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The following sections provide the details of updates made to this document.
The changes in this construct address the following comments received during the Public Comment and Inspection Testing period (September 29 October 24, 2008).
5233, 5235, 5445, 5111, 5445, 5454, 5714, 5480, 5481, 5592, 5620, 5680, 5493, 5647, 5650, 5649
The following changes were applies through out the document for consistency with the HITSP suite of Interoperability Specifications
Removed Section 2.2.1 Data Mapping in order to improve the depth of the section and table numbering. This caused all the sections and tables to be renumbered.
Rearranged text in section because removal of Section 2.2.1
Rearranged various sections and tables. This affected section and table numbering but did not cause any specification changes
Added a note explaining the harmonization of various vocabularies lead by the HITSP Foundations Committee. This includes Administrative Gender, Marital Sex and Body Site
Improved various links to Value Set Members
Changed Static to Enumerated in Vocabulary tables based upon update to Table 2-1 Value Set Metadata
Changed Dynamic Value Sets to Criteria Based in Vocabulary tables based upon update to Table 2-1 Value Set Metadata
Figure 1.2-1 Component Document Map
Removed figure.
Added text to further explain HITSP/C80
Added table to describe the format of Value Set Definitions
Added table to describe the format of Value Set Definitions for LOINC values
Added further explanation in Table 2.1-1 for Value Set Members discussed normative published standards are the proper place to obtain vocabularies for value sets
Table 2.1-1 Example Value Set Definition
Replaced Static/Dynamic from the table and replaced with Enumerated/Criteria Based. Also provided text to explain Enumerated and Criteria Based
Section 2.2.1.1 Address Information
State
Clarified text description
Country
Added table to define country code vocabulary - uses ISO 3166-1
Section 2.2.1.2.8 Religious Affiliation
Removed table of Value Set Definitions for religious affiliation
Section 2.2.2.4 Social History Type
Added vocabulary for Social History Type
Section 2.2.3.1 Problems and Diagnoses
Problems
Deleted text that required terms descend from the clinical finding (404684003) concept
Diagnosis
The Diagnosis section and ICD-9 vocabulary has been removed as it is not being referenced by other HITSP constructs.
Problem Severity
Moved the Allergy/Adverse Event Severity Tables to Problem Severity. Renamed tables to Problem Severity
Problem Status
Deleted Problem Status vocabulary as it has not been constrained by HITSP
Allergy Status
Deleted Allergy Status vocabulary as it has not been constrained by HITSP
Section 2.2.3.1.7 Functional Assessment
Added Functional Assessment
Section 2.2.3.3.7 Medication Brand Name
Added requirement that the value shall descend from the RxNorm concept type of Brand Name
Section 2.2.3.3.8 Medication Clinical Drug Name
Added requirement that the value shall descend from the RxNorm concept type of clinical drug or pack
Section 2.2.3.3.9 Medication Drug Class
Added requirement that the value shall descend NDF-RT concept types of Mechanism of Action, Physiologic Effect or Chemical Structure`
Section 2.2.3.4.4 Allergy/Adverse Event Product
Deleted table and reference already defined vocabularies:
- Medication Ingredient Name, Medication Drug Class, and Medication Clinical Drug Name
Section 2.2.3.4.6 Medication Site
Deleted table in Medication Site and referenced Body Site. This did not change the vocabulary chosen, but since it uses the same as Body Site it did not need to be duplicated
Section 2.2.3.5 Immunizations
Laboratory Test
Deleted table in for Lab Tests as it is a duplicate with Lab Orders
Immunization Services Funding Eligibility
Added table for this vocabulary
Section 2.2.3.6.3 Result Normalcy Status
Added Value Set Table for HL7 V.2.5.1
Added Vocabulary and Value Set Table for HL7 V3
Section 2.2.3.6.5 Vital Signs Result Type
Added Value Set Table for Vital Signs Result Type
Section 2.2.3.13 Medication Assessed in Genetic Test
Single Nucleotide Polymorphisms
Deleted Single Nucleotide Polymorphisms
Gene Game
Added text which allows the Approved Code or the Approved Name to be displayed
Section 2.2.3.14.1 Document Class
Changed Value Set to Enumerated
Section 2.3 Standards
Added ISO 3166 for Country Codes
Added CDC Implementation Guide for Immunizations Data Transaction
Removed International Classification of Diseases ICD-9-CM
Corrected the link to Federal Medication Terminologies
Added International Classification of Functioning, Disability and Health (ICF)
Minor editorial changes were made to this document.
Upon approval by the HITSP Panel on December 18, 2008, this document is now Released for Implementation.
Section 2.1.1 Value Set Metadata
- Updated this section to incorporate metadata definitions defined in HITSP/TN903
Section 2.1.2 Code System Metadata
- Added this section to incorporate metadata definitions defined in HITSP/TN903
Section 2.1.3 Value Set Member MetaData
- Added this section to incorporate metadata definitions defined in HITSP/TN903
Section 2.1.4 Value Set Versioning
- Added this section to incorporate version process defined in HITSP/TN903
Section 2.1.5 Component Constraints
- Updated this section to remove the table formatting
Section 2.1.6 Component Dependencies
- Updated this section to identify code systems used by this specification using metadata defined in HITSP/TN903
Section 2.2 Rules For Implementing Value Sets
- Updated the metadata in this section for all value sets to ensure that all metadata described in HITSP/TN903 is present for each value set. Corrected metadata for several value sets
Section 2.3 Standards
- Updated this section to remove selected standards. These were moved to the dependencies section as this specification does not by itself select a standard; only by referencing the value sets in a data element has that function
Minor editorial changes were made to this document. Removed boilerplate text for simplification. The term actor was replaced with interface.
Upon approval by the HITSP Panel on July 8, 2009, this document is now Released for Implementation.
[1] HL7 has not established identifiers for these tables and was unable to resolve this issue prior to publication. HITSP recommends the use of the following values in HL7 Version 2 messages until this issue is resolved.
[2] HL7 has not established identifiers for these tables and was unable to resolve this issue prior to publication. HITSP recommends the use of the following values in HL7 Version 2 messages until this issue is resolved
[3] FIPS 5-2 will be superceded by INCITS 38:200X when that specification becomes available. The content of the two are the same, but the maintainer of the code set has been changed.
[4] The HITSP Foundations Committee hasdeveloped and published a harmonized value set. HITSP member Standards Development Organizations (SDOs) have agreed to support the harmonized value set in future releases of their standards
[5] The HITSP Foundations Committee hasdeveloped and published a harmonized value set. HITSP member SDOs have agreed to support the harmonized value set in future releases of their standards
[6] The HL7 Implementation Guide for CDA Release 2: CDA Framework for Questionnaire Assessments, Release 1 contains a list of usefully related SNOMED CT codes in an informative spreadsheet included with the publication. That publication can be found on the HL7 Draft Standards page here: http://www.hl7.org/dstucomments/index.cfm .
[7] The HITSP Foundations Committee hasdeveloped and published a harmonized value set. HITSP member SDOs have agreed to support the harmonized value set in future releases of their standards
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