Pending Labs and CCDA

[dan...@macpractice.net]

Greetings!

I have two questions concerning CCDA, pending tests and Meaningful Use stage 2

Our working definition of "pending test" is a test where samples have been taken and the doctor and patient are waiting for the results. Is this definition correct?

Assuming that is correct, how does one include this in a CCDA document? The Plan of Care section is appropriate for "Future scheduled tests" but it does not seem appropriate for "pending tests." Placing "pending tests" in the Results section and marking the Result Observation entry as "active" for Pending seems the most appropriate. However, Result Observation requires additional information about the observation that is not known to our system until we get the results back (eg the code). I have tried to mark the code with a nullFlavor, however I cannot get it to pass the NIST Transport Testing Tool as the code cannot have a nullFlavor.

What is the correct way of representing pending tests in the CCDA document? Is there any sample data with a sample CCDA document that I may view?

Thank you.

[Brian Weiss]

Daniel,

 

The Result Observation in the CCDA IG (section 5.70) notes the following:

“Pending” results (e.g., a test has been run but results have not been reported yet) should be represented as “active” ActStatus.

 

Consistent with what you suggested below…

 

Have you put in the @xsi:type attribute in your Result Observation?  Because it should take a nullFlavor OK...  For example, try this:

<code nullFlavor="NI" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/> <!-- No code here -->

 

More generally, if you send over the XML snippet of your Result Observation, I’ll try to take a look at it over the weekend.  If not, I’ll try to work up a sample for you from scratch – but would probably be more helpful for you if I can work off of your starting point.

 

If we can’t figure it out by Monday, we’ll post our open questions on the HL7 SDWG listserv and/or NIST testing forum, for further guidance, on Monday...

 

Brian

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[Brian Weiss]

Woops, I meant to show you nullFlavor with value as well…

<value  xsi:type="PQ" nullFlavor="NI"/>

 

Brian