COCT_MT260022CA - Hierarchical Message Description

COCT_MT260022CA
Issue Event detected-basic

Derived from RMIM: _ and HMD: _

DetectedIssueEvent

Design Comments:

This is the list of clinical and business-rule issues that have been detected and recorded involving the current action.

Rationale:

Provides a list of issues that have been detected.

classCode [1..1] (M)
Observation (CS) {CNE:C:ActClass:ALRT, fixed value= "ALRT"}

moodCode [1..1] (M)
Observation (CS) {CNE:C:ActMood:EVN, fixed value= "EVN"}

code [1..1] (M)
Observation (CV) {CNE:V:ActDetectedIssueCode}

Design Comments:

A coded value that is used to distinguish between different kinds of issues. Types of issue include: unrecognized identifiers, permission issues, drug-drug contraindications, drug-allergy alerts, duplicate therapies, etc.

Rationale:

Identifies what kind of issue was detected.

This is mandatory so as to ensure that one issue type can be distinguished from another.

Mapping:

Contraindication.crossSensitive (if code is related reaction dected issue then crossSensitive is 'True')

Mapping:

Distinguishes between DAI, DDI, DosageCheck, DPD, and Duplicate Therapy Contraindications

Mapping:

Contraindication.DosageContraType

Mapping:

OverrideReason.reasonDomain

Mapping:

ZP3.3

Mapping:

E06(for contraindications errors are handled at transmission or controlAct wrapper level)

Mapping:

05.03D

Mapping:

DUR Response Codes

Mapping:

Interaction Type

Mapping:

ZPS.7.1

Mapping:

ZDU.9.1(PLYPHRM)

Mapping:

ZDU.10.1 (PLYDOC)

Mapping:

ZDU.6.2

Mapping:

ZDU.6.4

Mapping:

ZDU.7.3

Mapping:

DRU.100-01

Mapping:

DUR/PPS.439-E4

Mapping:

A_DetectedMedicationIssue

text [0..1]
Observation (ST)

Design Comments:

A free form textual description of a detected issue. This textual information is provided to either augment the coded information or in place of the coded information.

Rationale:

Lets providers see textual explanation of the issue.

Mapping:

Contraindication.DDIDescription

Mapping:

E20(for contraindication errors are handled at transmission or controlact wrapper level)

Mapping:

ZPE.4

Mapping:

ZDU.11.1

statusCode [1..1] (M)
Observation (CS) {CNE:C:ActStatus:completed, fixed value= "completed"}

priorityCode [1..1] (M)
Observation (CV) {CNE:D:ActIssuePriority}

Design Comments:

A coded value denoting the importance of a detectable issue. Valid codes are: I - for Information, E - for Error, and W - for Warning.

Rationale:

Allows the provider to make informed decision on the importance and criticality of an issue. May also be used by the DIS to determine the order of returning issues. Attribute is mandatory because every issue needs to be prioritized.

targetSiteCode [0..5]
Observation (SET<ST>)

Design Comments:

Used to identify XPath referencesthat indicate which attributes in a message instance were involved in the issue.

mitigatedBy [0..25] (Mitigates)

Design Comments:

Indicates how the issue could be managed.

Rationale:

Allows past or potential managements to be displayed to assist providers in determining how to manage a particular issue.

triggerFor [0..1] (Trigger2)

Design Comments:

Information that indicates whether or not a detected issue needs to be managed.

Rationale:

Lets applications distinguish between minor issues that require no management versus those that need management to successfully process the request.

The association behaves as a mandatory attribute where the presence of the association indicates 'true', while the absence of indicates 'false'.

Mapping:

Contraindication.ManagementRequired (True, if this association is present)

Mitigates

Design Comments:

Indicates how the issue could be managed.

Rationale:

Allows past or potential managements to be displayed to assist providers in determining how to manage a particular issue.

typeCode [1..1] (M)
ActRelationship (CS) {CNE:C:ActRelationshipType:MITGT, fixed value= "MITGT"}

contextControlCode [1..1] (M)
ActRelationship (CS) {CNE:C:ContextControl:ON, fixed value= "ON"}

contextConductionInd [1..1] (M)
ActRelationship (BL){fixed value= "false"}

detectedIssueManagement [1..1] (DetectedIssueManagement)

Design Comments:

The processes and procedures employed by providers to resolve clinical conflicts between the action being performed and additional information already in the patient's record.

