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I am including a summary of last week’s call regarding the upcoming presentation to the MF to obtain support for continuing to develop the allergy/intolerance implementation guide. I underlined the key points and had one question (in red).
As you know, our current implemantion in EHR is allergy history capture with precoordinated SNOMED CT allergy to x concepts in non-FIHR structures, exchanged in text pdf with other hospitals. And our upcoming implementation for next year, which we are currently testing with our FIHR authorities, is allergen capture with a data model aligned to the FIHR export model and FIHR for data exchange between all care professionals. So in Belgium you have exemples of the two implementations you talked about in the word document. What we don't do is exchange between systems "allergy to X" data in SNOMED CT format. Those get flattenend in text still along with all the rest of the data in the hospital report when it is printed and sent in paper or in pdf to the general practitionner.
I find the sentences on the slides very long, so long I have trouble understanding them. I would strive for shorter and better punch lines with a bit more air in the slide between them, for readability.
I'm sorry I could not attend last meeting but one major point I find missing is that we do have several refsets ready for the allergy FIHR model. I merged that 800 most frequent allergen substances form the Vet/HL7 study on the 110 million record to my CSCT work in 2019 so that unique refset could be both used by us in Belgium and taken up by the Allergy CRG for everyone else. That was explicitly what I said I'd do at the SIG and I've done it. You have reviewed that list with me Bruce in summer 2019, and we separated the common allergens from the typically european/Belgian ones, so it is an Allergy CRG work. It all stands on the PVs of the time. And Natasha has her refsets which could be added to expand my core work further toward occupational and contact allergens. She and I have already decided we're going to do that once we have done the animal protein concepts.
We have done the value sets for all the FIHR Allergy components that can be done in SNOMED CT in the Belgian FIHR profile: reaction type, certainty, severity, a minimal manifestation refset. So you're not looking for support to make those refset but only to update them to v20200731 and maintain them in the future.
And finally, you don't just have the FIHR substances refsets, you have the 1-1 mapping of all of them to the precoordinated "allergy to X" or "non allergic hypersensitivity to X" matching concept that I have done for Belgium since we have EHRs now that can only use that and we're moving toward substance based allergy capture following the FIHR ligical model. So you have to refsets fitting the needs of the two main possible ways to capture allergies in EHRs. That's asking a lot less from the MF and being a lot further down the road. There is more to do actually to rewrite the implemantation guide to modern standards then to publish the FIHR refests. The refsets you can about just put them into Refset management tool, hit the update to current international version, and promote them and they'd already be ready to use.
Thanks Marie-Alexandra Lambot. Thank you for your feedback. Jim Campbell created this slide deck and will be presenting it at the MF call. I agree if this meant to be a visual presentation then the content on the slides could be broken up into several bullet points covering a few slides. With regard to value set development, looking back to the work you did, it looks like you had presented this during the September 2019 meeting. We can revisit your work and Natasha's with James R. Campbell and the other CRG members to see if we want recommend these refsets for inclusion in the international release.
Dear all. Yesterday's call with the MF went well I thought. There was agreement from several member countries to work together with our CRG to develop use cases that would be used for a proposal to seek approval from the management team. I have posted the recording below:
The recording will be played back for the Asia-Pacific memebers of the MF today.
I need to cancel tomorrow's call. We will meet again on Thursday, December 10 at 18:30 UTC to resume discussion on this topic as well as a follow-up on the CMAG decision about replacing Allergy to animal danger with Allergy to animal protein.
Asia-Pacific was a fairly quiet audience, but people were supportive of the IG development work. There were no new volunteers, although I know you garnered some from the first call – from Canada, at least.
The sessions were at least successful in raising awareness, so I wonder if the next step is to take this back to Ian Green to see what support can be provided.
10 Comments
Bruce Goldberg
Allergy CRG implementation guide discussion.docx
Marie-Alexandra Lambot
Hi Bruce,
As you know, our current implemantion in EHR is allergy history capture with precoordinated SNOMED CT allergy to x concepts in non-FIHR structures, exchanged in text pdf with other hospitals. And our upcoming implementation for next year, which we are currently testing with our FIHR authorities, is allergen capture with a data model aligned to the FIHR export model and FIHR for data exchange between all care professionals. So in Belgium you have exemples of the two implementations you talked about in the word document. What we don't do is exchange between systems "allergy to X" data in SNOMED CT format. Those get flattenend in text still along with all the rest of the data in the hospital report when it is printed and sent in paper or in pdf to the general practitionner.
