Re: [gpc-informatics] #196: Should the "active patient" be based on visits or encounters?

[Bushee, Glenn]

>From our data loading perspective, when entering information from a medication 
>order / dispense, for example, if there is an associated encounter number we 
>include it, but with the date in the particular table extracted from.  So, 
>from the observation_fact perspective, there are going to be many more entries 
>in the query that includes the lag function than the one I ran back in 
>September.

We’re loading the visit_dimension based on the PAT_ENC table data alone and the 
encounter start/end dates there.

If the numbers from the two queries weren’t so far off, then I’d agree that 
this is only a semantic distinction.  Did anyone else have numberers that were 
way different or is this uncovering a difference in practice with our data 
loading steps?

- Glenn

   Medical Informatics Senior Analyst
   CTSI – Clinical & Translational Science Institute
   gbus...@mcw.edu
   (414) 805-7239

From: , James R mailto:campb...@unmc.edu>>
Date: Tuesday, November 18, 2014 at 9:23 PM
To: "mailto:gpc-dev@listserv.kumc.edu>>" 
mailto:gpc-dev@listserv.kumc.edu>>
Cc: "m...@wisc.edu" 
mailto:m...@wisc.edu>>, George Kowalski 
mailto:gkowal...@mcw.edu>>, Glenn Bushee 
mailto:gbus...@mcw.edu>>
Subject: Re: [gpc-informatics] #196: Should the "active patient" be based on 
visits or encounters?

>From the structure of our EHR and my understanding as clinician/informatician 
>I cannot help but ask what is the difference between a visit and and 
>encounter?  A visit with me
as pricare is an encounter and most face-to-face with clinicians are 
encounters.  What is the distinction we are seeking here?
Jim

James R. Campbell MD
campb...@unmc.edu
Office: 402-559-7505
Secretary: 402-559-7299
Pager: 402-888-1230

On Nov 18, 2014, at 5:21 PM, "GPC Informatics" 
mailto:d...@madmode.com>> wrote:

#196: Should the "active patient" be based on visits or encounters?
--+---
Reporter:  mish  |   Owner:  mish
 Type:  problem   |  Status:  assigned
Priority:  minor |   Milestone:
Component:  data-quality  |  Resolution:
Keywords:|  Blocked By:
Blocking:|
--+---
Changes (by mish):

* priority:  major => minor
* status:  new => assigned


--
Ticket URL: 

gpc-informatics 
Greater Plains Network - Informatics

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Re: [gpc-informatics] #196: Should the "active patient" be based on visits or encounters?

[Campbell, James R]

>From the structure of our EHR and my understanding as clinician/informatician 
>I cannot help but ask what is the difference between a visit and and 
>encounter?  A visit with me
as pricare is an encounter and most face-to-face with clinicians are 
encounters.  What is the distinction we are seeking here?
Jim

James R. Campbell MD
campb...@unmc.edu
Office: 402-559-7505
Secretary: 402-559-7299
Pager: 402-888-1230

> On Nov 18, 2014, at 5:21 PM, "GPC Informatics"  wrote:
>
> #196: Should the "active patient" be based on visits or encounters?
> --+---
> Reporter:  mish  |   Owner:  mish
> Type:  problem   |  Status:  assigned
> Priority:  minor |   Milestone:
> Component:  data-quality  |  Resolution:
> Keywords:|  Blocked By:
> Blocking:|
> --+---
> Changes (by mish):
>
> * priority:  major => minor
> * status:  new => assigned
>
>
> --
> Ticket URL: 
> 
> gpc-informatics 
> Greater Plains Network - Informatics

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RE: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

[Wanta Keith M]

An order diagnosis originates from a clinical system and eventually makes its 
way into one of the two billing systems (Hospital or Professional).  Typically 
the physician needs to sign for an order, so you shouldn't trust a diagnosis on 
an order unless it was signed.

