1 Agenda For PSS preparation discuss naming of the final deliverables: – 3 Documents from OO EHR...

1

Agenda

For PSS preparation discuss naming of the final deliverables: – 3 Documents from OO EHR Functional Profile for Lab EHR Functional Requirements Implementation Guide for Lab Results

Interface (LRI) EHR Functional Requirements Implementation Guide for Lab Orders

Interface (LOI)

– 1 related Documents from CGIT Conformance framework for Incorporate

Introduction to the main requirements table for LRI Transaction FR Specification Background Table

Laboratory Results Interface (LRI)Functional and Behavioral Requirements Implementation Guide

S&I Framework, NIST, HL7 CGIT and OO WGs

January 22nd, 2014 Revised 02/12/14, 03/10/14 – Draft 2.3 ST

Updated 4/22/14

Contacts: [email protected] and [email protected]

3

Functional Requirements Categories

• Incorporation (focus of this slide deck)• Display (e.g., CLIA requirements)• Error Handling

– Receiver unable to handle data volume– How to respond

• Aggregate Requirements (Candidate requirements to consider)– What is a Lab Results– What is a Lab Report– What is a Patient Record– Matching (on what elements?)– General handling of the data (e.g., which DOB belongs to lab results)– ????

• Usability???• Other “uses” of the data (display requirements is one use)

4

Problem Statement: MU-2 Criterion

• Patient Safety• Common expectations for handling Lab Results• Consistent implementations for handling Lab Results

• Regulatory Requirements• CLIA – general requirements (need more specificity)

• Lack of Specificity of MU Requirements• Transmit Laboratory Results OK

• LRI IG provides detailed requirements• Used by LIS (and EHRs with LIS module) for sending lab result messages to ambulatory EHR

technology

• Receive Laboratory Results OK• LRI IG provides detailed requirements• Used by ambulatory EHR technology for receiving lab result messages from LIS (or EHRs with

LIS module)

• Incorporate Laboratory Results NOT OK• LRI IG provides no guidance (not that it should, it is an interface specification)• MU-2 Criterion: “Incorporate Lab Results” – What does that mean?• Needed by ambulatory EHR technology for determining what to do with the data elements in the

lab result messages received from LIS (or EHRs with LIS module)

5

Incorporate Lab Results – What does it mean?• HL7, S&I Framework, and NIST collaborate to produce the conformance

framework• Community subject matter experts determine the laboratory result-specific

requirements• The combination of the conformance framework and requirements =

Functional and Behavioral Requirements (defining capabilities, such as Incorporate Lab Results)

HL7 GCIT, EHR, & OO WG

NIST S&I Framework

RequirementsCommunity SMEs

Transaction Functional

Requirements

Conformance Framework

EHR FunctionalModel

Lab Functional Profile

High-Level

Very Specific

(Applicable to other domains)

Lab Results Interface (LRI) IG

6

Incorporate Lab Results

• Incorporating lab results involves Storing data elements that were received in the LRI message (elements in scope)

• Stored data elements are associated (linked) with a patient record• Stored data elements may be combined (linked) together in the

EHR system to provide capabilities such as– Clinical Decision Support– A Public Health Report sent by an EHR system– A Laboratory Results Report display

Store Associate Use Patient Record

Lab Results

AssociateLink/combine specific

data elements received in LRI message

Incorporate

Lab Results

Order

Provider

A B 21

7

Incorporate and Use Laboratory Results

The Incorporate and Use Laboratory Results functional requirements specify how laboratory results data are to be • Imported, attributed, associated, or stored such that the data is

subsequently available for use and • Used such that the laboratory results support various clinical purposes

Definitions from the Edition 2014 certification criterion published by the Office of the National Coordinator for Health Information Technology (ONC) are provided below as examples • “‘Incorporate’ is used to mean to electronically import, attribute,

associate, or link information in EHR technology.”• “…to electronically process structured information from another

source such that it is combined (in structured form) with information maintained by EHR technology and is subsequently available for use within the EHR technology by a user.”

