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Note: These comments were sent February 14th, 2008. This page is now an archive.

Background Information

Our Comments

Together the EIA and HL7-Emergency Care Special Interest Group have reviewed the ONC Consultations and Transfers of Care Draft Detailed Use Case (Jan 18, 2008).

The consultation use case fails to include the Emergency Department Consultation which has aspects that are important to include at this point in the detailed use case. Clinicians consult emergency physicians on patients from their office and patients known only via telephone on a regular basis. Currently, this consult is sometimes communicated by the patient but is often communicated via telephone by the requesting clincian.

Elsewhere this has been described as a “Emergency Department Referral” however it defines the same communication. This consultation type has been well vetted and subsequently developed into an IHE Profile viewable on their web page. It is titled Emergency Department Referral (EDR). Further, this IHE profile builds on an approved HL7 standard titled “Emergency Department Attachment” (CDAR1AIS0002R021).

IHE’s document can be found here: http://wiki.ihe.net/index.php?title=Emergency_Department_Referral The technical standard can be found here: http://wiki.ihe.net/index.php?title=PCC_TF-1/EDR

Of particular importance is that IHE’s EDR expanded the scope of the CCD to include a few additional data elements including Mode of Arrival, ETA, and intended disposition. These should be included at a later point when the Use Case’s Specifications are developed.

We have specific recommendations for this document:

  1. P6, 2.0 First paragraph, last sentence. Please add Emergency Care Facility to the list. This is requested to affirm that the use case includes the related, yet somewhat distinct use case.
  2. P7, Change to “..settings involved. A telephone communication leading to an Emergency or other referral will also be addressed. Specific information...”. This is to specifically include this potentially troublesome, yet important use case.
  3. p15, Finalize first sentence with “...home health care, outpatient care, or telephone setting.”
  4. P17: 7.1.2 Change to “... consulting clinician or facility” The referral can be to a group of physicians, a facility, or an individual physician. Wording should reflect this.
  5. P19: Change 7.1.1 per comment above
  6. p19: Change to “... recommended clinicians, facility, or assist the patient in identifying...”
  7. p20 Change “clinician” to “clinican or facility”
  8. p41 10.0 Change end of first paragraph: “...with a non-specialty specific consultation or transfer of care.”
  9. p41 Other types of data to be considered include intended disposition (in addition to Recommended plan of care), mode of arrival, and estimated time of arrival. We recommend not specifying which data pieces may be considered for consultation vs transfer of care.

onc_referral_use_case_comments.txt (1092 views) · Last modified: 2008/02/14 15:24 by