx templates for use in the NCDR registry.

Denise Downing {AORN} and PCC Co-chair and UDI

• Implantable Medical Device Registry Profile and possible collaboration between PCC and Card Domains. This profile could be useful for a wide range of devices. these would include the measurements from devices, which is very important to Cardiology. This may also offer surveillance. This will be a FHIR based profile that specifics the pt, devices and operator. There will be a new actor developed, "Point-of-Care Device Manager". Jerry asked about support for a patient with multiple devices (e.g. ICD with multiple leads) so the patient is already known. This should be supported by the model being proposed.
  • Nick and Chris will participate in the PCC TC discussion next week related to this proposal. Cardiology is interested in participating in this effort and could contribute to the Vol 1 use cases as well as the proposed solution. We will have to work to align development schedules related to this work item.

Cardiology Technical Committee