ࡱ> SRU]P` 6bjbj 2i-        ---8-4.$ M>/P0f0f0f0-2242$hWTچ ;1@-2;;چ  f0f0"EBEBEB; f0 f0EB;EBEBh~  Tf02/ S->|`8<MO?pT Tl36Q5EB6D)8333چچAX333M;;;;  D#   #          Attendees: NameE-mail AddressSessions AttendedNancy LeRoy HYPERLINK "mailto:nancy.leroy@med.va.gov" nancy.leroy@med.va.govTues: Q1-Q4; Wed: Q1-Q4John Travis HYPERLINK "mailto:jtravis@cerner.com" jtravis@cerner.comTues: Q1-Q4; Wed: Q1-Q4Matthew Greene HYPERLINK "mailto:michelle.dougherty@ahima.org" matthewgreene2@med.va.govTues: Q1-Q4; Wed: Q1-Q4Bob Dolin HYPERLINK "mailto:Robert.H.Dolan@kp.org" Robert.H.Dolin@kp.orgTues: Q1Tod Ryal HYPERLINK "mailto:mtucker@regenstreif.org" tryal@cerner.comTues: Q1, Q3: Wed: Q1, Q2, Q4Jari PorrasmaaJari.porrasmaa@uku.fiTues: Q1Harry Rhodes HYPERLINK "mailto:Harry.Rhodes@ahima.org" Harry.Rhodes@ahima.orgTues: Q1-Q2Michelle Dougherty HYPERLINK "mailto:Michelle.Dougherty@AHIMA.org" Michelle.Dougherty@AHIMA.orgTues: Q4Calvin Beebe HYPERLINK "mailto:cbeebe@mayo.edu" cbeebe@mayo.eduTues: Q1Mike Kenig HYPERLINK "mailto:mkenig@epicsystems.com" mkenig@epicsystems.comTues: Q1Peter Haug HYPERLINK "mailto:Peter.haug@ike.comj" Peter.haug@ike.comjTues: Q1Keith W. BooneKeith.boone@dictaphone.comTues: Q1Bill BraithwaiteBill.Braithwaite@ehealthinitiative.orgTues: Q1Garry Cruickshank HYPERLINK "mailto:g.Cruickshank@sympatico.ca" g.cruickshank@sympatico.caWed: Q4 Highlights from meeting: Tuesday, September 13, 2005 Decision was made to move from DSTU to normative ballot. Preliminary work on Query by parameter began. V2.6 ballot reconciliation was completed. V3 query message use case began. Wednesday, September 14, 2005 Begin to review and update consent section in V2.X Met with Garry Cruickshank from the Canada Health Infoway Canadian Electronic Drug Messaging (CeRx) project regarding their need for consent messages in V3. Tuesday, September 13, 2005 Quarter 1 - Joint meeting with Structured Documents. The meeting was opened with Bob Dolin asking the question, is there enough interest to go to normative ballot? Do we want to have a V3 MR message? There seems to be interest in query process at least from the international community. Jari Porrasmaa shared that Finland will be looking for this in the future. He mentioned that the UK has already done some messaging in this arena. Its a metadata registry for document retrieval, patient demographics. John Travis shared that Cerner has a vested interest in going forward since they will be working with the UK. He also mentioned that France and Australia also have an interest in this. The observation was made that we would need to have active input from those who have an interest in the development of the query process. Keith Boone gave the group a brief update regarding XDS which is a cross enterprise-sharing system. EB XML - Is intended for use in RHIOs or other organizations with facilities in disparate locations to share documents. Keith sees this DSTU as a potential interface to the XDS project. Bob Dolin did a review of the DSTU for the committee. The storyboard is not normative although the interactions are. Two messages have been defined. The meat of the V3 MR/IM DSTU is: Section 2. Document Type 2.1 Storyboards (currently are 2) 2.2 Application note 2.3 trigger events 2.4 Refined MIMs 2.5 Hierarchy message descriptions 2.6 Interactions A question was asked regarding the receiving system if we had considered/included the need for acknowledging the receipt of the document. Example was given of a duplicate message sent regarding the same document without any change from what the receiving system already possessed. The belief is that this is addressed within the Medical Record chapter through the document states and the 4 transition states. Keith suggested the state transition diagram from medical records needed to be added to the CDA. Calvin reminded the committees that this had previously been discussed at length and the decision was not to include it in the CDA. Bob asked Bill Braithwaite if we needed to fold in additional requirements from the NLM project. Bill states participants would like a clear demarcation between the messaging and the transport mechanism. This is because some will be using EB XML or another transport service. Bob feels that Rene Spronks proposal (see attachment) is a good start to developing the first query message.  