8

What Constitutes a Lab Results and Patient Record?• Lab Results

– Exactly what is it? What data?– What parts are immutable and have to maintained/retrievable as such?– What is associated?– What parts are OK to be “just” part of the patient record?

• Patient Record– Exactly what is it? What data?

• Define aggregate requirements– Not addressed in this presentation– Coded elements triplets– Lab test report– Etc.

9

Incorporate Lab Results – NIST Approach for Edition 2014 Certification Testing

• HL7 v2.5.1 LRI IG was derived from Base Standard

• NIST used LRI IG and consulted Laboratory SMEs

• NIST developed LRI Test Tool, including Juror Document for ATLs* to use for lab results Incorporation Verification during certification testing

HL7v2.5.1 Base

Standard

HL7v2.5.1 LRI IG

LRI Juror Document used

in NIST Validation Tool

NIST consultation with Laboratory

SMEs

*Accredited Testing Laboratory

• Test procedure not well defined—no requirements and very limited time

• Testing only can be as good as the requirements they are based on

• “incorporate” far to vague and not the responsibility of NIST to determine

10

Incorporate Lab Results – NIST Juror Document for Edition 2014 Certification Testing

Data Element Incorporation Categorization

11

Incorporate Lab Results – Preferred Approach for Edition 201X Certification Testing (Stage 3 MU)

• HL7 v2.5.1 LRI IG is derived from Base Standard

• EHR-S FM Incorporate Lab Results Profile is derived from EHR-S FM

• LRI Functional and Behavioral Requirements IG is derived from LRI IG and EHR-S FM Profile

HL7v2.5.1 Base

Standard

HL7v2.5.1 LRI IG

EHR-S FM Profile with LRI Details

LRI Transaction Functional

Requirements IG

EHR-S FM with High-level Requirements for “Incorporate”

Incorporate and Use Conformance

Framework

Input to Testing

Specific Message Elements

Specific Functional & Behavioral Requirements

12

Sender Receiver

In-scope Data Elements

HL7 Lab Results Message

Create and Send Message

per LRI IG Specifications

Use Data Elements per LRI

Functional & Behavioral

Requirements IG

Process Received

Message per LRI IG

Specifications

Incorporate Data Elements per LRI

Functional & Behavioral

Requirements IG

Incorporation and Use Process Diagram

1

1

2

2

3

3

5

45

4

Elements with R, RE, or C Usage

Store and Associate

Use (Display, PH, CDA, CDS, etc.)

Parse and Process

Input Data, Create and Send Message

13

LRI Implementation Guide Scope

• We are targeting requirements only within this scope

LRI IG defines a very specific scope…

…implies system functions…

…says little about overall system capabilities

In-scope(Lab Results Incorporate)

System

14

IG / Standards

PID.3.1

Defined Requirements

Assigned Requirements

IncorporateDisplay

ID# R

PID.5.7 Name Type Code

RE

OBX.3.1 Obs ID R

OBX.5 Obs Value

RE

OBR.16.1 Ordering Provider ID#

RE

Incorporate

OBX.3.2 Text RE

MSH.21 Msg Profile ID

RE

Location Usage

PID.3.5 ID Type Code

R

OBX.17 Obs Method

O

Each data element is assigned a requirement selected from

the options defined for Incorporate or Display

Store exact

Store exact

Store exact; translate & store translation

Store exact

Translate & store translation

Translate & store translation

Process

Made Available

Indifferent

Exact

Permitted

Exact

Exact

Stored equivalent

Stored equivalent

Permitted

Permitted

Permitted

• Store exact• Store exact;

translation allowed & store translation

• Translate & store OR store exact Or both

• Made Available• Process

Use

• Exact• Stored

equivalent• Referenced• Translated

version of exact stored

• Permitted

(CDS/PHA)