In the revenue cycle for professional billing (this normally means outpatient 
visits), you will find diagnoses on charges that originated from one of the 
many clinical systems.  Many would assume these all show up on professional 
billing claim types, but that isn't always the case if the charges are not 
billed to insurance.

-Original Message-
From: gpc-dev-boun...@listserv.kumc.edu 
[mailto:gpc-dev-boun...@listserv.kumc.edu] On Behalf Of Dan Connolly
Sent: Tuesday, November 18, 2014 10:52 AM
To: Phillip Reeder; gpc-dev@listserv.kumc.edu; campb...@unmc.edu
Cc: gpc-...@listserv.kuc.edu
Subject: RE: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

I just realized this proposal doesn't facilitate the main distinction our users 
are accustomed to: billing vs. clinical diagnosis. They'd have to know to 
choose the union of Enounter, Order, Problem list, and Professional. In HERON 
at KUMC, the union of Problem List and Encounter is represented as a Clinical 
folder.

And we don't (yet?) support Professional Diagnosis nor Order Diagnosis. What 
are those? I'd appreciate somebody filling me/us in on what workflows those 
represent.

-- 
Dan



From: Phillip Reeder [phillip.ree...@utsouthwestern.edu]
Sent: Wednesday, November 12, 2014 2:13 PM
To: gpc-dev@listserv.kumc.edu; campb...@unmc.edu; Dan Connolly
Cc: gpc-...@listserv.kuc.edu
Subject: Re: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

Based on the emails I found, and what is on babel, this is what I think
the modifiers should be.  The only difference from Babel is in the Billing
Diagnosis modifiers where I tried apply what was in the various emails.

Cerner had Inactive and Canceled modifiers for the Problem List Diagnosis
in one of the emails.  I¹m unsure if they need to be added or if they
could be mapped to the three modifiers from Epic.

For consistency, is there a preference for Principle vs Primary?  Does it
make a difference?

ModifierModifier Code   Clarity 
Table

Billing Diagnosis
Admit Diagnosis Principle   DX|BILL:ADMIT PRINCIPLE 
HSP_ACCT_ADMIT_DX
Admit Diagnosis Secondary   DX|BILL:ADMIT SECONDARY 
HSP_ACCT_ADMIT_DX
Discharge Diagnosis Principle   DX|BILL:PRINCIPAL   
HSP_ACCT_DX_LIST
Discharge Diagnosis Secondary   DX|BILL:SECONDARY   
HSP_ACCT_DX_LIST
Discharge Diagnosis Present on Admis..  DX|BILL:POA 
HSP_ACCT_DX_LIST
Encounter Diagnosis
Admit Encounter Diagnosis   DX|ENC:ADMIT
HSP_ADMIT_DIAGNOSIS
Discharge Encounter Diagnosis   DX|ENC:DISCHARGE
HSP_DISCH_DIAGNOSIS
Primary Encounter Diagnosis DX|ENC:PRIMARY  
PAT_ENC_DX
Secondary Encounter Diagnosis   DX|ENC:SECONDARY
PAT_ENC_DX
Medical History Diagnosis   DX:HISTORY  
MEDICAL_HX
Order Diagnosis
Order Medication Diagnosis  DX|ORDER:MED
ORDER_DX_MED
Order Procedure Diagnosis   DX|ORDER:PROC   
ORDER_DX_PROC
Problem List Diagnosis
Active Problem  DX|PROB:ACTIVE  
PROBLEM_LIST
Deleted Problem DX|PROB:DELETED 
PROBLEM_LIST
Resolved ProblemDX|PROB:RESOLVED
PROBLEM_LIST
Professional Diagnosis
Primary Professional Diagnosis  DX|PROF:PRIMARY 
ARPB_TRANSACTIONS
Secondary Professional DiagnosisDX|PROF:SECONDARY   
ARPB_TRANSACTIONS


On 11/12/14, 1:33 PM, "GPC Informatics"  wrote:

>#90: Diagnoses Modifiers for data attribution
>--+
> Reporter:  campbell  |   Owner:  preeder
> Type:  design-issue  |  Status:  assigned
> Priority:  major |   Milestone:  data-domains2
>Component:  data-stds |  Resolution:
> Keywords:|  Blocked By:
> Blocking:  70, 91, 120   |
>--+
>Changes (by dconnolly):
>
> * cc: gpc-dev@Š (added)
> * owner:  dconnolly => preeder
> * status:  reopened => assigned
>
>
>Comment:
>
> Phillip, I re-opene this because your question (Wednesday, November 12,
> 2014 12:44 PM) shows we clearly didn't carry out the recorded decision.
>
> Do you have a preference on what the modifiers actually should be?
>
>--
>Ticket URL:
>
>gpc-informatics 
>Greater Plains Network - Informatics


___

Re: [gpc-informatics] #186: Querying age by numerical constraints

[GPC Informatics]

#186: Querying age by numerical constraints
-+
 Reporter:  huhickman|   Owner:  jdale
 Type:  problem  |  Status:  assigned
 Priority:  major|   Milestone:  data-domains2
Component:  data-stds|  Resolution:
 Keywords:  age valueset obesity-cohort  |  Blocked By:
 Blocking:  67   |
-+
Changes (by dconnolly):

 * owner:  huhickman => jdale
 * status:  reopened => assigned


Comment:

 Justin volunteered 11 Nov (notes: #12) to try to reproduce Hubert's work.

--
Ticket URL: 

gpc-informatics 
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Re: [gpc-informatics] #71: portable HERON ETL for Epic

[GPC Informatics]

#71: portable HERON ETL for Epic
-+---
 Reporter:  dconnolly|   Owner:  bos
 Type:  enhancement  |  Status:  assigned
 Priority:  major|   Milestone:
Component:  etl-dev  |  Resolution:
 Keywords:   |  Blocked By:  127
 Blocking:   |
-+---

Comment (by bos):

 Yes, there is no reason not to merge them, but I've got to resolve my
 "merge with ancestor" issue.

--
Ticket URL: 

gpc-informatics 
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RE: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

[Dan Connolly]

I just realized this proposal doesn't facilitate the main distinction our users 
are accustomed to: billing vs. clinical diagnosis. They'd have to know to 
choose the union of Enounter, Order, Problem list, and Professional. In HERON 
at KUMC, the union of Problem List and Encounter is represented as a Clinical 
folder.

And we don't (yet?) support Professional Diagnosis nor Order Diagnosis. What 
are those? I'd appreciate somebody filling me/us in on what workflows those 
represent.

-- 
Dan



From: Phillip Reeder [phillip.ree...@utsouthwestern.edu]
Sent: Wednesday, November 12, 2014 2:13 PM
To: gpc-dev@listserv.kumc.edu; campb...@unmc.edu; Dan Connolly
Cc: gpc-...@listserv.kuc.edu
Subject: Re: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

Based on the emails I found, and what is on babel, this is what I think
the modifiers should be.  The only difference from Babel is in the Billing
Diagnosis modifiers where I tried apply what was in the various emails.

Cerner had Inactive and Canceled modifiers for the Problem List Diagnosis
in one of the emails.  I¹m unsure if they need to be added or if they
could be mapped to the three modifiers from Epic.

For consistency, is there a preference for Principle vs Primary?  Does it
make a difference?