EMBED Word.Document.8 \s  Current needs to go to normative ballot: Time does not allow us to go to ballot in November. The request for ballot has to be submitted by October 17, 2005. Update the current model against the: Current RIM Current CDA so they are the same language and consistent Query messages need to be added. Use the summary list John Travis put together from his call for use cases. Review the IHE ITI/XDS technical framework release 2 for the query work that has already been done and is currently being used. Review Renes proposal Bob will F/U with Bill Braithwaite about the HL7 NLM project requirements. Time line for going to ballot: Have updated DSTU ready to present to the committee at the January 2006 WGM for committee approval for ballot and Submit the request for ballot Go to ballot in March 2006. Action items: Bob will reconcile with CDA Review other chapters to see how they have handled query messages probably a separate topic. Co-chairs of MR/IM will be responsible for monitoring the ballot timeline and keeping the committee and work on track. Co-chairs will facilitate use case development to elaborate on example use cases for the query message structure Bob proposes Bob will update the Medical Records model, after which co-chairs will facilitate a review of the parameters that should be included in the query message. Keith suggests Bob do a presentation of V3 modeling presentation in January. Bob will complete work and send it out on the list serve for committee members to review prior to the January 2006 meeting. A joint meeting will be scheduled for the January 2006 WGM for Tuesday Q1 & Q2 joint meeting. Quarter 2: V2.6 ballot reconciliation was done. All but two were publishing, formatting corrections that were done. Quarter 3: V2.6 ballot reconciliation was completed. Two reference corrections were reviewed and the changes were made per the balloters suggestions. Reviewed the uses case scenarios submitted to the committed via e-mail. See attached summary document.  EMBED Word.Document.8 \s  Quarter 4: Based on his summarization of the sample query by parameter examples he received, John has begun an excel spreadsheet with the TXA elements across the top. The committee began drafting use cases by describing query scenarios and then listing the required parameters. Work on query use cases continued. See attached workbook for details.  EMBED Excel.Sheet.8  Matt will continue to work on building uses cases between meetings. Michelle asked the question is there work for this committee to define the legal health record? After discussion there doesnt seem, at least at this time, to be a place for this topic. Wednesday, September 14, 2005 Quarter 1 Quarter 3: Time was spent reviewing and updating the 9.9.1 Medicolegal agreements short description section of V2.X. Refer to the document for details.  EMBED Word.Document.8 \s  Quarter 4: Garry Cruickshank from the Canadian Health Infoway Canadian Electronic Drug Messaging (CeRx) project requested to meet with the committee to discuss Consents and key words. Garry began by giving the committee a brief presentation on health care in Canada and this new project. Healthcare in Canada is publicly funded and under provincial jurisdiction, although the federal government tries to influence through its financial contributions. The Canada Health Act does guarantee some consistency across the country. Canada has a law known as PIPEDA (Personal Information Protection and Electronic Documents Act), which is broader than the U.S. HIPAA legislation. Gary is involved with an e-prescribing and electronic health records portion of the Infoway project. The project will need all sorts of messaging including e-prescribing and consent messages. The consent-messaging piece revolves around the patients right to mask their information. Masking data is a methodology that would allow the patient to hide their data at different levels. Examples are: a diagnosis, which would include all associated prescriptions, dispenses, a particular prescription, which would include