Stream: argonaut
Topic: Are Imaging results included in the CCDS?
Cooper Thompson (Dec 06 2018 at 16:12):
I was looking closely at the MU3 CFR, and it seems to indicate (by my interpretation) that Imaging results are considered part of the Procedures CCDS category. However there isn't any language in US Core about imaging results that I could see. The profiled DiagnosticReport clearly calls out that it is for lab only. If we were to include Imaging results in the Procedure resource, the actual result would presumably be in Procedure.report, which points to the non-profiled DiagnosticReport.
So I guess I'm looking for two things:
- Does US-Core / Argonaut consider Imaging results to be part of the CCDS?
- If so, how should they be represented in FHIR?
Eric Haas (Dec 06 2018 at 16:22):
not specifically, we focused on lab. We opened up DiagnosticReport to allow it but no guidance provided. This is something we could consider as a new Argonaut 2019 argonaut project. Steering committee call tomorrow to discuss next years agenda....
Cooper Thompson (Dec 06 2018 at 16:51):
I guess regardless of whether there is any Argonaut work, it does seem to me that imaging is clearing with the scope of the CCDS. Agree?
Brett Marquard (Dec 06 2018 at 19:18):
if you can, please post relevant MU3 CFR piece here (link or text)...I don't remember guidance for imaging in C-CDA, which is also required to support CCDS
Drew Torres (Dec 06 2018 at 19:34):
Imaging is not in scope os CCDS at all. There is no mention of it.
Cooper Thompson (Dec 06 2018 at 21:40):
There are two sources I'm looking at: CCDS definition for Procedure, which may be non-authorative, but does list radiology under the Procedure CCDS category, and the CFR. The specific CFR sections are the bit about imaging for VDT, and then the bit that says APIs should do the same that VDT does:
DIAGNOSTIC IMAGE REPORTS We proposed to require that a Health IT Module would need to demonstrate that it can make diagnostic image reports available to the patient in order to be certified. We explained that a diagnostic image report contains a consulting specialist's interpretation of image data, that it is intended to convey the interpretation to the referring (ordering) physician, and that it becomes part of the patient's medical record. Comments. Commenters were generally supportive of including diagnostic image reports and associated context in the “VDT” criterion. Some commenters requested clarification on where this data would be accessible within the C-CDA. Response. We have adopted this proposal to include the diagnostic imaging report (including the consulting specialist's interpretation) as a requirement in the “VDT” criterion. Health IT Modules may include this information in the “Results” section of the CCD. We clarify that unstructured data for the interpretation text is acceptable.
Then later:
We proposed a new 2015 Edition criterion at §?170.315(g)(7) that would require health IT to demonstrate it could provide application access to the Common Clinical Data Set via an application programming interface (API), and requiring that those same capabilities be met as part of the “VDT” criterion
Drew Torres (Dec 06 2018 at 23:43):
That is not the way it should be read. Procedure reports are different from the C-CDA specification. It only talks about the reports... Not the images. Second point is only about similarities between the 2. It should not be considered literally. As another example, Encounter/Discharge diagnosis is required in C-CDA and by CEHRT, but not required for API.
Drew Torres (Dec 06 2018 at 23:43):
Gender identity is another example.
Drew Torres (Dec 06 2018 at 23:44):
The API doesn't have to expose it, but it is a requirement to be able to support LOINC/SNOMED for GI.
Cooper Thompson (Dec 10 2018 at 14:09):
Ah - I guess to be clear, when I'm talking about "Imaging" I'm actually referring to the narrative result for an imaging procedure. Not the actual diagnostic or reference image exchange.
Last updated: Apr 12 2022 at 19:14 UTC