ModifierModifier Code   Clarity 
Table

Billing Diagnosis
Admit Diagnosis Principle   DX|BILL:ADMIT PRINCIPLE 
HSP_ACCT_ADMIT_DX
Admit Diagnosis Secondary   DX|BILL:ADMIT SECONDARY 
HSP_ACCT_ADMIT_DX
Discharge Diagnosis Principle   DX|BILL:PRINCIPAL   
HSP_ACCT_DX_LIST
Discharge Diagnosis Secondary   DX|BILL:SECONDARY   
HSP_ACCT_DX_LIST
Discharge Diagnosis Present on Admis..  DX|BILL:POA 
HSP_ACCT_DX_LIST
Encounter Diagnosis
Admit Encounter Diagnosis   DX|ENC:ADMIT
HSP_ADMIT_DIAGNOSIS
Discharge Encounter Diagnosis   DX|ENC:DISCHARGE
HSP_DISCH_DIAGNOSIS
Primary Encounter Diagnosis DX|ENC:PRIMARY  
PAT_ENC_DX
Secondary Encounter Diagnosis   DX|ENC:SECONDARY
PAT_ENC_DX
Medical History Diagnosis   DX:HISTORY  
MEDICAL_HX
Order Diagnosis
Order Medication Diagnosis  DX|ORDER:MED
ORDER_DX_MED
Order Procedure Diagnosis   DX|ORDER:PROC   
ORDER_DX_PROC
Problem List Diagnosis
Active Problem  DX|PROB:ACTIVE  
PROBLEM_LIST
Deleted Problem DX|PROB:DELETED 
PROBLEM_LIST
Resolved ProblemDX|PROB:RESOLVED
PROBLEM_LIST
Professional Diagnosis
Primary Professional Diagnosis  DX|PROF:PRIMARY 
ARPB_TRANSACTIONS
Secondary Professional DiagnosisDX|PROF:SECONDARY   
ARPB_TRANSACTIONS


On 11/12/14, 1:33 PM, "GPC Informatics"  wrote:

>#90: Diagnoses Modifiers for data attribution
>--+
> Reporter:  campbell  |   Owner:  preeder
> Type:  design-issue  |  Status:  assigned
> Priority:  major |   Milestone:  data-domains2
>Component:  data-stds |  Resolution:
> Keywords:|  Blocked By:
> Blocking:  70, 91, 120   |
>--+
>Changes (by dconnolly):
>
> * cc: gpc-dev@Š (added)
> * owner:  dconnolly => preeder
> * status:  reopened => assigned
>
>
>Comment:
>
> Phillip, I re-opene this because your question (Wednesday, November 12,
> 2014 12:44 PM) shows we clearly didn't carry out the recorded decision.
>
> Do you have a preference on what the modifiers actually should be?
>
>--
>Ticket URL:
>
>gpc-informatics 
>Greater Plains Network - Informatics




UT Southwestern Medical Center
The future of medicine, today.

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RE: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

[Dan Connolly]

Now that I think about it, primary/non-primary is orthogonal to data 
attribution. I'm inclined to make that a separate issue, if only to simplify 
teleconference discussion.

--
Dan


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RE: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

[Dan Connolly]

Let's be careful when trusting to memory when it comes to what we discussed or 
agreed to at 
HackathonOne.
 Records clearly show that what we discussed in the Quality Assurance scripting 
for i2b2 
ETLs
 session was not "secondary":


  *   ENCOUNTER DX

 *   PRIMARY DX

 *   NONPRIMARY DX

  *   BILLING DX

 *   DISCHARGE PRINCIPAL 52534-5  8319008|Principal diagnosis(qualifier)|

 *   DISCHARGE NONPRINCIPAL

 *   PROFESSIONAL DX PRIMARY

 *   PROFESSIONAL DX NONPRIMARY

That proposal also got sent to gpc-dev March 04, 2014 1:17 PM and ​minutes 18 
Mar show we 
RESOLVED to adopt it.

But then we didn't, actually, adopt it. So here we are, discussing what to 
adopt.

--
Dan



From: Campbell, James R [campb...@unmc.edu]
Sent: Tuesday, November 18, 2014 8:07 AM
To: Apathy,Nate; 
Cc: Dan Connolly; verhagen.lau...@mcrf.mfldclin.edu
Subject: RE: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

I agree that 'secondary' is potentially misleading and only ask for affirmation 
from the GPC ETL managers since that was the modifier term we affirmed at 
hackathon I
Jim


From: Apathy,Nate [nate.apa...@cerner.com]
Sent: Tuesday, November 18, 2014 7:40 AM
To: Campbell, James R; 
Cc: dconno...@kumc.edu; verhagen.lau...@mcrf.mfldclin.edu
Subject: Re: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

That sounds like a reasonable convergence of cancelled/deleted terms to
me. Laurel, those terms work for Marshfield as well, correct?

