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Tuesday, June 30, 2015

Allergies, Severity and Criticality in HL7 CCDA

A rather long document wound up in my e-mail this morning, sent to Structured Documents cochairs, HL7 Leadership and several other individuals (myself included).  The e-mail addresses concerns from the HL7 Patient Care Workgroup about a patient safety issue with the current C-CDA templates for Allergies, specifically in how these templates address Criticallity of an allergy, vs. Severity of a reaction.  C-CDA does NOT in fact relate criticallity with an allergy, only severity.  BTW, that concept of allergy severity goes back to 2005 and before, and was adopted in CCD, and forward into subsequent releases.

The Patient Care Workgroup has been working on these topics for a number of years, and believes that they should be addressed in the HL7 C-CDA DSTU 2.1 Update Project.  I could readily be convinced that is the case.

The concern of the Patient Care Workgroup is that the existing templates do not appropriately address how allergies should presented to a clinician, and as a result, produce a patient safety concern that should be addressed as soon as possible.

I'm pleased to see HL7 having to take on this kind of challenge, and look forward to see how this changes our processes going forward.  In this case, we have a "conflict" between two governance groups over something that could affect patient care.  Arguably, there should be a process to address this sort of issue.  Today, medical device manufacturers also have processes to address patient safety issues in the technology they produce, I think HL7 will need to adopt similar processes.

We saw a somewhat similar issue (addressing security rather than safety) crop up last year with CDA stylesheets.


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