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Vital Sign Observation (V2)
Issues (5)
Change Request Status = Closed (ccda-issue-85): Erratum-964 Separate conformance statements and modify Value Set members
TypeChange RequestStatusChange Request Status = Closed PriorityNormal
Events
Tracking / Status = Closed 2017-10-16 15:45:26: Tracking by Lisa Nelson
Tracking / Status = Feedback needed 2017-10-12 21:30:16: Tracking by Lisa Nelson
Description
I think we can do this in temple editor.
Assignment2017-09-28 02:58:01: Assigned To dr Kai U. Heitmann by Lisa Nelson
Assignment2017-09-18 20:38:58: Assigned To Lisa Nelson by Lisa Nelson
Tracking / Status = Open 2017-09-18 20:38:57: Tracking by Lisa Nelson
Description
Finding:

-Break statement into two conformance statements.

-SHALL contain exactly one [1..1] code

-SHOULD be selected from ValueSet Vital Sign Result  

Add 29463-7 Body weight to value set.

Remove 3141-9 Body weight Measured from value set.     

Suggestion:

- Prior Conformance

5. SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Vital Sign Result urn:oid:2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:1098-7301).



Table includes:

3141-9 Body weight Measured from value set.  

Table does not include:

29463-7 Body weight to value set.

- Conformance After Update:

5. SHALL contain exactly one [1..1] code (CONF:1098-7301).

a. This code SHOULD contain zero or one [0..1] @code, which SHOULD be selected from ValueSet Vital Sign Result urn:oid:2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:1098-32934)."


Table includes:

29463-7 Body weight to value set.

Table does not include:

3141-9 Body weight Measured from value set.   


Further explanation:

-CONF:7301; CONF:1098-32934

Change Request Status = In Progress (ccda-issue-86): Erratum-986 New vital sign observation code for Oxygen Saturation
TypeChange RequestStatusChange Request Status = In Progress PriorityNormal
Events
Tracking / Status = In Progress 2017-10-23 22:56:45: Tracking by Lisa Nelson
Tracking / Status = Open 2017-10-23 22:56:29: Tracking by Lisa Nelson
Description
We are going to add an STU comment that this term needs to be added to the value set. We checked the value set that is published in VSAC and 59408-5 Oxygen Saturation does not appear to be present.

We added DSTU Comment 1476.
Assignment2017-09-28 02:58:34: Assigned To Didi Davis by Lisa Nelson
Description
Value Set issue
Assignment2017-09-18 21:00:15: Assigned To Lisa Nelson by Lisa Nelson
Tracking / Status = Open 2017-09-18 21:00:14: Tracking by Lisa Nelson
Description
Finding:

-LOINC Recommends new code: 59408-5 Oxygen saturation in Arterial blood by Pulse oximetry. Update reference in Value Set table from www.loinc.org to specific value set in https://vsac.nlm.nih.gov/. Ensure that values in table are up to date. 

Suggestion:

-Prior to update

5.SHALL contain exactly one [1..1] code, which SHOULD be selected from ValueSet Vital Sign Result urn:oid:2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:1098-7301).



-------------------

Table 501: Vital Sign Result 


Value Set: Vital Sign Result urn:oid:2.16.840.1.113883.3.88.12.80.62 


This identifies the vital sign result type. Specific URL Pending 


Value Set Source: http://www.loinc.org/


- After update

5. SHALL contain exactly one [1..1] code (CONF:1098-7301).

a. This code SHOULD contain zero or one [0..1] @code, which SHOULD be selected from ValueSet Vital Sign Result urn:oid:2.16.840.1.113883.3.88.12.80.62 DYNAMIC (CONF:1098-32934).


--------------------------

Table 497: Vital Sign Result

Value Set: Vital Sign Result urn:oid:2.16.840.1.113883.3.88.12.80.62

This identifies the vital sign result type.

Value Set Source: https://vsac.nlm.nih.gov/


Further explanation:

- CONF:59408

Change Request Status = Closed (ccda-issue-105): Erratum-1220 Update to DYNAMIC
TypeChange RequestStatusChange Request Status = Closed PriorityNormal
Events
Tracking / Status = Closed 2017-10-09 23:32:58: Tracking by Lisa Nelson
Assignment2017-09-30 19:59:05: Assigned To dr Kai U. Heitmann by Lisa Nelson
Description
Question for Kai - see event below.
Tracking / Status = Open 2017-09-30 19:58:43: Tracking by Lisa Nelson
Description
I didn't change anything because the DYNAMIC binding was there already. HOWEVER....I have a question about this one.  Why wouldn't the value set be included as a vocabulary conformance that includes/points to the actual Value Set.  Why is this just presented as a narrative description?
Assignment2017-09-22 02:45:19: Assigned To Lisa Nelson by Lisa Nelson
Tracking / Status = Open 2017-09-22 02:45:18: Tracking by Lisa Nelson
Description
Finding:

- Update to DYNAMIC 

Suggestion:

- Prior Conformance: 

a. The interpretationCode, if present, SHALL contain exactly one [1..1] @code (ValueSet: 

Observation Interpretation (HL7) urn:oid:2.16.840.1.113883.1.11.78 STATIC 2014-09-01) (CONF:1098-32886).