If we can help with the guide, the CSCT will.
Best
M-A
Bruce Goldberg
Hi Marie-Alexandra. Thanks for your support.
Bruce
Bruce Goldberg
Attached is a link to the meeting recording
https://snomed.zoom.us/rec/share/TvY8sR4vKNxPKC5Eks33xVVKXACUSyzLwBxvCFTr7JKc6yX4PiszFl-tpiykUJQs.BTkHHPq-aqjDYiVj Passcode: 6#c#6fyk
Bruce Goldberg
I am attaching the presentation created by James R. Campbell to be given to the MF next Tuesday. Please add any comments that you may have.
Bruce
AllergyImplementationProposalToMF2020.pptx
Marie-Alexandra Lambot
I find the sentences on the slides very long, so long I have trouble understanding them. I would strive for shorter and better punch lines with a bit more air in the slide between them, for readability.
I'm sorry I could not attend last meeting but one major point I find missing is that we do have several refsets ready for the allergy FIHR model. I merged that 800 most frequent allergen substances form the Vet/HL7 study on the 110 million record to my CSCT work in 2019 so that unique refset could be both used by us in Belgium and taken up by the Allergy CRG for everyone else. That was explicitly what I said I'd do at the SIG and I've done it. You have reviewed that list with me Bruce in summer 2019, and we separated the common allergens from the typically european/Belgian ones, so it is an Allergy CRG work. It all stands on the PVs of the time. And Natasha has her refsets which could be added to expand my core work further toward occupational and contact allergens. She and I have already decided we're going to do that once we have done the animal protein concepts.
We have done the value sets for all the FIHR Allergy components that can be done in SNOMED CT in the Belgian FIHR profile: reaction type, certainty, severity, a minimal manifestation refset. So you're not looking for support to make those refset but only to update them to v20200731 and maintain them in the future.
And finally, you don't just have the FIHR substances refsets, you have the 1-1 mapping of all of them to the precoordinated "allergy to X" or "non allergic hypersensitivity to X" matching concept that I have done for Belgium since we have EHRs now that can only use that and we're moving toward substance based allergy capture following the FIHR ligical model. So you have to refsets fitting the needs of the two main possible ways to capture allergies in EHRs. That's asking a lot less from the MF and being a lot further down the road. There is more to do actually to rewrite the implemantation guide to modern standards then to publish the FIHR refests. The refsets you can about just put them into Refset management tool, hit the update to current international version, and promote them and they'd already be ready to use.
Bruce Goldberg
Thanks Marie-Alexandra Lambot. Thank you for your feedback. Jim Campbell created this slide deck and will be presenting it at the MF call. I agree if this meant to be a visual presentation then the content on the slides could be broken up into several bullet points covering a few slides. With regard to value set development, looking back to the work you did, it looks like you had presented this during the September 2019 meeting. We can revisit your work and Natasha's with James R. Campbell and the other CRG members to see if we want recommend these refsets for inclusion in the international release.
Bruce Goldberg
Here is a revised presentation which addresses some of Marie-Alexandra Lambot's concerns.
AllergyImplementationProposalToMF2020_2.pptx
Bruce Goldberg
Dear all. Yesterday's call with the MF went well I thought. There was agreement from several member countries to work together with our CRG to develop use cases that would be used for a proposal to seek approval from the management team. I have posted the recording below:
https://drive.google.com/file/d/1m3F7bFstp_AgYEwOfS7W_vByW3_uofl_/view
The recording will be played back for the Asia-Pacific memebers of the MF today.
I need to cancel tomorrow's call. We will meet again on Thursday, December 10 at 18:30 UTC to resume discussion on this topic as well as a follow-up on the CMAG decision about replacing Allergy to animal danger with Allergy to animal protein.
Zoom Details
https://snomed.zoom.us/j/934143312?pwd=REVPWFl2Zm56a3AvandGSGxiMXYzQT09
Meeting ID: 934-143-312
Happy Thanksgiving!
Bruce Goldberg
Response from Asia Pacific side of member forum:
Asia-Pacific was a fairly quiet audience, but people were supportive of the IG development work. There were no new volunteers, although I know you garnered some from the first call – from Canada, at least.
The sessions were at least successful in raising awareness, so I wonder if the next step is to take this back to Ian Green to see what support can be provided.
I can follow-up with Ian.