Rationale:

Presents alternatives for how the issue could be managed or has been managed in the past.

Mapping:

A_DetectedMedicationIssue

DetectedIssueManagement

Design Comments:

The processes and procedures employed by providers to resolve clinical conflicts between the action being performed and additional information already in the patient's record.

Rationale:

Presents alternatives for how the issue could be managed or has been managed in the past.

Mapping:

A_DetectedMedicationIssue

classCode [1..1] (M)
Act (CS) {CNE:C:ActClass:ACT, fixed value= "ACT"}

moodCode [1..1] (M)
Act (CS) {CNE:C:ActMood:DEF, fixed value= "DEF"}

code [1..1] (M)
Act (CV) {CNE:D:ActDetectedIssueManagementType}

Design Comments:

Indicates the kinds of management actions that can be taken, based on the issue type.

Rationale:

Ensures consistency in description of management actions.

This is mandatory so as to ensure distinction between different kinds of management.

Mapping:

ManagedContraindication.State

Mapping:

OverrideReason.reason

Mapping:

D65(when dealing with clinical indication overrides, otherwise use overrides in ControlAct wrapper.

Mapping:

ZPB3.10

Mapping:

Intervention Codes

Mapping:

ZPS.8

Mapping:

ZPS.15

Mapping:

ZDP.21.1

Mapping:

DRU.100-02

Mapping:

DRU.100-03

Mapping:

DUR/PPS.440-E6

Mapping:

DUR/PPS.441-E6

Mapping:

Claim.420-DK

Mapping:

A_DetectedMedicationIssue

text [0..1]
Act (ST)

Design Comments:

Additional free-text details describing the management of the issue.

Rationale:

Allows additional clinical detail to be conveyed that are important clinically and not conveyed by the code.

author [0..1] (Author1)

Design Comments:

Identifies the provider who created the management of the issue.

Rationale:

Part of the audit record, but may not always be known for historical managements.

Mapping:

OverrideReason.provider

Mapping:

ManagedContraindication.provider

Mapping:

A_DetectedMedicationIssue

Author1

Design Comments:

Identifies the provider who created the management of the issue.

Rationale:

Part of the audit record, but may not always be known for historical managements.

Mapping:

OverrideReason.provider

Mapping:

ManagedContraindication.provider

Mapping:

A_DetectedMedicationIssue

typeCode [1..1] (M)
Participation (CS) {CNE:C:ParticipationType:AUT, fixed value= "AUT"}

time [1..1]
Participation (TS.FULLDATETIME)

Design Comments:

The date and time on which the provider used this management for the issue in the past.

Rationale:

Part of the audit record but not always available and therefore only marked as 'populated'.

Mapping:

ManagedContraindication.CreationDate

assignedEntity [1..1] (R_AssignedPersonIdentified-informational)

Trigger2

Design Comments:

Information that indicates whether or not a detected issue needs to be managed.

Rationale:

Lets applications distinguish between minor issues that require no management versus those that need management to successfully process the request.

The association behaves as a mandatory attribute where the presence of the association indicates 'true', while the absence of indicates 'false'.

Mapping:

Contraindication.ManagementRequired (True, if this association is present)

typeCode [1..1] (M)
ActRelationship (CS) {CNE:C:ActRelationshipType:TRIG, fixed value= "TRIG"}

contextControlCode [1..1] (M)
ActRelationship (CS) {CNE:C:ContextControl:ON, fixed value= "ON"}

contextConductionInd [1..1] (M)
ActRelationship (BL){fixed value= "false"}

actRequest [1..1] (ActRequest)

ActRequest

classCode [1..1] (M)
Act (CS) {CNE:C:ActClass:ACT, fixed value= "ACT"}

moodCode [1..1] (M)
Act (CS) {CNE:C:ActMood:RQO, fixed value= "RQO"}