SHALL entry in warnings causing test failure

[Kalyan Dasika]

Hi:

I've used the attached CDA document to validate here https://cda-validation.nist.gov/cda-validation/muNHCS12.html

In the outline, I get zero validation errors and it says the result of the test is passed. However, our testing vendor told us that in addition to the outline they will also look at all the SHALL entries in the warning list and flag them as errors. 

There is a SHALL entry in the warning list which I'm afraid will be flagged as a failed test. 

Message	SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Problem Type urn:oid:2.16.840.1.113883.3.88.12.3221.7.2 STATIC 2014-09-02 (CONF:1098-9045).
Context	/ClinicalDocument[1]/component[1]/structuredBody[1]/component[6]/section[1]/entry[1]/observation[1]
Test	count(cda:code[@code=document('https://hit-dev.nist.gov:11080/muValidationNHCS12/schematron/nhcs/voc.xml')/voc:systems/voc:system[@valueSetOid='2.16.840.1.113883.3.88.12.3221.7.2']/voc:code/@value or @nullFlavor])=1

As per this SHALL entry, it is expecting the code element on the observation in component #6 which is the Problem section to have a code set to one from a value set of Problem Type. But there is a also a requirement, as per the NHCS validator that this code should be 52534-5 otherwise the outline flags it as an error. 

<code code="52534-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="Principal Diagnosis"/>

              

Please advise how we may go about handling this case.

Any help is highly appreciated.

Thank you,

Kalyan Dasika

[Kalyan Dasika]

As a follow up to my previous post, I'm attaching a screenshot of 

case1: no outline errors but with a SHALL and 

case2: with an outline error, both referring to the same xml entry.

case1: the code element in the observation satisfies the requirement of the NHCS validator but throws a SHALL warning

case2: if I change the code element to the one from the value set taken from the SHALL warning entry, then outline indicates a validation error

I hope this clearly demonstrates the contradiction in the validation.

Thanks,

Kalyan Dasika

[McCaffrey, Andrew (Fed)]

Hello,

Questions about the ONC Health IT Certification Program should be sent
to: ONC.Cert...@hhs.gov.

-Andrew

On 7/14/19 8:52 PM, Kalyan Dasika wrote:
> Hi:
>
> I've used the attached CDA document to validate
> here https://cda-validation.nist.gov/cda-validation/muNHCS12.html
>
> In the outline, I get zero validation errors and it says the result of
> the test is passed. However, our testing vendor told us that in addition
> to the outline they will also look at all the SHALL entries in the
> warning list and flag them as errors.
>
> There is a SHALL entry in the warning list which I'm afraid will be
> flagged as a failed test.
>
> Message SHALL contain exactly one [1..1] code, which SHOULD be selected
> from ValueSet Problem Type urn:oid:2.16.840.1.113883.3.88.12.3221.7.2
> STATIC 2014-09-02 (CONF:1098-9045).
> Context
> /ClinicalDocument[1]/component[1]/structuredBody[1]/component[6]/section[1]/entry[1]/observation[1]
> Test
> count(cda:code[@code=document('https://hit-dev.nist.gov:11080/muValidationNHCS12/schematron/nhcs/voc.xml')/voc:systems/voc:system[@valueSetOid='2.16.840.1.113883.3.88.12.3221.7.2']/voc:code/@value
> or @nullFlavor])=1
>
>
> As per this SHALL entry, it is expecting the code element on the
> observation in component #6 which is the Problem section to have a code
> set to one from a value set of Problem Type. But there is a also a

> requirement, as per the NHCS validator that this code should be *52534-5
> *otherwise the outline flags it as an error.

>
>
> <code code="52534-5" codeSystem="2.16.840.1.113883.6.1"
> codeSystemName="Principal Diagnosis"/>
>
>
> Please advise how we may go about handling this case.
>
> Any help is highly appreciated.
>
> Thank you,
> Kalyan Dasika
>

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[Kalyan Dasika]

Hello Andrew:

Thank you for the response. 

For this particular case, looks like the validator was implemented with a contradiction built in, as I explained in my previous posts. 

Thank you,

Kalyan

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