Clarification on Clinical Information Reconciliation and Incorporation (§170.315(b)(2)) Testing Using HealthIT Sample Files

[Rajkumar P]

Hi Team,

I have mostly completed the development for the Clinical Information Reconciliation and Incorporation (§170.315(b)(2)) feature. I need some clarification regarding the testing scenarios and the usage of the HealthIT sample files.

Currently, my testing flow is as follows:

1. Upload the sample C-CDA file 170.315_b2_ciri__r11_svap_uscdiv4_sample1_recon_v1.xml into the application.
2. Perform reconciliation by selecting the Medications, Allergies, and Problems sections.
3. Save the reconciliation.
4. Navigate to the VDT (View, Download, and Transmit) module.
5. Download the newly generated C-CDA document.
6. Upload the downloaded C-CDA document to the HealthIT C-CDA Validator (USCDI v4).

I have also tested using the sample files available on the HealthIT C-CDA Validator. However, when validating the generated C-CDA, I receive around 13 validation errors.

Could you please clarify the following?

• Are the sample files provided by HealthIT intended to be used directly for §170.315(b)(2) CIRI certification testing, or are they only reference/sample documents?
• Is my testing workflow (Upload → Reconcile → Save → Download via VDT → Validate in the C-CDA Validator) the correct approach for certification testing?
• Are the validation errors expected because the sample file is only a reference document, or should the generated C-CDA pass validation without these errors?
• Is there any official certification testing scenario or specific set of sample files that should be used for validating the CIRI workflow?

Please let me know if there is a recommended testing process or any documentation that I should follow.

Thank you.
Rajkumar..

[Prahbu Shankar]

Hello Rajkumar,

• Are the sample files provided by HealthIT intended to be used directly for §170.315(b)(2) CIRI certification testing, or are they only reference/sample documents?

• • The sample files provided by HealthIT are intended only as reference/sample documents. They should not be used directly for §170.315(b)(2) CIRI certification testing.
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• Are the validation errors expected because the sample file is only a reference document, or should the generated C-CDA pass validation without these errors?

• •   The sample file is provided only as a reference document. The user should generate a C-CDA file and test it in the validator against the selected scenario file. The generated C-CDA should pass validation without these errors.  

Thanks,

-Prabhu

[Rajkumar P]

My doubt is: In your database, the Codeine code is 1550, but the expected code is 2670. How can I change it? 

Current Code.                         Change To
233604007 (Pneumonia)   195967001 (Asthma)
1550 (Codeine)                2670 (Codeine)
No Aspirin allergy             Add Aspirin allergy (1191)

[Prahbu Shankar]

Hello Rajkumar, 

which data base you are reffering to?

Thanks,

-Prabhu

[Rajkumar P]

Hi Prabhu,

I'm referring to the SNOMED, RxNorm, and ICD-10 tables used in our application.

I noticed the following changes are needed:

• SNOMED: 233604007 (Pneumonia) should be changed to 195967001 (Asthma).
• RxNorm: 1550 (Codeine) should be changed to 2670 (Codeine).
• Allergy: Currently there is no Aspirin allergy. I need to add Aspirin allergy (1191).

Could you please let me know which table or master data needs to be updated to make these changes?

Thanks,
Rajkumar