Minutes, SDTC Conference Call, Thursday, November 1, 2001
The call was convened late, at 11:15 eastern standard time.
Attending: Liora Alschuler, Bob Dolin, Calvin Beebe, Sandy Boyer, Simona Cohen, Amnon Shabo, Rich Mushlin
1. Report from SLC, for those who weren't there, especially priorities and timetables for future work (Liora)
Minutes from SLC will be posted shortly.
2. RIM harmonization report (Bob, Sandy)
Bob feels we can bring Fred’s proposal to RIM harmonizaton as-is, although it will need areas of work on vocab.
Sandy will address these.
3. CMET harmonization report (Bob, Sandy)
We submitted four CMETs for harmonization: patient, provider, location, and device. These are all taken directly
from the CDA header. We need to support these with formal documentation using the Rose Tree/Vizio tooling. We
also need to compare them carefully with the CMETs introduced by other groups. Bob will advise the SDTC list of
which CMETs are most important to review so we can provide input prior to the harmonization meeting at the end
of the month.
4. Referenced coordinates/spatial coordinates proposal (if not fully covered in 2) (Fred)
See above.
5. L2/L3
Summary of concensus and open issues on framework requirements (Liora)
The primary open question that must be resolved is the functional distinction between Levels Two and Three. Liora
suggested the principle that the distinction should be one that is useful from a processing point of view, that is, that
the level of the document be a useful guide to what type of processing can be done with the document. There seems
to be a consensus around Bob’s proposal that at Level One, type codes can be linked with sections, but are not
specificied and not required. At Level Two, section-level type codes will be specified, and will be mandatory or
optional. At Level Three, we will add the semantic formalism required to encode observations and procedures.
Essentially, at Level Three, we will be able to plug in the CMETs produced by Orders & Observations. Using
template mechanics, we can constrain the CMETs according to document type.
There remain many open issues, including the great degree of optionality in commonly-used document types. In an
H&P, anything could be expressed. There will be narrative text at all levels which may remain unencoded.
Liora will revise the requirements document reflecting this discussion.
Proposals for specialized document types:
BMT Discharage Summary, Level Two; (Amnon)
Transplantation Essential Data (TED), (Amnon)
We discussed the proposal submitted by Amnon for a Level Two BMT Discharge Summary document and a Level
Three BMT TED. Simona pointed out the use of extracts from related documents which is an example of the
application of compound documents, an open issue for Level One.
Bob offered to work with the documents and schemas to express the semantics as RIM constructs, but he will be
unable to get to this for some time. Calvin offered to suggest ways in which the documents could conform more
closely to the Level One CDA and he will post his comments to the list prior to next week’s call.
There was consensus that these proposals represent an excellent set of requirements that will enrich and inform both
the construction of the generic Level Two & Three proposals but which can also form the basis for the first set of
specialized CDA document types.
We will review Amnon’s proposal in greater detail and discuss it further next week.
Level Three; DICOM SR, (Fred)
Surgical Pathology, (Liora, John)
There was no other discussion of specialized document types.
Open Issues:
1. Revisions to Level 1
schema: normative for next release; informative for existing (just post)
data types DTD :: after close of ballot, check and note issues
technical corrections, as needed
families of documents:: compound and document links/extracts
2. Framework for Levels 2&3: Reach consensus on requirements, ballot structure for l2/3, if receive bona fide
requirements for specializations, include those, too, else ballot as framework.
Needed: mechanism for capturing specifications for Level Two; view of templates for Level Three as plug-ins or
constraints.
3. Non-clinical document types. We have requirements to create a framework for non-clinical documents of the
following types: consent/adv directives (for treatment); privacy/access control (for records); FDA (C-DISC),
guidelines.
4. Statement on implementation of digital sig/witness: LA to follow work within CQ
5. Followup with Clinical LOINC on document ontology: Calvin
Meeting adjourned at 12:50 EST