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Name HL7 Version 3 Standard: Care Provisions, Release 1
Period Begin May 24, 2007
Period End May 23, 2011
Days until Close 262
Description This DSTU has been extended an additional 24 months upon the approval of the TSC as indicated in TSC Tracker item #1046: http://hl7projects.hl7.nscee.edu/tracker/index.php?func=detail&aid=1046&group_id=52&atid=313.
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Last Updated Current Status / Comment Made by
Dec 05, 2008 New Kirnak, Alean
  Vaccine Forecast Decision Support would like to make use of CareRecord as a payload format for passing data to and from the service. The required input is an immunization history and other medical summary data. The output is a validated immunization history and a recommendation for vaccines to be administered. Adding the following data elements will allow CareRecord to be used for this decision support and possibly other decision support applications.

(1) Need a way to express an immunization in terms of the diseases it targets - i.e. combo vaccines need to broken into doses by disease (shots vs. doses). For instance, Vaccine Family (targeted disease) expressed by dose (as opposed to by shot - combo vaccines may have more than one)

(2) Need to be able to show 3 separate groups within substanceAdministration tag: a.) Reported, b.) Validated by dose, including a way to express an invalid dose c.) Forecasted (which may repeat for different jurisdictions)

(3) EffectiveTime needs to include effectiveTime/low, effectiveTime/optimum, and effectiveTime/high

(4) Need a Partial Dose flag.

(5) CareRecord should be harmonized with POIZ. Investigation shows the two standards are already very close.

Fields needed by CareRecord include: a) confidentialityCode; b) uncertaintyCode.

A few tag names are also different but it may be better to either ignore the differences or modify POIZ, which is also in DSTU. These include:

POIZ tag names:

administerableMedication.administerableMedicine.name
administerableMedication.administerableMedicine.asMedicineManufacturer.manufacturer.id
administerableMedication.administerableMedicine.lotNumberText
administerableMedication.administerableMedicine.expirationTime

vs CareRecord tag names:

administerableMaterial.administerableMaterial.name
administerableMaterial.administerableMaterial.asMedicineManufacturer.manufacturer.id
administerableMaterial.administerableMaterial.lotNumberText
administerableMaterial.administerableMaterial.expirationTime
Sep 04, 2007 New Boone, Keith
  Each care entry can have a "conditions" associated with it. One use for this is to describe the preconditions under which a substance administration is to occur (e.g. Tylenol 500mg, 1-2 tabs every four hours as needed for pain).

The issue I raise is that the constraints on condition are too restrictive:

1. condition.value is required, but if the only value you have is text, then this could be found in condition.text, and requiring condition.value gets in the way (especially if you want more compatibility with other HL7 standards, such as CDA Release 2).
2. condition.interpretationCode is also required, but in the above case, I find nothing in interpretationCode that SHOULD be required in the use case just provided.

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