Exact

Permitted

Exact

Exact

Stored equivalent

Stored equivalent

Permitted

Permitted

Permitted

Use

General Process The words “translate”, “translated”, and “translation” may be used differently by different HL7 Workgroups

15

S-MA

S-PR

Option assigned to

each data element

is the minimum

requirement

Store

Yes

Permitted

Store Action Options

S-EX

Store Requirements

S-EX-TR

S-TR

If S-EX option is the requirement, then implementation SHALL “store” exactly and SHALL NOT “translate”

If S-MA is the requirement, then S-EX, S-EX-TR, or S-TR also would be allowed

If S-EX-TR option is the requirement, then implementation SHALL “store” exactly and MAY “translate” and if translated SHALL store translation

If S-PR is the requirement, then S-EX, S-EX-TR, S-TR, or S-MA also would be allowed

Implementation Choices

If S-TR option is the requirement, then the implementation SHALL implement one of the following: 1) “store” exactly, or 2) “translate” and SHALL store translation, or 3) 1 and 2

Store exactly

Store exactly; translation allowed, and if translated store translation

Translate and store translation OR store exactly OR both

Provide to the system as needed to be used for logical operation; permitted to store exactly, translate and store translation or both

Use in logical operation of system; permitted to discard, to store exactly, to translate and store translation, or both

16

S-MA

S-PR

Option assigned to

each data element

is the minimum

requirement

Store

Yes

Permitted


S-EX

Providing Finer Granularity for Translate

S-EX-TR

S-TR

Store exactly

Store exactly; translation allowed, and if translated store translation

Translate and store translation OR store exactly OR both

Provide to the system as needed to be used for logical operation; permitted to store exactly, translate and store translation or both

OO-S-EQ Translate received data to equivalent value and then storeOO-S-ME Map received data to local value via mapping table external to EHR, then store local value. In addition, store either a pointer to the referenced value in mapping table or store the original unmapped valueOO-S-MI Map received data to value in internal table/file in EHR, then store pointer to referenced value

Translation Options

Use in logical operation of system; permitted to discard, to store exactly, to translate and store translation, or both

Translate can

be further

refined

17

Assigning Incorporation Requirement – OBX.3.1

Data ElementStore Action Options

Available to IG Authors

S-EX Store data exactly as received, no translation stored

S-EX-TR Store data exactly as received; translation allowed, and if translated store translation

S-TR Translate data received and store translation OR store data exactly as received OR both

Impact on Implementers

EHR must be designed to store only exact data received in the message

EHR must be designed to store exact data received in the messages, and also may be designed to translate the data and store the translated version

EHR may be designed to translate data received and store translated version OR may be designed to store exact data received OR may be designed to do both


IG Authors Choose Data Stored in EHRData



“30341-2” must be stored, no translation may be stored

“30341-2” must be stored; may also be translated to “815117” and then translation also must be stored

“30341-2” is translated to “815117” and translation must be stored

OR

OR

“30341-2” must be stored exactly as received

“30341-2” is translated to “815117” and translation must be stored; and “30341-2” also must be stored as exact data

OR

OR

OBX.3.1Test ID

30341-2

18

Steps in Assigning Incorporation of Received Lab Data in EHR

*See Notes page for legend

Data Elements Incorporation Requirements

PID.3.1 ID# R

PID.3.5 ID Type R

PID.5.2 Given Name R

OBX.5 Obs Value RE

PID.5.1.1 Surname R

Store Action

OBR.7.1 Obs Date/Time R

Location Usage

OBX.3.1 Test ID R

Example Message Data

PID.7.1 DoB R

OBX.3.2 Test Text R

OBX.6.1 UoM ID RE

OBX.6.2 UoM Text C(RE\X)