all dispenses, a medication list, etc. Currently most of the required messages are in the pharmacy chapter but additional message requests have also been taken to the Patient Care TC (medical conditions, basic observations, professional services, adverse drug reactions and allergies). They have two messages for consents they would like to have developed and brought to ballot during the V3 ballot of the Medical Records chapter. The group is willing to assist the committee with advancing the work for this initiative. Garry shared a brief PowerPoint presentation to further explain the need and the work on the messages that has already been done. (Insert the PowerPoint) Next Garry shared the concept of Keywords that is a part of the legislation and the project. Keywords is a technique that one jurisdiction in Canada has set-up to implement the masking requirement. The key word is supplied by the patient and must be given each time a service is required. The other option allows sending that consent has been provided. The messages also allow for emergency access by healthcare providers. The entire Canadian system is a request system that allows for accept, reject, overwriting. Given that Medical Records does not plan to ballot normative materials until the spring ballot, Garry suggested that the Canadian messages be presented in the next ballot under Medical records for information only, clearly being noted as Canadian versions. This occurred with the last ballot cycle with material in Patient Care and was well received. The Canadian team would then work with Medical Records to prepare the material for normative ballot the next cycle. The committee agreed this was acceptable. Garry suggested he could arrange to have their current material posted for review and discussion in its Canadian view and it might be discussed at teleconferences if need be, Weve invited Gary or a representative to attend the January meeting on Tuesday Q2.  Agenda for January 2006 Working Group Meeting: Tuesday: Q1 Joint with structured documents Presentation of query message(s) Presentation of proposed V3 ballot material for committee approval Q2 Presentation and continued discussion with Canada INFOHIGHWAY project regarding V3 consent messages. Q3 & Q4 - Complete V2 consent section review. Wednesday: Q1 Q4 - Additional topics to be determined based on between WGM work. Action items from this meeting: John and Matt are going to work on use case storyboards for the QBP. Bob is working on the currency of the current DSTU against the current RIM and the current CDA. Bob is going to create and propose the message structure for the QBP requirements. Nancy will attempt to determine what the ballot milestones and timeline is. Nancy will complete the administrative meeting work for the next meeting. Nancy will distribute the consent work from this meeting to several list serves (i.e. MR/IM, PA, E.H.R. , Patient Care, International Affiliates, orders and observations) requesting comments, additions, and validate the need in V2 and/or V3. Teleconferences will be scheduled as needed.     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Ul,!(.Db.k\Ul0lrb}q(}q\ee}qe%Z&@`)^&4&%%%*l*lJ)%%%l|'|'|'|'((( ,!(((,!D4,`P P P P P P    Medical Records - Query MedRec Proposal Proposal #910 - Version 0.5 Status : Final Date : 20040823 Author : Ren Spronk, HL7 Netherlands,  HYPERLINK "mailto:rene.spronk@ringholm.nl" rene.spronk@ringholm.nl The contents of this document have been placed in the public domain. Note that the images in this document are based on HL7 Artifacts, these are HL7 Inc. Content Page  TOC \o "1-3" \h \z  HYPERLINK \l "_Toc81036414" 1. Introduction  PAGEREF _Toc81036414 \h 2  HYPERLINK \l "_Toc81036415" 1.1. Retrieve Documents Query  PAGEREF _Toc81036415 \h 2  HYPERLINK \l "_Toc81036416" 1.1.1. Storyboard  PAGEREF _Toc81036416 \h 2  HYPERLINK \l "_Toc81036417" 1.1.2. Static models  PAGEREF _Toc81036417 \h 3   AUTONUMLGL  Introduction The Medical Records domain covers a broad area of functionality related to document management systems. The domain currently only describes document notification messages, a document cant be retrieved from a document management system by means of a version 3 message. This proposal describes a query, its related response, and the underlying storyboard for inclusion in the Medical Records domain. Acknowledgements: The development of this document was financed by NICTIZ ( HYPERLINK "http://www.nictiz.nl" www.nictiz.nl), the Dutch Institute for ICT in Healthcare.   