My only adjustment would be on your second point to simplify it to
³non-primary² since it seems that the ³secondary² term is not truly
reflective of an ordinal relationship in any of our source systems. It
could confuse users if we have both secondary and non-primary in the term.

Thanks,

Nate Apathy
Program Manager, Cerner Research



-Original Message-
From: , "campb...@unmc.edu" 
Date: Tuesday, November 18, 2014 at 8:28 AM
To: "gpc-dev@listserv.kumc.edu" 
Cc: Nate Apathy , Dan Connolly
, Laurel Verhagen 
Subject: Re: [gpc-informatics] #90: Diagnoses Modifiers for data
attribution

So, if I am hearing you correctly Nate, we will change 'Deleted' to
''Deleted/Cancelled' and use across Cerner and Epic and change 'Secondaty'
to 'Secondary/Nonprimary' for convergence since in Epic we are using
Secondary to annotate diagnoses 2-N and it does not mean 'second'
JIM

James R. Campbell MD
campb...@unmc.edu
Office: 402-559-7505
Secretary: 402-559-7299
Pager: 402-888-1230

> On Nov 17, 2014, at 2:33 PM, "GPC Informatics"  wrote:
>
> #90: Diagnoses Modifiers for data attribution
> --+
> Reporter: campbell | Owner: nateapathy
> Type: design-issue | Status: assigned
> Priority: major | Milestone: data-domains2
> Component: data-stds | Resolution:EC
> Keywords: | Blocked By:
> Blocking: 70, 91, 120 |
> --+
>
> Comment (by nateapathy):
>
> That's correct - in the Cerner Millennium Problem List the valid statuses
> are Active, Cancelled, and Resolved, and Cancelled would be used for the
> use case you are describing re: "Deleted" from Epic.
>
> We keep the Problems List and Diagnoses List separate (you can turn
> problems into diagnoses in the chart, of course, but on the database side
> there are distinct and separate tables (PROBLEM and DIAGNOSIS). For
> modifiers on diagnosis codes, we only specify between primary and non-
> primary, as Laurel described earlier in this thread, so I wouldn't vote
> for Secondary as the modifier of choice. We are using "Primary" and "non-
> Primary" in our current i2b2 projects. It's not reflected in Babel yet
> because we haven't finished the deployment but I'll have an updated
> diagnosis ontology in December.
>
> --
> Ticket URL:
>
> gpc-informatics 
> Greater Plains Network - Informatics

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Meeting notes for 11/18

[Hickman, Hubert B]

https://docs.google.com/document/d/18EVk8xyca2QUjBHJ13l5ASXOUA9Fg87Bp9e-4gVhvgU/edit?usp=sharing

All should be able to edit.

Hubert Hickman
Applications Sr. Analyst
huhick...@nebraskamed.com
(402) 559-4838



Nebraska Medicine E-mail Confidentiality Disclaimer

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RE: NAACCR metadata, latest go-round

[Lenon Patrick]

Great, thanks, especially for the bit about the shortcuts.  That would have 
been tough to suss out on my own.


From: Dan Connolly [mailto:dconno...@kumc.edu]
Sent: Monday, November 17, 2014 5:43 PM
To: Lenon Patrick; 'Gpc-dev@listserv.kumc.edu'
Subject: RE: NAACCR metadata, latest go-round

1) I remember the data being a little messy... the code only loads the sections 
that I was confident had no PHI (aside from the MRN, which gets deidentified 
later). I eyeballed all the data in one of the views. What a pain. But I 
haven't found any way around it.

As to how the code works... I suppose you're reading it correctly. I haven't 
looked at it in quite a while. If you feel like contributing a design sketch to 
add to the top of naaccr_concepts_load.sql, I can see that it gets code 
reviewed and integrated. (see for example the "Medication dispense facts" 
comment in epic_meds_transform.sql). "Patches welcome," as they say.

