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Mapping of encounter section present in CCD to the encounter thing type in Healthvault RRS feed

  • Question

  • Hello,

    I am creating a CCD which will have just the encounter section in addition to the normal CCD header which wil have patient name and other information.
    Given in the ccd_ccr example with respect to encounter section, based on which tag/value present in the encounters section of the CCD does the Healhvault platform map to the patients encounter information? The scenario which I am refering to is after a user uploades his/her CCD, it gets dispalyed in a grid now when the user clicks on "add items" button under "items added to healthvault?" column, the healthvault maps the data present in the CCD automatically to the respective thing types. I wanted to know how this happens. Currently I am focusing only on "encounters" section. Below is the encounters ccd part from the example,

    <component>
            <section>
    			<templateId root="2.16.840.1.113883.10.20.1.3"/>
    			<!-- Encounters section template -->
    			<code code="46240-8" codeSystem="2.16.840.1.113883.6.1"/>
    			<title>Encounters</title>
    			<text>
    				<table border="1" width="100%">
    					<thead>
    						<tr>
    							<th>Encounter</th>
    							<th>Location</th>
    							<th>Date</th>
    						</tr>
    					</thead>
    					<tbody>
    						<tr>
    							<td>Checkup Examination</td>
    							<td>Good Health Clinic</td>
    							<td>Apr 07, 2000</td>
    						</tr>
    					</tbody>
    				</table>
    			</text>
    			<entry typeCode="DRIV">
    				<encounter classCode="ENC" moodCode="EVN">
    					<templateId root="2.16.840.1.113883.10.20.1.21"/>
    					<!-- Encounter activity template -->
    					<id root="2a620155-9d11-439e-92b3-5d9815ff4de8"/>
    					<code code="GENRL" codeSystem="2.16.840.1.113883.5.4" displayName="General">
    						<originalText>Checkup Examination</originalText>
    					</code>
    					<effectiveTime value="20000407"/>
    					<participant typeCode="LOC">
    						<templateId root="2.16.840.1.113883.10.20.1.45"/>
    						<!-- Location participation template -->
    						<participantRole classCode="SDLOC">
    							<id root="2.16.840.1.113883.19.5"/>
    							<playingEntity classCode="PLC">
    								<name>Good Health Clinic</name>
    							</playingEntity>
    						</participantRole>
    					</participant>
    				</encounter>
    			</entry>
    				</section>
          </component>
          <!-- 
    Thanks
    Thursday, August 20, 2009 12:01 AM

Answers

  • In your example, you need to include the templateId for the Encounters section.  Otherwise consuming systems, including HealthVault, won't know how to interpret the section.  This is likely why it is not working for you.  Underneath the section element you need to include the following:

    <templateId root="2.16.840.1.113883.10.20.1.3"/>

    This is documented in CONF-453 of the CCD Implementation Guide.

    "If you see the <originalText> "check up examination", this is also present within <text> </text> block, so is this mapping required?"
    I don't see "Checkup examination" anywhere in the narrative block you provided.  The typecode = "DRIV" indicates that your narrative block is fully derived from the structured entries.  This doesn't appear to be the case in your example.  You have what appears to be Q&A instead the encounter information.  orginalText is primarily used in cases of post-coding - as in the originator of the information did not assign a code, but it was done so at a later date - it does not need to exactly match your narrative block.  On import HealthVault will always prefer the code displayName if it exists.  Thus "General" would be the type display - not "Checkup examination".

    "My another question is, in the example the <text> consists of just one table but the <text> in my encounter section will consist of multiple tables? Will that create any issue?"
    It shouldn't cause any problems.  You can do whatever is permitted by the CDA R2 schema for the StrucDoc.Text type.
    • Marked as answer by sd1162 Monday, August 24, 2009 6:35 PM
    Monday, August 24, 2009 6:27 PM

All replies

  • Does this help you in anyway?  (This is for CCR)

    http://msdn.microsoft.com/en-us/healthvault/dd797577.aspx


    Raj HealthVault Developer Tool http://xray.getrealconsulting.com
    Thursday, August 20, 2009 2:56 PM
  • We run a transform in the background that converts the CCD data into the HealthVault data types.

    The sample you provided should work fine with the HealthVault conversion.

    We currently having mappings from a CCD encounter to the following encounter elements in HealthVault:

    - when
    - type
    - reason
    - duration
    - facility

    Is there a specific question you had about the conversion?

    Thursday, August 20, 2009 9:24 PM
  • Thanks for the information.

