Process of Defining Topic / Data Elements

Here I think we are just trying to help make “tangible” the process of how to take a spreadsheet of conditions/values and work them into ANF topics/Data elements. For example, we would like to answer “what is a topic.”

• Inventory existing coding guidance (e.g. SNOMED COVID, or LOINC) from standard organizations

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Limitations and/or issues with identifying Topics / Data  Elements

Part of the deliverable is to serve as an Implementation Guide for creating full stack knowledge artifacts, which means we need to air out the dirty laundry so to speak and be honest on how the full stack development process is.

Example of Work Product (e.g., Chronic Lung Disease)

For this section, we can’t have all your elements in the spreadsheet you are working with, but a few good selections of where the process/outcome of topic/data element identification was easy, middle of the road, and hard would be great for readers to further understand how to apply this process elsewhere.

Identified Issues

Fixes for Issues (e.g., how creating topics enables better data element definitions)

No adjustment is necessary. There is an existing exact match for the variable

Optional adjustment. If it is felt that the existing concept is logically the correct one but the terming is suboptimal the fix could be to add a synonym to the existing concept for VA use.

In-depth adjustment or an identified gap.

Open

The optimal process to fix this error would be to fix it locally for the immediate benefit of the VA. Then there would need to be a submission of the change request to the US National Release Center (NRC). The US NRC would evaluate the request as to whether it is applicable to only the US or if it is an issue for the International core of SNOMED. If the US NRC determined that this was an issue for the International core they would then forward the request to the International staff for consideration. Acknowledging that there is limited bandwidth at both the US and International level for authoring, the request may not make the next 6-month Release cycle. This request has been submitted to the US Content Request Service for evaluation (Request ID: 349742, Jira Ticket ID: USCRS-31022).

As an example, the request submitted to fix the error was picked up and forwarded immediately to SNOMED International, and will only be available in the US Release for the VA to use in March 2021.

The corrected concept will now subsume other chronic lung disorders (See the updated concept here).

To speed up the process to meet the VA Use Cases the error could be fixed directly in both the VA extension and the US National Release. The corrected content would have then been immediately available to the VA and also available in the September 2020 US Release.

The process would be the same for a noted gap in variables, it would be authored locally for the VA and US National Release and forwarded to SNOMED International for consideration.

Open

Literature exists to support the addition of a new concept of “Chronic asthma (disorder)” and the existing concept model could be used to define the meaning.