2) My recollection is that getting the WHO files is pretty painless (at least 
compared with, say, UMLS); anything we would set up to reduce duplicated effort 
would be at least as much hassle... especially since we'd have to set it up.

3) The code to build the ontology is designed to be run each time the data is 
loaded. (No, I don't recall discussing this in gpc-dev).

4) If you got naaccr_shortcuts.csv from version control on elephant, you can 
follow your nose thru "renamed shortcut concepts and reworked staging concept 
hierarchy (#2112)" to KUMC ticket 
#2112 to the milford 
release to... 
darn; there should be a link to the relevant blog article:

  *   HERON Milford simplifies the Cancer Cases 
folder

A new folder, Cancer Cases (Abridged), debuts with the Milford release. This 
folder contains the frequently searched concepts from the Cancer Cases folder. 
Advanced searchers can still search the entire tumor registry in the unabridged 
folder.
Oops; that should be in the list of blog articles on 
TumorRegistry.

--
Dan

From: 
gpc-dev-boun...@listserv.kumc.edu 
[gpc-dev-boun...@listserv.kumc.edu] on behalf of Lenon Patrick 
[ple...@uwhealth.org]
Sent: Monday, November 17, 2014 4:32 PM
To: 'Gpc-dev@listserv.kumc.edu'
Subject: NAACCR metadata, latest go-round
Hi all, hoping some of you are in a good state of mind to share your 
experience, brilliance, shattering good looks... enough flattery?

Anyway, my first attempt at building a NAACCR ontology was disappointing in 
that the NAACCR tables were not as helpful as I expected.  Fundamental problem: 
A lot of junk in the column where the code value normally resides.  So in that 
column I have found (besides codes):

* Code ranges (e.g. "1-100, 110-12")

* References to outside sources (WHO in particular)

* The word "BLANK", presumably to indicate the field is optional?

* ..

* *

* Comments, sometimes with HTML markups


Looking at the heron naaccr_txform and naaccr_concepts_load scripts, the 
ultimate NAACCR ontology consists of all unique base/concept codes found in the 
imported NAACCR data file (now in table tumor_reg_codes) merged with some 
fields from either the NAACCR code table (naaccr.t_code) or one of the external 
tables (e.g., WHO.TOPO).

So, questions arise:

1)  First, is the above description reasonably accurate?  Please point out 
any glaring errors.  I did leave out some detail like special cases.

2)  I looked at WHO's site, and began applying for access to their tables 
as listed in heron\heron_staging\tumor_reg\icd_o_meta.py .  However, before I 
continue, will every site have to do this individually?  Tom Mish is of the 
opinion YES.  But, does anyone have a legal/kosher/ethical way for us to not 
duplicate this effort?

3)  If I'm correct that only codes that appear in the Registry data will be 
loaded into the ontology, well, is that OK?  This fixes the problems with code 
ranges and non-code values, and the ontology tree is effectively pre-trimmed.  
But what are the implications for future loads of new data?  Has this 
discussion already happened?

4)  Bonus question:  What the heck is naaccr_shortcuts.csv?  It looks very 
useful, I have no idea what for.


Thanks in advance for any input all of y'all provide.


Patrick Lenon
HIMC Informatics Specialist
608 890 5671

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RE: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

[Campbell, James R]

I agree that 'secondary' is potentially misleading and only ask for affirmation 
from the GPC ETL managers since that was the modifier term we affirmed at 
hackathon I
Jim


From: Apathy,Nate [nate.apa...@cerner.com]
Sent: Tuesday, November 18, 2014 7:40 AM
To: Campbell, James R; 
Cc: dconno...@kumc.edu; verhagen.lau...@mcrf.mfldclin.edu
Subject: Re: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

That sounds like a reasonable convergence of cancelled/deleted terms to
me. Laurel, those terms work for Marshfield as well, correct?