-Conformance After Update:

a. The interpretationCode, if present, SHALL contain exactly one [1..1] @code (ValueSet: 

Observation Interpretation (HL7) urn:oid:2.16.840.1.113883.1.11.78 DYNAMIC (CONF:1098-32886).

Further explanation:

- 32886

Change Request Status = Closed (ccda-issue-141): Erratum-814 Update 32866 to SHALL value set binding
TypeChange RequestStatusChange Request Status = Closed PriorityNormal
Events
Tracking / Status = Closed 2017-10-16 22:02:37: Tracking by Lisa Nelson
Assignment2017-09-28 15:52:05: Assigned To Didi Davis by Lisa Nelson
Tracking / Status = Open 2017-09-28 15:51:54: Tracking by Lisa Nelson
Description
I modified the constraint description. But, got stuck trying to add a value set binding on interpretation/@code.

Value Set Question
Assignment2017-09-26 02:49:50: Assigned To Lisa Nelson by Lisa Nelson
Tracking / Status = Open 2017-09-26 02:49:49: Tracking by Lisa Nelson
Description
Finding:

- Update 32866 to SHALL value set binding 

Suggestion:

-Prior Conformance:
a. The interpretationCode, if present, SHALL contain exactly one [1..1] @code (ValueSet: Observation Interpretation (HL7) urn:oid:2.16.840.1.113883.1.11.78 STATIC 2014-09-01) (CONF:1098-32886).
-Conformance After Update:
a. The interpretationCode, if present, SHALL contain exactly one [1..1] @code, which SHALL be selected from ValueSet Observation Interpretation (HL7) urn:oid:2.16.840.1.113883.1.11.78 DYNAMIC (CONF:1098-32886).

Further explanation:

-'32886, 

Change Request Status = Closed (ccda-issue-180): CS-20180129-02 Value element should allow nullFlavor
TypeChange RequestStatusChange Request Status = Closed PriorityNormal
Current Labels
 
 (CS) Customer Support 
Events
Tracking / Status = Closed 2018-06-04 21:16:16: Tracking by Didi Davis
 
 CS 
Description
This issue was resolved in JIRA - Sequoia-64 on May 17, 2018. 

Reran  https://gazellecontent.sequoiaproject.org/EVSClient/detailedResult.seam?type=CDA&oid=1.3.6.1.4.1.12559.11.28.1641 where ccda212265 did not allow for null.  Verified this was address in this rerun permanent link. 
https://gazellecontent.sequoiaproject.org/EVSClient/detailedResult.seam?type=CDA&oid=1.3.6.1.4.1.12559.11.28.13274

Tracking / Status = In Progress 2018-04-30 22:23:51: Tracking by Lisa Nelson
 
 CS 
Description
JIRA Ticket: SEQUOIA-64 
Tracking / Status = In Progress 2018-02-05 22:39:53: Tracking by Lisa Nelson
Assignment2018-02-05 22:39:17: Assigned To Abderrazek Boufahja by Lisa Nelson
Assignment2018-01-31 02:43:21: Assigned To Abderrazek Boufahja by Lisa Nelson
Description
Determined that no additional change is needed.  Status will be changed to Pending.
Tracking / Status = Feedback needed 2018-01-31 02:42:49: Tracking by Lisa Nelson
Description
I fixed this issue by removing the mandatory flag on the value element.  However, it now seems weird that the @unit attribute is required.  If the value has a nullFlavor, then it doesn't make sense in that case to require the @units attribute.  Abderazak, do we need to make a further modification?

I communicated with the customer to let them know this issue had been resolved.  Please look at unit attribute constraint before processing the updates.  Thank you.
Assignment2018-01-31 02:34:53: Assigned To Lisa Nelson by Lisa Nelson
Tracking / Status = Open 2018-01-31 02:34:52: Tracking by Lisa Nelson
Description
Finding:

I am seeing an unexpected error when attempting to validate a CCD using the Sequoia C-CDA R2.1 validator.  It is not allowing a nullFlavor for the “value” element in the “Vital Sign Observation (V2)” template.  However, the C-CDA R2.1 spec doesn’t state that nullFlavor isn’t allowed—only that the “value” element must be present with the “units” attribute populated.

 

File Name: patient_CCDA_CCD_R2_1_altered.xml

OID : 1.3.6.1.4.1.12559.11.28.1641

Schematron :  N/A (Version N/A)

Schematron Validation Result :  N/A

Validation Date :  1/29/18 6:01:04 PM (CET GMT+0100)

Model Based Validator :  HL7 - C-CDA R2.1 - Meaningful Use Stage 3 (Version N/A)

Model Based Validation Result :  FAILED   SC

Permanent link :  https://gazellecontent.sequoiaproject.org/EVSClient/detailedResult.seam?type=CDA&oid=1.3.6.1.4.1.12559.11.28.1641

Data Visibility :  Private - Owned By kstevenson / DOD

 

 

 

I believe the nullFlavor should be allowed for the “value” element since it isn’t specifically not allowed.  In particular, CONF:1098-7305 requires that the “value” element be present with @xsi:type=”PQ”, but doesn’t state that nullFlavor cannot be used.

 

Suggestion:

-

Further explanation:

-

 
 
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