Social History Observation - problems with value set binding on code element

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    • Type: Change Request
    • Resolution: Persuasive with Modification
    • Priority: Medium
    • C-CDA Templates Clinical Notes (CDA)
    • 2.1.0.6 [deprecated]
    • Structured Documents
    • Value sets [deprecated]
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      Create a new LOINC value set with a set of concepts supplied from the community (call to EHRs, Regenstrief, and Gravity Community to gather the concepts/loinc codes to see this member value set).

      Concepts that have more specific observation representations will not be included in the LOINC member value set (e.g. Smoking).

      In future, SD will consider a new Grouping Value Set and then make the existing SCT value set one member (for backward compatibility) and make a new LOINC value set with a set of concepts supplied from the community (call to EHRs, Regenstrief, and Gravity Community to gather the concepts/loinc codes to see this member value set).

      No TEMPLATE Change until a future ballot.
      Will Announce availability of new value set through SD and provide guidance through the Examples Task Force.

      Show
      Create a new LOINC value set with a set of concepts supplied from the community (call to EHRs, Regenstrief, and Gravity Community to gather the concepts/loinc codes to see this member value set). Concepts that have more specific observation representations will not be included in the LOINC member value set (e.g. Smoking). In future, SD will consider a new Grouping Value Set and then make the existing SCT value set one member (for backward compatibility) and make a new LOINC value set with a set of concepts supplied from the community (call to EHRs, Regenstrief, and Gravity Community to gather the concepts/loinc codes to see this member value set). No TEMPLATE Change until a future ballot. Will Announce availability of new value set through SD and provide guidance through the Examples Task Force.
    • Lisa Nelson / Rob McClure : 22 - 0 - 0
    • Clarification
    • Non-substantive

      This value set binding seems problematic: SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Social History Type 2.16.840.1.113883.3.88.12.80.60 DYNAMIC (CONF:1198-8558). If @codeSystem is not LOINC, then this code SHALL contain at least one [1..*] translation, which SHOULD be selected from CodeSystem LOINC (2.16.840.1.113883.6.1) (CONF:1198-32951).

      We believe it does not reflect what is needed and being done today by implementers, and as stated does provide guidance that is helpful for validation. 

      Discussed this with C-CDA IAT Participants on 3/24/2021 - Recommendation was to Create a new Grouping Value Set and then make the existing SCT value set one member (for backward compatibility) and make a new LOINC value set with a set of concepts supplied from the community (call to EHRs, Regenstrief, and Gravity Community to gather the concepts/loinc codes to see this member value set).

      Once this value set was created, the Social History Observation template would need to be modified to use the new grouping value set with DYNAMIC binding. The binding strength of Observation.code is CWE, so this would be equivalent to an extensional binding strength in FHIR.

      This issue should be tagged as both Terminology and TemplateStructure.

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            Assignee:
            Unassigned
            Reporter:
            Lisa R. Nelson
            Lisa R. Nelson
            Watchers:
            3 Start watching this issue

              Created:
              Updated:
              Resolved: