Meeting Name
Location:
Meeting Date and Time:
Next Meeting Scheduled:
LCC All Hands Meeting – C-CDA Ballot Review
Web / Conference Call
Monday, November 18, 2013 @ 5pm ET
Thursday, November 21, 2013 @ 5pm ET
Agenda
 Cognitive and Mental Status Templates – Proposed Changes
Attendance
Name/Affiliation
Becky Angeles
David Tao
Emma Jones
Evelyn Gallego
Holly Urban
Larry Garber
Lynette Elliott
Sarah Gaunt
Stephen Chu
Susan Campbell
Zabrina Gonzaga
Annalisa Wilde
Benjamin Flessner
Beth Halley
Diane Evans
Donna Doneski
Gaye Dolin
George Cole
Gordon Raup
Jennie Harvell
Joanne Lynn
Laura Heerman Langford
Lester Keepper
Lindsey Hoggle
Lisa Nelson
Rita Torkzadeh
Rob Hausam
Russ Leftwich
Sue Mitchell
Terry O’Malley
Email
becky.angeles@esacinc.com
dtao12@gmail.com
emma.jones@allscripts.com
evelyn.gallego@siframework.org
hurban@zynx.com
Lawrence.Garber@reliantmedicalgroup.org
lynette.elliott.@esacinc.com
sarah.gaunt@lantanagroup.com
stephen.chu@nehta.gov.au
Bostoncampbell@mindspring.com
zabrina.gonzaga@lantanagroup.com
awilde@healthix.org
benjamin@epic.com
ehalley@mitre.org
diane.evans@impact-advisors.com
donna@nasl.org
gaye.dolin@lantanagroup.com
george.cole@allscripts.com
graup@datuit.com
Jennie.Harvell@hhs.gov
joanne.lynn@altarum.org
Laura.Heermann@imail.org
lkeepper@shapehitech.com
lhoggle@eatright.org
lisarnelson@cox.net
ritork3@gmail.com
rrhausam@gmail.com
ehealth@pobox.com
suemitchell@hotmail.com
tomalley@partners.org
Attended
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
No
Discussion
Several C-CDA ballot comments were submitted regarding the “Cognitive” and “Mental” Templates. On the
Monday, November 11th Pilots WG call, the LCC community crafted several proposed changes to the templates
related to these areas. Those proposed changes are being discussed on the call today with the Lantana team
(Sarah and Zabrina).
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Page 1
UPDATE Mental Status Section
• Description:
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The Mental Status Section contains observation and evaluations related to patient's psychological
and mental competency and deficits including but not limited to any of the following types of
information:
• Appearance (e.g., unusual grooming, clothing or body modifications)
• Attitude (e.g., cooperative, guarded, hostile)
• Behavior/psychomotor (e.g., abnormal movements, eye contact, tics)
• Mood and affect (e.g., anxious, angry, euphoric)
• Speech and Language (e.g., pressured speech, perseveration)
• Thought process (e.g., logic, coherence)
• Thought content (e.g., delusions, phobias)
• Perception (e.g., voices, hallucinations)
• Cognition (e.g., memory, alertness/consciousness, attention, orientation) – which were
included in Cognitive Status Observation and Cognitive Abilities Observation in earlier
publications of C-CDA.
• Insight and judgment (e.g., understanding of condition, decision making)
While there is currently no single standard hierarchy of the aspects of mental status, the Problem
Concern Act (or Health Concern Act?) may be used to group multiple Problem Observations
related to Mental Status, and the Mental Status Organizer may be used to group related Mental
Status Observations (e.g., results of mental tests) and associated Assessment Scale
Observations.
UPDATE Mental Status Observation
• Description:
Mental Status Observation covers a broad range of mental status information, including objective
and measured data to address those categories described in the Mental Status Section. See also
Assessment Scale Observation for specific collections of observations that together yield a
summary evaluation of a particular condition.
ADD Mental Status Organizer (proposed NEW)
• Description:
The Mental Status Organizer template may be used to group related Mental Status Observations
(e.g., results of mental tests) and associated Assessment Scale Observations into subcategories,
such as Mood and Affect, Behavior, Thought Process, Perception, Cognition, etc.
UPDATE or REMOVE Cognitive Status templates (combine with Mental Status templates)
• REMOVE Cognitive Abilities Observation from C-CDA (or figure out how to “remove” It)
• RENAME Cognitive Status Observation to Mental Status Observation
• Ensure “cognitive” attributes/elements are included in the “mental”
• RENAME Cognitive Status Organizer to Mental Status Organizer
• Ensure “cognitive” attributes/elements are included in the “mental”
REMOVE Non-medicinal Supply Activity from Mental Status Section (Functional Section) (Medical Supply,
Planned)
REMOVE Caregiver Characteristics from Mental Status Section (link from Social History?)
REMOVE Assessment Scale Observation from Mental Status Observation and Cognitive Status
Observation
Table 294 – Problem Type: REPLACE 373930000 Cognitive Status Finding code WITH 384821006 Mental
state, behavior and/or psychosocial function finding
Table 359 – Mental Status Observation Type – enlarge table to include values from Cognitive and
everything from Larry’s (Bill’s) Mental Status bulleted list. Also need to align with Care tool needs.
New Comment from Emma: What about the Mental Status Subsection and Psychiatric Subsection of
Physical Exam in Appendix J in the old C-CDA? How is the Mental Status Section (NEW) related to that
subsection – if at all and what is the distinction? Where is Appendix J in the new version of C-CDA? There
is a reference to the appendix in the Physical Exam Section template.
Next Steps
 Sarah/Lantana will dive into the proposed changes to the Cognitive and Mental Status templates and we
will use the last 20 mins of Thursday’s call to discuss any questions and counter proposals she has
Action Items
Name
Page 3
Task
Due Date