    The example works fine though but when I try to create my own encounter section based on the example it does not seem to map " when I click on Add items i get there are no health information to be mapped. According to the below code,
    <code code="GENRL" codeSystem="2.16.840.1.113883.5.4" displayName="General">
    						<originalText>Checkup Examination</originalText>
    					</code>
    
    If you see the <originalText> "check up examination", this is also present within <text> </text> block, so is this mapping required? As when i create my own encounter section, there will not be any match between the text within <text> and the <originaltext>. My another question is, in the example the <text> consists of just one table but the <text> in my encounter section will consist of multiple tables? Will that create any issue?

    Below is the encounter section that we are creating,
    		           <component>
    			            <section>
    				            <title>Encounters</title>
    				            <text>
    					        <paragraph>Please tell us whether you have the following symptoms:</paragraph>
    <table border="1" width="100%"><thead><tr><th>Question</th><th>Answer</th></tr></thead><tbody><tr><td>Tremors</td><td>Yes</td></tr><tr><td>Stiffness, cramping or heaviness in a limb</td><td>Yes</td></tr><tr><td>Slowness of movements (difficulty with fine motor skills such as doing buttons or getting change from a pocket, shuffling gait)</td><td>Yes</td></tr><tr><td>Dyskinesia (involuntary writhing or fidgety movements)</td><td>Yes</td></tr><tr><td>Balance problems requiring a walker or wheelchair</td><td>Yes</td></tr><tr><td>Hallucinations</td><td>No</td></tr><tr><td>Cognitive difficulties or dementia (trouble managing finances, keeping up with current events or getting lost easily)</td><td>No</td></tr><tr><td>Sleep disturbance with marked snoring, gasping breath or thrashing about</td><td>Yes</td></tr><tr><td>Repeated strokes (more than 1)</td><td>Yes</td></tr><tr><td>Passing out spells or near passing out, particularly when standing up (commonly, not just once in a while)</td><td>No</td></tr><tr><td>Urinary or bowel incontinence</td><td>No</td></tr></tbody></table>
    <paragraph>Have the following symptom(s) started gradually and progressed over time, say over the course of months to years?</paragraph>
    <table border="1" width="100%"><thead><tr><th>Question</th><th>Answer</th></tr></thead><tbody><tr><td>Tremors</td><td>Yes</td></tr><tr><td>Stiffness, cramping or heaviness in a limb </td><td>Yes</td></tr><tr><td>Slowness of movement</td><td>Yes</td></tr><tr><td>Balance problems</td><td>Yes</td></tr><tr><td>Sleep disturbance</td><td>Yes</td></tr></tbody></table> </text> <entry typeCode="DRIV"> <encounter classCode="ENC" moodCode="EVN"> <templateId root="2.16.840.1.113883.10.20.1.21"/> <!-- Encounter activity template --> <id root="d003747e-6244-4348-beb3-26b3de39f1e8"/> <code code="GENRL" codeSystem="2.16.840.1.113883.5.4" displayName="General" /> <effectiveTime> <low value="20090806183930"/> <high value="20090821111317"/> </effectiveTime> <participant typeCode="LOC"> <templateId root="2.16.840.1.113883.10.20.1.45"/> <!-- Location participation template --> <participantRole classCode="SDLOC"> <id root="2.16.840.1.113883.19.5"/> <playingEntity classCode="PLC"> <name>MAPC</name> </playingEntity> </participantRole> </participant> </encounter> </entry> </section> </component>


    Thanks
    • Edited by sd1162 Friday, August 21, 2009 6:17 PM encounter section example
    Friday, August 21, 2009 5:51 PM
  • In your example, you need to include the templateId for the Encounters section.  Otherwise consuming systems, including HealthVault, won't know how to interpret the section.  This is likely why it is not working for you.  Underneath the section element you need to include the following:

    <templateId root="2.16.840.1.113883.10.20.1.3"/>

    This is documented in CONF-453 of the CCD Implementation Guide.

    "If you see the <originalText> "check up examination", this is also present within <text> </text> block, so is this mapping required?"
    I don't see "Checkup examination" anywhere in the narrative block you provided.  The typecode = "DRIV" indicates that your narrative block is fully derived from the structured entries.  This doesn't appear to be the case in your example.  You have what appears to be Q&A instead the encounter information.  orginalText is primarily used in cases of post-coding - as in the originator of the information did not assign a code, but it was done so at a later date - it does not need to exactly match your narrative block.  On import HealthVault will always prefer the code displayName if it exists.  Thus "General" would be the type display - not "Checkup examination".

    "My another question is, in the example the <text> consists of just one table but the <text> in my encounter section will consist of multiple tables? Will that create any issue?"
    It shouldn't cause any problems.  You can do whatever is permitted by the CDA R2 schema for the StrucDoc.Text type.
    • Marked as answer by sd1162 Monday, August 24, 2009 6:35 PM
    Monday, August 24, 2009 6:27 PM