Two definitions of Care Plan Section
Andrew McCaffrey
PCC People,
A vendor related a problem he encountered while testing, I think it
results from an incompatibility between two PCC documents.
In Vol 2 of PCC Technical Framework, Care Plan Section
(1.3.6.1.4.1.19376.1.5.3.1.3.31) is defined in 6.3.3.6.1. The parent
template comes from CCD. The LOINC code is 61145-9. There are no
required/optional entries described.
However in CDA Content Modules, Care Plan Section
(1.3.6.1.4.1.19376.1.5.3.1.3.31, same template ID) is also defined in
6.3.3.6.15. The parent template is the same one from CCD as in the
TF-defined Care Plan Section. However, the LOINC code is 18776-5.
There are five optional entries included.
My guess is that the CDA Content Modules is correct (since that LOINC
code matches the LOINC code described in the CCD parent template) and
that the TF Vol 2 language is just legacy language. However, I wanted
to run this by you guys just to make sure my assumption is correct.
Thanks for your time.
--
Andrew McCaffrey
andrew.m...@nist.gov
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Andrew McCaffrey
Actually, now that I dig a little deeper (I was wondering why I re-wrote
the schematron rule), it may not be as simple as I initially thought.
There is a CP that changes the LOINC code for Care Plan:
ftp://ftp.ihe.net/Patient_Care_Coordination/Maintenance2011/CPs/Incorporated/CP-PCC-0085-01.doc
"The PCC Care Plan section makes reference to the LOINC code for
Treatment Plan. At the face to face meeting in July the committee
agreed that Care Plans and Treatment Plans do not represent the same
thing and a new code is needed for Care Plan."
So, it seems that the intent would be to for "18776-5" to no longer be
the LOINC code for PCC's Care Plan... but in that case, I believe the
reference to CCD Section 3.16 should be removed as well.
What should implementors be using as a LOINC code and parent template
for PCC Care Plan Section?
Thanks.
Andrew McCaffrey
Thanks. I'm coming at this problem through the context of an IHE PCC
document type. IHE does not (yet) reference the HL7 Consolidated CDA
guide, so anything to be found there presumably can't be used to help
define IHE PCC templates...
On 11/30/2011 10:51 AM, Tao, David (H USA) wrote:
> I recommend looking at the latest HL7 Consolidated CDA guide, one of the purposes of which was to resolve discrepancies such as you pointed out. Looks like LOINC 18776-5 wins! See section 4.39, copied below. Also, the conformance criteria lists the optional content modules.
> David
>
> 4.39 Plan of Care Section 18776-5
> [section: templateId 2.16.840.1.113883.10.20.22.2.10(open)]
> The Plan of Care section contains data that defines pending orders, interventions, encounters, services, and procedures for the patient. It is limited to prospective, unfulfilled, or incomplete orders and requests only, which are indicated by the @moodCode of the entries within this section. All active, incomplete, or pending orders, appointments, referrals, procedures, services, or any other pending event of clinical significance to the current care of the patient should be listed unless constrained due to privacy issues. The plan may also contain information about ongoing care of the patient and information regarding goals and clinical reminders. Clinical reminders are placed here to provide prompts for disease prevention and management, patient safety, and health-care quality improvements, including widely accepted performance measures. The plan may also indicate that patient education was given or will be provided.
> 1. SHALL contain exactly one [1..1] templateId/@root="2.16.840.1.113883.10.20.22.2.10" (CONF:7723).
> 2. SHALL contain exactly one [1..1] code/@code="18776-5" Plan of Care (CodeSystem: 2.16.840.1.113883.6.1 LOINC) (CONF:7724).
> 3. SHALL contain exactly one [1..1] text (CONF:7725).
> 4. MAY contain zero or more [0..*] entry (CONF:7726) such that it
> a. SHALL contain exactly one [1..1] Plan of Care Activity Act (templateId:2.16.840.1.113883.10.20.22.4.39) (CONF:8804).
> 5. MAY contain zero or more [0..*] entry (CONF:8805) such that it
> a. SHALL contain exactly one [1..1] Plan of Care Activity Encounter (templateId:2.16.840.1.113883.10.20.22.4.40) (CONF:8806).
> 6. MAY contain zero or more [0..*] entry (CONF:8807) such that it
> a. SHALL contain exactly one [1..1] Plan of Care Activity Observation (templateId:2.16.840.1.113883.10.20.22.4.44) (CONF:8808).
> 7. MAY contain zero or more [0..*] entry (CONF:8809) such that it
> a. SHALL contain exactly one [1..1] Plan of Care Activity Procedure (templateId:2.16.840.1.113883.10.20.22.4.41) (CONF:8810).
> 8. MAY contain zero or more [0..*] entry (CONF:8811) such that it
> a. SHALL contain exactly one [1..1] Plan of Care Activity Substance Administration (templateId:2.16.840.1.113883.10.20.22.4.42) (CONF:8812).
> 9. MAY contain zero or more [0..*] entry (CONF:8813) such that it
> a. SHALL contain exactly one [1..1] Plan of Care Activity Supply (templateId:2.16.840.1.113883.10.20.22.4.43) (CONF:8814).
Boone, Keith W (GE Healthcare)
keith
_________________________________
Keith W. Boone
Standards Architect
GE Healthcare
T +1 617.519 2076
M +1 617 640 7007
keith...@ge.com
www.gehealthcare.com
116 Huntington Ave
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USA
GE imagination at work
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Subject: Two definitions of Care Plan Section
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Andrew McCaffrey
Does anyone have any further thoughts on this issue? Was the intent to
entirely break the connection to CCD? Or perhaps the intent was to have
two Care Plans, one compatible with CCD and one that had the flexibility
required by IHE (this would mean a new template would have to be created)?
For testing purposes, I think I'll put the template back to its
pre-CP-85 definition so that the LOINC codes do not conflict. But I'm
curious about what the intent was...
Thanks.
Boone, Keith W (GE Healthcare)
Keith
-----Original Message-----
From: ihe-pcc-im...@googlegroups.com [mailto:ihe-pcc-im...@googlegroups.com] On Behalf Of Andrew McCaffrey