Re: [Laika-talk] question regarding CCD .xls stylesheet

[Dennis W. <dw...@cc...>]

Agreed.  I alluded to conferring with our HL7/HITSP contacts.  I think
because it relates to guardian info (which we're not checking), we have
plenty of time to do full process resolution - i.e. getting an HL7 fix.

 

From: Robert McCready [mailto:rmc...@mi...] 
Sent: Thursday, July 31, 2008 2:47 PM
To: Dennis Wilson
Cc: Project Laika
Subject: Re: question regarding CCD .xls stylesheet

 

Hello Dennis,

The comment about the orgins of the Laika style sheert are correct.  We
are using the HL7 CCD style sheet and appending the check list for the
CCHIT fields.  

Unless there has been an upgraded version of the HL7 CCD style sheet,
this affects just about everyone using HL7's views.  I think that HL7
needs to be updated on this.  Don't know if you have a higher-level
contact into that organization, but the HL7 authors are the ones who
probably need to fix this.

---
Rob McCready


On 7/31/08 3:42 PM, "Dennis Wilson" <dw...@cc...> wrote:

Thanks for passing along.  I'll look into this when I get back from
vacation next week.  I'm just doing a quick email check at the moment.
 
Something to keep in mind is the guardian info is not one of the data
elements we're looking at for 2008.  So that may reduce the criticality
of this issue. We should have the time to look deeply into the issue,
confer with our HL7 and HITSP experts, and get a consensus fix in place
- without disrupting on-going certification inspections.
 
 

From: Alicia Thompson 
Sent: Thursday, July 31, 2008 2:32 PM
To: Dennis Wilson
Cc: Amit Trivedi
Subject: FW: question regarding CCD .xls stylesheet


 

Alicia Thompson

Certification Program Director, CCHIT

Certification Commission for Healthcare Information Technology

720-201-3693 voice | 312.896.1466 fax

ath...@cc...



Learn more about CCHIT certification - http://cchit.org

________________________________

From: Tarah Hirschey [mailto:thi...@at...] 
Sent: Thursday, July 31, 2008 1:04 PM
To: Alicia Thompson
Cc: Matt Hofmann; JoRel Nye
Subject: question regarding CCD .xls stylesheet

Alicia,
The stylesheet provided by CCHIT for viewing CCD documents has a slight
bug - it is looking for the guardian info in the wrong spot.
Below are details as explained by one of our developers:
 
There are two documents that I've been relying on to develop the CCD
export.  One is "HITSP Summary Documents Using HL7 Continuity of Care
Document (CCD) Component" (HITSP_V2.1_2007_C32.pdf, available in
G:\Clinicals\Clinicals Zone\CCHIT\HITSP_C32v2.1_TestPackage\); the other
is "HL7 Implementation Guide: CDA Release 2 - Continuity of Care
Document (CCD)" (CCD-final.pdf, available in G:\Clinicals\Clinicals
Zone\CCHIT\CDA_CCD\CDA_R2\CCD\).
 
These documents describe how the CCD export should be formatted, so that
a stylesheet (such as the CCD.xsl stylesheet located in
G:\Clinicals\Clinicals Zone\CCHIT\CDA_CCD\CDA_R2\infrastructure\cda\)
can easily transform the raw XML into human-readable HTML.  I think the
CCD.xsl file may have originated from HL7 people, rather than from
CCHIT, but I'm not sure.
 
Now for the technical part:
 
The HITSP/C32 spec states:
-      C32-[46]: With the exception of guardians, supporting persons or
organizations shall be represented in the HL7 CDA using the
<participant> element in the header of the <ClinicalDocument>. 
-      C32-[47]: Guardians shall be represented using the <guardian>
element subordinate to the <patient> element.
Similarly, the CCD-final spec states:
-      CONF-109: A patient guardian SHALL be represented with
ClinicalDocument / recordTarget / patientRole / patient / guardian.
 
In short, guardians are represented using a <guardian> element, and all
other "supporting persons" are represented using <participant> elements.
 
However, the provided CCD.xsl stylesheet tries to look for guardian
information under a <participant> element.  As such, CCD exports
generated by our system (which follows the specs to the letter, of
course!) were failing to display guardian information.
 
The CCD.xsl file should be modified such that it looks for guardian
information under a <guardian> element, rather than under a
<participant> element, as described in the specs above (I have already
modified our copy of CCD.xsl so that guardian info displays correctly).

 
Please comment.
 
Thanks,
Tarah
 
Tarah Hirschey, P.A.
Clinicals Product Manager
athenahealth
311 Arsenal St
Watertown, MA 02472
617-402-1468
thi...@at...
www.athenahealth.com