Update from SNOMED International meeting

https://confluence.ihtsdotools.org/pages/viewpage.action?pageId=50594085

discussion with Jim Case about when to submit content

1. SNOMED has changed their policy to make it consistent with the license....i.e. Extension can say that snomed core is in error. 
2. General Assembly meeting - Don will need to clarify things with LOINC...need to figure out an easier way to collaborate and integrate.
3. When should "we" submit content to snomed international and/or US extension. Wait until "we" have tested and evolved the terminology – take time to integrate all together and formulate into a coherent model and supporting content.
4. Australia does not report back "who" is using SNOMED/Extension. It is too onerous to track. Need to discuss this with NLM? and determine what our strategy should be. maybe we don't use the US extension?

John Kilbourne 

Liz McCool

 definition from Susan M:

Deep Tissue Pressure Injury: Persistent non-blanchable deep red, maroon or purple discoloration

Intact or non-intact skin with localized area of persistent non-blanchable deep red, maroon, purple discoloration or epidermal separation revealing a dark wound bed or blood filled blister. Pain and temperature change often precede skin color changes. Discoloration may appear differently in darkly pigmented skin.  This injury results from intense and/or prolonged pressure and shear forces at the bone-muscle interface.  The wound may evolve rapidly to reveal the actual extent of tissue injury, or may resolve without tissue loss. If necrotic tissue, subcutaneous tissue, granulation tissue, fascia, muscle or other underlying structures are visible, this indicates a full thickness pressure injury (Unstageable, Stage 3 or Stage 4). Do not use DTPI to describe vascular, traumatic, neuropathic, or dermatologic conditions.

Susan Castillo make a Jira issue...add pressure injury deep modeling principals...john will model pressure injury of deep tissue differently...

Wound Tissue Color

• VA SME request to differentiate bright and pale for red and pink values.

Will need to discuss adding "foreign body" to this refset; we probably need a physical object; what is available now is a finding and a morphology foreign body

Keith – Can you have a refset with concepts from different domains? morphology and findings? Does this make it harder for the implementors...? 

2017-10-16 SOLOR Dev Meeting notes

Yes, you can have have concepts from different domains in a refset. In Analysis Normal form we want to be more constrained. If the benefits are important to clinical input forms then here is the model. This refset is intended to represent the values needed to populate this particular model. Rather than this refset is general for all uses. The model needs a name and a version. Jay Lyle name and version CIMI model (we can call them a snapshot version for now) for each of these questions

SOLOR DEV team will not change any refsets for now with regard to these questions.

Associated Clinical Quality Measures

<Identify if this refset will be associated with any clinical quality measures>

Refset Description Template

October 30th release of skin wound assessment extension/refsets

• release note?
• update termSpace with latest US and snomed international after October 30th? 
• termMed needs to update release process to include text definitions and nursing dialect (they are currently working on it)
• termSpace release we should QA the release files - how/who?