My only adjustment would be on your second point to simplify it to
³non-primary² since it seems that the ³secondary² term is not truly
reflective of an ordinal relationship in any of our source systems. It
could confuse users if we have both secondary and non-primary in the term.

Thanks,

Nate Apathy
Program Manager, Cerner Research



-Original Message-
From: , "campb...@unmc.edu" 
Date: Tuesday, November 18, 2014 at 8:28 AM
To: "gpc-dev@listserv.kumc.edu" 
Cc: Nate Apathy , Dan Connolly
, Laurel Verhagen 
Subject: Re: [gpc-informatics] #90: Diagnoses Modifiers for data
attribution

So, if I am hearing you correctly Nate, we will change 'Deleted' to
''Deleted/Cancelled' and use across Cerner and Epic and change 'Secondaty'
to 'Secondary/Nonprimary' for convergence since in Epic we are using
Secondary to annotate diagnoses 2-N and it does not mean 'second'
JIM

James R. Campbell MD
campb...@unmc.edu
Office: 402-559-7505
Secretary: 402-559-7299
Pager: 402-888-1230

> On Nov 17, 2014, at 2:33 PM, "GPC Informatics"  wrote:
>
> #90: Diagnoses Modifiers for data attribution
> --+
> Reporter:  campbell  |   Owner:  nateapathy
> Type:  design-issue  |  Status:  assigned
> Priority:  major |   Milestone:  data-domains2
> Component:  data-stds |  Resolution:EC
> Keywords:|  Blocked By:
> Blocking:  70, 91, 120   |
> --+
>
> Comment (by nateapathy):
>
> That's correct - in the Cerner Millennium Problem List the valid statuses
> are Active, Cancelled, and Resolved, and Cancelled would be used for the
> use case you are describing re: "Deleted" from Epic.
>
> We keep the Problems List and Diagnoses List separate (you can turn
> problems into diagnoses in the chart, of course, but on the database side
> there are distinct and separate tables (PROBLEM and DIAGNOSIS). For
> modifiers on diagnosis codes, we only specify between primary and non-
> primary, as Laurel described earlier in this thread, so I wouldn't vote
> for Secondary as the modifier of choice. We are using "Primary" and "non-
> Primary" in our current i2b2 projects. It's not reflected in Babel yet
> because we haven't finished the deployment but I'll have an updated
> diagnosis ontology in December.
>
> --
> Ticket URL:
>
> gpc-informatics 
> Greater Plains Network - Informatics

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Re: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

[Apathy,Nate]

That sounds like a reasonable convergence of cancelled/deleted terms to
me. Laurel, those terms work for Marshfield as well, correct?

My only adjustment would be on your second point to simplify it to
³non-primary² since it seems that the ³secondary² term is not truly
reflective of an ordinal relationship in any of our source systems. It
could confuse users if we have both secondary and non-primary in the term.

Thanks,

Nate Apathy
Program Manager, Cerner Research



-Original Message-
From: , "campb...@unmc.edu" 
Date: Tuesday, November 18, 2014 at 8:28 AM
To: "gpc-dev@listserv.kumc.edu" 
Cc: Nate Apathy , Dan Connolly
, Laurel Verhagen 
Subject: Re: [gpc-informatics] #90: Diagnoses Modifiers for data
attribution

So, if I am hearing you correctly Nate, we will change 'Deleted' to
''Deleted/Cancelled' and use across Cerner and Epic and change 'Secondaty'
to 'Secondary/Nonprimary' for convergence since in Epic we are using
Secondary to annotate diagnoses 2-N and it does not mean 'second'
JIM

James R. Campbell MD
campb...@unmc.edu
Office: 402-559-7505
Secretary: 402-559-7299
Pager: 402-888-1230