OBX.8 Abn Flag R

OBX.23.1 Perf Org R

OBX.24.1 Street REOBX.24.3 City RE

OBX.24.4 State RE

OBX.24.5 Zip RE

OBR.22.1 Test Rpt Date/Time R

PATID1234

MR

Jones

William

19610615

20110331140551-0800

20110331160428-0800

30341-2Erythrocyte sedimentation rate10

millimeter per hour

mm/h

N

Century Hospital

2070 Test Park St.

Los Angeles

CA

90067

S-EX

S-EX-TR

S-EX-TR

S-EX

S-EX

S-EX

S-EX

S-EX-TR

S-EX

S-EX

S-EX

S-EX

S-EX

S-TR

S-EX

S-EX

S-EX

S-TR

Han

s s

ugge

sted

ind

icat

ing

both

Sen

der a

nd R

ecei

ver

Usa

ge

19















“Erythrocyte sedimentation rate” must be stored, no translation may be stored

“Erythrocyte sedimentation rate” must be stored; may also be translated to “Sed Rate” and then translation also must be stored

“Erythrocyte sedimentation rate” is translated to “Sed Rate” and translation must be stored

OR

OR

“Erythrocyte sedimentation rate” must be stored exactly as received

“Erythrocyte sedimentation rate” is translated to “Sed Rate” and translation must be stored; and “Erythrocyte sedimentation rate” also must be stored as exact data

OR

OR

OBX.3.2Test Text

Erythrocyte sedimentation rate

20




PID.3.1 ID# R

PID.3.5 ID Type R


OBX.5 Obs Value RE

PID.5.1.1 Surname R

Store Action


Location Usage

OBX.3.1 Test ID R


PID.7.1 DoB R

OBX.3.2 Test Text R

OBX.6.1 UoM ID RE


OBX.8 Abn Flag R

OBX.23.1 Perf Org R


OBX.24.4 State RE

OBX.24.5 Zip RE


PATID1234

MR

Jones

William

19610615

20110331140551-0800

20110331160428-0800


millimeter per hour

mm/h

N

Century Hospital

2070 Test Park St.

Los Angeles

CA

90067

S-EX

S-EX-TR

S-EX

S-EX

S-EX

S-EX

S-EX-TR

S-EX

S-EX

S-EX

S-EX

S-EX

S-TR

S-EX

S-EX

S-EX

S-EX-TR

S-TR

21

Assigning Incorporation Requirement – OBX.5














“10” must be stored, no translation may be stored

“10” must be stored; may also be translated to “nn” and then translation also must be stored

“10” is translated to “nn” and translation must be stored

OR

OR

“10” must be stored exactly as received

“10” is translated to “nn” and translation must be stored; and “10” also must be stored as exact data

OR

OR

OBX.5 Observation Value

10 (If Data type is NM)

For OBX.5 the Store requirement is specific to the data type

X

X

X

XXX

22




PID.3.1 ID# R

PID.3.5 ID Type R


OBX.5 Obs Value RE

PID.5.1.1 Surname R

Store Action


Location Usage

OBX.3.1 Test ID R


PID.7.1 DoB R

OBX.3.2 Test Text R

OBX.6.1 UoM ID RE


OBX.8 Abn Flag R

OBX.23.1 Perf Org R


OBX.24.4 State RE

OBX.24.5 Zip RE


PATID1234

MR

Jones

William

19610615

20110331140551-0800

20110331160428-0800


millimeter per hour

mm/h

N

Century Hospital

2070 Test Park St.

Los Angeles

CA

90067

S-EX

S-EX-TR

S-EX

S-EX

S-EX

S-EX

S-EX

S-EX

S-EX

S-EX

S-EX

S-TR

S-EX

S-EX

S-EX

S-EX-TR

S-TR

S-EX-TR

23


OBX.24.1 Perf Org Street Address










2070 Test Park St. S-EX Store data exactly as received, no translation stored




“2070 Test Park St.” must be stored, no translation may be stored

“2070 Test Park St.” must be stored; may also be translated to “2070 Test Park Street” and then translation also must be stored

