Adding Multiple Ethnic Codes to Validation?

[dcar...@mieweb.com]

So, we still get this if you try to add more than 1 ethnicity (like you can with race):

Result Description: Consol US Realm Header SHALL contain at least one [1..*] recordTarget, where its type is Record Target (CONF:5266) each SHALL contain exactly one [1..1] patientRole, where (CONF:5268) patient Role SHALL contain exactly one [1..1] patient, where (CONF:1198-5283) patient MAY contain zero or one [0..1] ethnicGroupCode, which SHALL be selected from ValueSet Ethnicity Value Set 2.16.840.1.114222.4.11.837 DYNAMIC (CONF:5323)
Document Xpath: /ClinicalDocument/recordTarget/patientRole/patient

New certification requirements though require you to be able to collect multiple "ethnicities" (so, someone could be specifically Bolivian and Peruvian, etc.

Anyone know if this is being addressed soon?

[Nagesh Bashyam]

Dave

The multiple races and ethnicities can be coded using the sdtc extensions. Also the HL7 published companion guide has a section on Race and Ethnicities encoding.

Is the problem below when you use the sdtc extension or is it something else ?

Let us know so that we can determine if there is anything that we need to do.

Thanks
Dragon

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[dcar...@mieweb.com]

Thank you for the reply Dragon.

Yes, I get this error:
Error - Consol US Realm Header SHALL contain at least one [1..*] recordTarget, where its type is Record Target (CONF:5266) each SHALL contain exactly one [1..1] patientRole, where (CONF:5268) patient Role SHALL contain exactly one [1..1] patient, where (CONF:1198-5283) patient MAY contain zero or one [0..1] ethnicGroupCode, which SHALL be selected from ValueSet Ethnicity Value Set 2.16.840.1.114222.4.11.837 DYNAMIC (CONF:5323)
/ClinicalDocument/recordTarget/patientRole/patient
Line number: 33

When I try to use the sdtc extention to add a second Ethnicity. Here is what I have in the CCDA header patient section:
<patient>
<name>
<family>Hart</family>
<given>William</given>
<given>S.</given>
</name>
<administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1"/>
<birthTime value="19541130000000-0500"/>
<maritalStatusCode code="M" codeSystem="2.16.840.1.113883.5.2" displayName="Married"/>
<raceCode code="2058-6" codeSystem="2.16.840.1.113883.6.238" displayName="African American"/>
<sdtc:raceCode code="2106-3" codeSystem="2.16.840.1.113883.6.238" displayName="White"/>
<ethnicGroupCode code="2152-7" codeSystem="2.16.840.1.113883.6.238" displayName="La Raza"/>
<sdtc:ethnicGroupCode code="2143-6" codeSystem="2.16.840.1.113883.6.238" displayName="Gallego"/>
<languageCommunication>
<templateId root="2.16.840.1.113883.3.88.11.83.2"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.2.1"/>
<languageCode code="en"/>
</languageCommunication>
</patient>

The error returned pretty clearly states that it is still checking for a 0..1 fidelity in ethnicGroupCode, vs. raceCode, which I believe has been changed to be 0...*.

[Nagesh Bashyam]

Dave

Dan completed the analysis and narrowed down the issue to an error in the XML. Hopefully it helps.

As per the MDHT error provided, the file passes validation when providing a valid code to ethnicGroupCode/@code which is selected from the Ethnicity Value Set 2.16.840.1.114222.4.11.837. Code 2152-7 is not a part of the valueSet. There are only two codes within it:
1: 2135-2 Hispanic or Latino
2: 2186-5 Not Hispanic or Latino

The issue is completely unrelated to sdtc:ethnicGroupCode. Removing it without fixing the code results in the same error. And, leaving it in place with no edits and fixing the code in ethnicGroupCode/@code does not result in an error to the sdtc element or the original element.

Here is the fix in XML:
Original:

<ethnicGroupCode code="2152-7"
codeSystem="2.16.840.1.113883.6.238" displayName="La Raza"/>

Fix:
<ethnicGroupCode code="2186-5"
codeSystem="2.16.840.1.113883.6.238" displayName="Not Hispanic or Latino"/>

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From: transport-t...@googlegroups.com [mailto:transport-t...@googlegroups.com] On Behalf Of dcar...@mieweb.com

[dcar...@mieweb.com]

LOL, well, except that, LaRaza is a subset of Hispanic or Latino ;)

So, I am getting that, right now, CCDA is only supporting "Yes/No" essentially.

My question is, given that (for whatever reasons) 2015 certification measures are requiring the ability to select multiple "ethnicities" in the product (which would mean selecting more than one of the "deeper" dive Hispanic classifications like I did in my example) ... are there plans for CCDA to support reflecting that level of information in the header, like they are allowing now for race (obviously, I guess one could add the "specific" Ethnicity values to the "Social History" section).

I guess that isn't really a question for the TTT thread here though, more for the CCDA architecture groups... so, thank you.

[dcar...@mieweb.com]

Well, wait, I guess maybe I misread that... I guess I could put in the "sdtc" values the specific items, and that might pass? I will try that.

[Nagesh Bashyam]

Yea, appropriate for SDWG.

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