> On Nov 17, 2014, at 2:33 PM, "GPC Informatics"  wrote:
>
> #90: Diagnoses Modifiers for data attribution
> --+
> Reporter:  campbell  |   Owner:  nateapathy
> Type:  design-issue  |  Status:  assigned
> Priority:  major |   Milestone:  data-domains2
> Component:  data-stds |  Resolution:EC
> Keywords:|  Blocked By:
> Blocking:  70, 91, 120   |
> --+
>
> Comment (by nateapathy):
>
> That's correct - in the Cerner Millennium Problem List the valid statuses
> are Active, Cancelled, and Resolved, and Cancelled would be used for the
> use case you are describing re: "Deleted" from Epic.
>
> We keep the Problems List and Diagnoses List separate (you can turn
> problems into diagnoses in the chart, of course, but on the database side
> there are distinct and separate tables (PROBLEM and DIAGNOSIS). For
> modifiers on diagnosis codes, we only specify between primary and non-
> primary, as Laurel described earlier in this thread, so I wouldn't vote
> for Secondary as the modifier of choice. We are using "Primary" and "non-
> Primary" in our current i2b2 projects. It's not reflected in Babel yet
> because we haven't finished the deployment but I'll have an updated
> diagnosis ontology in December.
>
> --
> Ticket URL: 
>
> gpc-informatics 
> Greater Plains Network - Informatics

The information in this e-mail may be privileged and confidential,
intended only for the use of the addressee(s) above. Any unauthorized use
or disclosure of this information is prohibited. If you have received this
e-mail by mistake, please delete it and immediately contact the sender.


CONFIDENTIALITY NOTICE This message and any included attachments are from 
Cerner Corporation and are intended only for the addressee. The information 
contained in this message is confidential and may constitute inside or 
non-public information under international, federal, or state securities laws. 
Unauthorized forwarding, printing, copying, distribution, or use of such 
information is strictly prohibited and may be unlawful. If you are not the 
addressee, please promptly delete this message and notify the sender of the 
delivery error by e-mail or you may call Cerner's corporate offices in Kansas 
City, Missouri, U.S.A at (+1) (816)221-1024.
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Re: [gpc-informatics] #90: Diagnoses Modifiers for data attribution

[Campbell, James R]

So, if I am hearing you correctly Nate, we will change 'Deleted' to 
''Deleted/Cancelled' and use across Cerner and Epic and change 'Secondaty' to 
'Secondary/Nonprimary' for convergence since in Epic we are using Secondary to 
annotate diagnoses 2-N and it does not mean 'second'
JIM

James R. Campbell MD
campb...@unmc.edu
Office: 402-559-7505
Secretary: 402-559-7299
Pager: 402-888-1230

> On Nov 17, 2014, at 2:33 PM, "GPC Informatics"  wrote:
>
> #90: Diagnoses Modifiers for data attribution
> --+
> Reporter:  campbell  |   Owner:  nateapathy
> Type:  design-issue  |  Status:  assigned
> Priority:  major |   Milestone:  data-domains2
> Component:  data-stds |  Resolution:EC
> Keywords:|  Blocked By:
> Blocking:  70, 91, 120   |
> --+
>
> Comment (by nateapathy):
>
> That's correct - in the Cerner Millennium Problem List the valid statuses
> are Active, Cancelled, and Resolved, and Cancelled would be used for the
> use case you are describing re: "Deleted" from Epic.
>
> We keep the Problems List and Diagnoses List separate (you can turn
> problems into diagnoses in the chart, of course, but on the database side
> there are distinct and separate tables (PROBLEM and DIAGNOSIS). For
> modifiers on diagnosis codes, we only specify between primary and non-
> primary, as Laurel described earlier in this thread, so I wouldn't vote
> for Secondary as the modifier of choice. We are using "Primary" and "non-
> Primary" in our current i2b2 projects. It's not reflected in Babel yet
> because we haven't finished the deployment but I'll have an updated
> diagnosis ontology in December.
>
> --
> Ticket URL: 
> 
> gpc-informatics 
> Greater Plains Network - Informatics

The information in this e-mail may be privileged and confidential, intended 
only for the use of the addressee(s) above. Any unauthorized use or disclosure 
of this information is prohibited. If you have received this e-mail by mistake, 
please delete it and immediately contact the sender.

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