“2070 Test Park St.” is translated to “2070 Test Park Street” and translation must be stored

OR

OR

“2070 Test Park St.” must be stored exactly as received

“2070 Test Park St.” is translated to “2070 Test Park Street” and translation must be stored; and “2070 Test Park St.” also must be stored as exact data

OR

OR

24




PID.3.1 ID# R

PID.3.5 ID Type R


OBX.5 Obs Value RE

PID.5.1.1 Surname R

Store Action


Location Usage

OBX.3.1 Test ID R


PID.7.1 DoB R

OBX.3.2 Test Text R

OBX.6.1 UoM ID RE


OBX.8 Abn Flag R

OBX.23.1 Perf Org R


OBX.24.4 State RE

OBX.24.5 Zip RE


PATID1234

MR

Jones

William

19610615

20110331140551-0800

20110331160428-0800


millimeter per hour

mm/h

N

Century Hospital

2070 Test Park St.

Los Angeles

CA

90067

S-EX

S-TR

S-EX-TR

S-EX

S-EX

S-EX

S-EX

S-EX-TR

S-EX

S-EX

S-EX

S-EX

S-EX

S-TR

S-EX

S-EX

S-EX

S-EX-TR

25

Century Hospital Laboratory Report

MR# PATID1234 Jones, William (6/15/1961)

3/31/2011 1405 ET

10 mm/h

2070 Test Park StreetLos Angeles, CA 90067

Name/DoB:Patient ID:

Collection Date/Time:

Report Date/Time: 3/31/2011 1604 ET

ESR (815117) 3/31/2011

1405 ET

OBX.23.1

OBX.5

OBX.24.1

OBX.24.5

OBX.24.4

OBX.24.3

PID.7.1

PID.5.2PID.5.1.1

PID.3.1

OBR.7.1

OBR.22.1

OBR.7.1

OBX.8

PID.3.5

OBX.3.2

Location of abnormal flag if result value is not normal

Displays in red text if result value is not normal

OBX.3.1

26

Steps in Incorporation of Received Lab Data and Display in EHR



Display Requirements

PID.3.1 ID# R

PID.3.5 ID Type R


OBX.5 Obs Value RE

PID.5.1.1 Surname R

Store Action


Location Usage

OBX.3.1 Test ID R


PID.7.1 DoB R

OBX.3.2 Test Text R

OBX.6.1 UoM ID RE


OBX.8 Abn Flag R

OBX.23.1 Perf Org R


OBX.24.4 State RE

OBX.24.5 Zip RE


PATID1234

MR

Jones

William

19610615

20110331140551-0800

20110331160428-0800


millimeter per hour

mm/h

N

Century Hospital

2070 Test Park St.

Los Angeles

CA

90067

Laboratory Report

(ESR)

U-REF

(ColorCode/flag Abnormals Only)

U-EX

U-EQ (MR#)

U-TR (6/15/1961)

U-TR (3/31/2011 1406 ET)

U-TR (3/31/2011 1604 ET)

U-TR

U-TR

Not Used

(815117)

U-EX

U-EX

U-EX

U-EX

U-EX

U-EX

U-EX

U-EX

U-EX

S-EX

S-EX-TR

S-EX-TR

S-EX

S-EX

S-EX

S-EX

S-EX-TR

S-EX

S-EX

S-EX

S-EX

S-EX

S-TR

S-EX

S-EX

S-EX

S-TR

27

EHR

Message

Result 10John Cohen

John Cohen Patient Record

Result 10

Store Exact Version: S-EX

• The “Store Exact Version: S-EX” diagram illustrates the incorporation requirement where data received in the message are stored unaltered in the EHR technology and related to the appropriate patient record

