Test Data Revisions - (f)(7) Transmission to Public Health Agencies – Health Care Surveys

[John Stamm]

Team,

 

Epic has been working through the test data for the Surveys as posted on the NIST site.

https://cda-validation.nist.gov/cda-validation/muNHCS.html

 

We've run into a few places where the test data seems to be inconsistent and spent some time reviewing these inconsistencies with Brian Gugerty.  I've attached our findings here. 

- One document includes a list of discrete items in the test data with recommended adjustments. 

- The second is the test data, adjusted for those changes.  I've highlighted in red the places where there was what I believe to be a substantive change reflected in the first document.  Spelling changes are not called out unless they reflect a substantive change.

 

This information is also reflected on the ONC Jira (JIRA-1884).

https://oncprojectracking.healthit.gov/support/browse/JIRA-1884

 

We also had some discussions regarding the sequencing of events in the test data.  As the times of the test data visits are significantly in the past, there may be some challenges with such a significant requirement for backdating events.  I believe that the preferred approach in that case was to keep the test data event timestamps in the same relative sequence, even if the individual dates/times have to be adjusted to be more modern.

 

Brian – could you confirm that:

- You don't have any concerns with these test data modifications?  Or if you do, could you let us know what they are so that we can adjust?

- Your preference over backdating events is to keep the various events recent but in the correct sequence?

 

Thanks,

John

[Shayaan Munshi]

Hi John, 

There are two separate URL's for NHCS DSTU and NHCS DSTU 1.2

National Health Care Surveys (NHCS), Release 1 - US Realm HL7 Draft Standard for Trial Use (DSTU), December 2014

https://cda-validation.nist.gov/cda-validation/muNHCS.html 

National Health Care Surveys Release 1, DSTU Release 1.2 – US Realm, August 2016, Draft Standard for Trial Use (DSTU)

https://cda-validation.nist.gov/cda-validation/muNHCS12.html

Is this testing for DSTU 1.2 against https://cda-validation.nist.gov/cda-validation/muNHCS.html ? 

Regards,

Shayaan

[John Stamm]

Shayaan,

You are correct that I posted the wrong link above.  It should be the 1.2 page.

https://cda-validation.nist.gov/cda-validation/muNHCS12.html

-John

[John Stamm]

Team,

The JIRA post linked was closed with a request to send this information to onc.cert...@hhs.gov.  I have passed along this post to that email group.

-John

[John Stamm]

Team,

There has been some discussion around the right method to represent vital sign participants.  

In talking with Brian, it seems like the best approach is to not hold up the majority of the updates for a discussion of vital sign participants.  So for the time being, we've removed those comments from the files and re-uploaded them here. 

We will plan to review the approach to vital sign participants offline and submit a separate change request when we have more clarity on the best direction for that issue.

Thanks,

John

[Brian Gugerty]

John,

Thanks for this post.

On 4/17/2018 CDC’s National Center for Health Statistics presented a webinar titled:  Update to the National Health Care Surveys Registry to the EHR Vendors Collaborative Initiative. Many members of this Group and many EHR company representatives also attended. At that time, we were strongly encouraging EHR companies build functionality into their products based on HL7 CDA® R2 Implementation Guide: National Health Care Surveys Release 1, DSTU Release 1.2 – US Realm and certify those products to Public Health Agencies – Health Care Surveys – 45 CFR 170.315(f)(7). During that webinar we invited all EHR companies to meet with us if there were questions about the standard or the test data.  Several companies took us up on that offer. Epic was one of them.  John and his team uncovered some deficiencies in the test data and some opportunities for improvement of the test data as well.  He attached two documents to the post I am replying to now.  

We agree with all the suggested changes proposed by Epic in the following attached (to this tread) files: Epic Test Data Updates 10-17-19.xlsx and Epic Test Data Comments 10-17-19.xlsx. It should be noted that there was considerable discussion and give and take that preceded our agreement with Epic where we tried to consider the perspective of all implementers, not just Epic. 

Brian Gugerty DNS, RN

Senior Service Fellow

Centers for Disease Control and Prevention (CDC)

National Center for Health Statistics (NCHS)

Division of Health Care Statistics (DHCS)

3311 Toledo Road

Hyattsville, MD 20782 USA

e-mail: va...@cdc.gov

Office phone: +1 301.458.4977

Mobile phone: +1 410.703.4561

[Brian Gugerty]

John asks - You don't have any concerns with these test data modifications? Brian's reply: I don’t have concerns about the updated modification you posted on 10/17/19.

John asks - Your preference over backdating events is to keep the various events recent but in the correct sequence? Brian's reply -Yes sequence and, if possible, relative time lapse.  I.e. test data ED encompassingEncounter effectiveTime low/ Date and Time of admission or visit or arrival is 201501030021 and encompassingEncounter effectiveTime high/ Date and Time of departure or discharge is 201501031130; it would help if file submitted for evaluation had something like:  encompassingEncounter effectiveTime low/ Date and Time of admission or visit or arrival is 201910170021 and encompassingEncounter effectiveTime high/ Date and Time of departure or discharge is 201910171130  OR  201910170900  and 201910172009.