• In this example, John Cohen is a patient whose laboratory result value (OBX.5) is “10”• When this laboratory result is received in the message, it is stored as is in the patient’s record in

the EHR

28

EHR

Message

Test Name Erythrocyte Sedimentation RateJohn Cohen


Store Exact and Equivalent Version: S-EX-TR

• The “Store Exact and Equivalent Version: S-EX-TR” diagram illustrates the incorporation requirement where data received in the message are stored exactly and also translated to an equivalent value and then stored in the EHR technology related to the appropriate patient record

• In this example, John Cohen is a patient for whom an Erythrocyte Sedimentation Rate laboratory test has been performed

• When the laboratory result message is received, the test name is stored both as “Erythrocyte Sedimentation Rate” and as “ESR” (which is equivalent to Erythrocyte Sedimentation Rate) in the patient’s record

Test Name ESR

Test Name Erythrocyte Sedimentation Rate

29

EHR

Message

B Dr. Dan Carter


Physician ID Table

B

Ordering Provider Name

BB

pointer

Dr. Dan Carter

Dr. Beth Smyth

Dr. …

Translate and Store or Store Exactly or Both Version: S-TR/OO-S-MI

• The “Translate and Store or Store Exactly or Both Version: S-TR/OO-S-MI” diagram illustrates the incorporation requirement where data received in the message are linked to data in an existing specific record or table in the EHR technology, so the value in that existing record or table is the “stored” version

• Note: the data in the existing record or table must match the received data exactly • In this example, Dr. Dan Carter is a physician whose information exists within an internal Physician Identification Table in

the EHR technology • When a message containing data about Dr. Carter as the Ordering Provider is received, they are stored in the patient’s

record in the EHR using a pointer to the referenced values in the Physician Identification Table

(OO-S-MI Map received data to value in internal table/file in EHR, then store pointer to referenced value)

30


Local Code 68590

Message

LN 718-8

Lab Test Result

EHR

Lab Result

Mapping Table

68590

12340

718-8

….

529-8

LN Local

….

OO-S-ME Map received data to local value via mapping table external to EHR, then store local value. In addition, store either a pointer to the referenced value in mapping table or store the original unmapped value

Translate and Store or Store Exactly or Both Version: S-TR/OO-S-ME

pointer

31

Requirement for Incorporation - Translate and Store or Store Exactly or Both Version (S-TR/OO-S-ME)• The “Translate and Store or Store Exactly or Both Version: S-TR-OO-

S-ME” diagram illustrates the incorporation requirement where data received in the message are mapped to related “local” data (i.e. EHR internal data in the EHR technology) so the EHR local value, which is mapped to a record in an external table that contains the received value, is stored in the patient record

• The received version of the data must be derivable for use via the mapping function, and the derived version of the data must match exactly the original data received in the message

• In this example– A laboratory test with specific LOINC code is received in the message– The LOINC code is mapped to an EHR internal (Local) code in the EHR technology– The Local code -- along with a pointer to the LOINC code and version in the

external table -- is stored in the patient record– When the LOINC code that was received in the message needs to be utilized, it is

derived by the EHR technology via the pointer to the external LOINC table

32

EHR

Message

A 123John Cohen


A 123matched…& may be discarded

Made Available Version: S-MA

33

Requirements for Incorporation – Made Available Version (S-MA)

• The “Made Available Version: S-MA” diagram illustrates the incorporation requirement where data received in the message are processed and made available for operational purposes (such as matching) as indicated by relevant functional requirements

• Once the data are utilized for the operational purpose, they do not need to be stored, associated, or displayed, so they may be discarded

• In this example– A patient identification number is received in the message– This number is used for matching in order to associate the lab results data to John

Cohen’s patient record in the EHR technology– Once the exact match is made, the patient identification number data received in

the message may be discarded

34

Use Options

NONE (for certification testing)

Store

Yes

Permitted

Derivation Action OptionsUse Options

Clinical Decision Support

Public Health Reporting

Display in EHR

Other…

Not Applicable

U-EX Use exact version of stored data;

U-TR Translate exact stored data to equivalent value

Other…

U-REF Use referenced data based on stored pointer

U-EQ Use stored equivalent value

35

Requirements for Use - Display

Display Options Description

U-EX Exact Data SHALL BE displayed to the user by the EHR technology, and what is displayed SHALL BE exactly the same as the text received in the message.

U-TR Translate to Equivalent

Data SHALL BE displayed to the user by the EHR technology, and these displayed data MAY BE a translation of or equivalent to (rather than exactly the same as) the text received in the message (e.g., if “erythrocyte sedimentation rate” is received in the message “ESR” or “Sed Rate” may be displayed to the user)

U-REF Data SHALL BE displayed to the user by the EHR technology, and these displayed data MAY BE referenced data based on stored pointer

U-EQ Display Stored Equivalent

Data SHALL BE displayed to the user by the EHR technology, and these displayed data MAY BE the equivalent of the text received in the message and stored in the patient record

Permitted

Data received in a message MAY BE displayed to the user by the EHR technology at the discretion of the EHR vendor. (e.g., the EHR vendor may design their system to display to the user the LOINC code for a laboratory test received in the message)

36

Extra Slides

37

Yes

Incorporation of DataStore Options

Permitted*

Use of DataUse Options



Display in EHR

Other…

Determine if data element is always to be stored, or if data element is a “Made Available” or “Process” kind of data element

1

Steps in Determining Incorporation and Use of Received Data

*Options for data that usually are not incorporated, i.e., are either “Made Available” or “Process” kinds of data

Made Available (S-MA): Availability of the data is verified during certification testing; storage of these data is not verified during certification testing

Certification Testing Options*

Process (S-PR): Certification testing is indifferent for these data; storage of these data is not verified during certification testing


S-EX None (Store data exactly as received only)

S-TR Translate and store translation OR store exactly OR both

S-EX-TR Store exactly; translation allowed, and if translated store translation

Translation Options

OO-S-EQ Translate received data to equivalent value and then store


OO-S-MI Map received data to value in internal table/file in EHR, then store pointer to referenced value

U-EX Use exact version of stored data; maintain an audit trail that includes the value used

U-TR Translate exact stored data to equivalent value; maintain an audit trail that includes the value used

Derivation Action Options

Other…

U-REF Use referenced data based on stored pointer; maintain an audit trail that includes the value used

U-EQ Use stored equivalent value; maintain an audit trail that includes the value used

38

Yes


Permitted*








Display in EHR

Other…





Other…







Translation Options




If data element is always to be stored, determine the action to be applied for storing

2

39

Yes


Permitted*








Display in EHR

Other…





Other…







Translation Options




If data element is assigned a S-EX-TR or S-TR Store Action, determine the Translation Option to be applied

3

40

Yes


Permitted*








Display in EHR

Other…





Other…







Translation Options




Determine use(s) for stored data

4

41

Yes


Permitted*








Display in EHR

Other…





Other…







Translation Options




Determine the derivation action to be applied for use of the data

5

42

Receive Store (in Patient’s Record)

Use*

ABC

*For example, clinical decision support, public health reporting, display in EHR

ABC ABC

ABCEHR Internal TableABC….

ABC abcEHR External Table

ABC….

S-EX

ABC ABC abcEHR Table

ABC

Possible Receive / Store / Use Combinations Diagram

ABC ABC

ABC

S-EX

S-EX-TRABC

OO-S-MI

abcabc

S-EX-TR

ABC

OO-S-ME

Poin

ter

Poin

ter

U-EX

U-TR

U-EX

U-TR

U-REF

U-REF

S-TR

1.

2.

3.

4.

5.

1 Agenda For PSS preparation discuss naming of the final deliverables: – 3 Documents from OO EHR...

Documents

Transcript of 1 Agenda For PSS preparation discuss naming of the final deliverables: – 3 Documents from OO EHR...