AUTONUMLGL  Retrieve Documents Query  AUTONUMLGL  Storyboard  The above scenario describes how an application can send a query to a document management system, and how the system responds with any matching documents.  AUTONUMLGL  Static models This query (a new R-MIM, RCMR_RM000030) is used to retrieve documents from a document management.  The QueryByParameter class and related classes capture information related to queries sent to an Act Reference Registry. You are referred to the Version 3 ballot materials for a description of the QueryByParameter and SortControl classes. QueryByParameter has a number of associated ParameterItem classes: PatientId: Identifies the recordTarget for which documents are requested. DocumentType: The document type (a code taken from the DocumentType vocabulary domain) of the requested document should be one of the codes specified by this parameter value. This parameter identifies what type of documents should be included in the response. EffectiveTime: The effective time of the requested documents should fall within the time interval specified by this parameter value. AuthorId: The Author of the requested documents should equal one of the authors identified by this parameter value. CustodianOrganization: Identifies the custodian organization of the requested documents. DocumentId: The ID of the requested document. If this parameter is used none of the other parameters needs to be valued; the ID is unique. Interactions: RCMR_IN000030: Retrieve Documents Query Transmission Wrapper: MCCI_MT000100 Send Message Payload ControlAct Wrapper: QUQI_MT021001 Query By Parameter Payload MT: RCMR_MT000030 Document Query (based on the new RMIM described in this proposal) RCMR_IN000031: Response to document query by Mgt Sys Transmission Wrapper: MCCI_MT000300 Application Level Response ControlAct Wrapper: QUQI_MT120001 Query Control Act Acknowledgement / Response Payload MT: RCMR_MT000002 Document Event, with Content      DATE 9/8/2005  PAGE 4  &*/01?@JMNOSTǹǮsbQBh1hCJOJQJaJ h1hY?CJOJQJ^JaJ h1hVCJOJQJ^JaJh{MCJOJQJ^JaJ h1h+5CJOJQJ^JaJ h1hVCJOJQJmH sH hV5CJ(^JaJ(hQ&5CJ(^JaJ(h1h@05CJ(^JaJ(h{M5CJ(^JaJ(h{M5CJ(aJ(h1hV5CJ(aJ(jhT1Uh1hV5CJOJQJaJ 1?@PQRSTUVWXYZ[\]  p#8gdVgdV $h^ha$gd+5 $$dgdV"$a$gd@0gdT1$a$gdV2^w]^`o  f  + , 9 :  $ $&dPgd+5$a$  p#8gd2  p#8gdVT^`ino ŶraP?. h1h+5CJOJQJ^JaJ h1h-$CJOJQJ^JaJ h1hR8CJOJQJ^JaJ h1hU9!0JCJOJQJaJ+j h1hU9!CJOJQJUaJ%jh1hU9!CJOJQJUaJh1hU9!CJOJQJaJh{MCJOJQJaJh1h+5CJOJQJaJhQ&CJOJQJ]aJh1hVCJOJQJ]aJh1hVCJOJQJaJh1h@0CJOJQJaJ  7 K i Mm`WSW?`W'jhIW3hQ&>*B*UphhQ&hIW3hQ&0JjhIW3hQ&0JU+h1hR8CJOJQJaJmH nH sH u4jh1hR8CJOJQJUaJmH nH sH uh1h@0CJOJQJaJh1hR8CJOJQJaJ h1h5CJOJQJ^JaJ h1h#]CJOJQJ^JaJ h1h+5CJOJQJ^JaJ h1h-$CJOJQJ^JaJ        % & ' ( , E F G ` a b c d e f g h ~k]T]hQ&mHnHuhIW3hQ&0JmHnHu$jhIW3hQ&0JUmHnHuj*hQ&UhIW3hQ&0JOJQJ'jhIW3hQ&>*B*UphhQ&hIW3hQ&0JhQ&mHnHsH jhIW3hQ&0JU hQj4hQ&UjhQ&U hQ&$hIW3hQ&0JOJQJmHnHsH    źӆņlź[ӆ jhQ&UmHnHu2jhIW3hQ&>*B*UmHnHphuhQ&mHnHuhQmHnHu j hQ&UmHnHujhQ&UmHnHuhQ&mHnHuhIW3hQ&0JmHnHu$jhIW3hQ&0JUmHnHu2jhIW3hQ&>*B*UmHnHphu      + , 0 8 9 : T , ʻʻݯ|paRa?a%jh1h2CJOJQJUaJh1h@CJOJQJaJh1h2CJOJQJaJh1h25OJQJh1hQ&CJOJQJaJh2CJOJQJaJhjszCJOJQJaJhQ&CJOJQJaJhq%0CJOJQJaJh1hR8OJQJmH sH %jh1hR8OJQJUmH sH h1hR8CJOJQJaJ%jh1hR8CJOJQJUaJ: k l m n O~vqgd{M$a$gd{Mgd{Mgd!&gdJ2gd>ekdN$$Ifl(%% t0644 la$If , - . ; < l m n o { | } NPQֶyymyaYUYUaJUa>ahQ&CJOJQJaJjh{Mh{MUh{Mjh{MUh{MCJOJQJaJh{MOJQJmH sH h1hJ2OJQJmH sH %jh1hJ2OJQJUmH sH h1hJ2CJOJQJaJh!&CJOJQJaJh1h2CJOJQJaJ h1h20JCJOJQJaJ%jh1h2CJOJQJUaJ+jh1h2CJOJQJUaJOQno SWQ57Em78mgd8 & FgdNgdJ2gd>gd!&gd{Mgd{MQR^_noz ̹whYJYJYh{Mh*CJOJQJaJh{MhNCJOJQJaJh1h{MCJOJQJaJhNCJOJQJaJht.CJOJQJaJhx CJOJQJaJh1hNCJOJQJaJh1hJ2CJOJQJaJ%jh{Mh{MCJOJQJUaJh1h!&CJOJQJaJh!&CJOJQJaJh{MCJOJQJaJh{Mjh{MU #/CHRS_`aer!2VWen еШЙЍЙ~ooеЙЙЙ_h{Mhp5CJOJQJaJh{Mht.CJOJQJaJh{Mhp/tCJOJQJaJh{MCJOJQJaJh{MhpCJOJQJaJh{M5CJOJQJaJhbCJOJQJaJh{Mh&gCJOJQJaJh{MhNCJOJQJaJh{MhN5CJOJQJaJh{Mh&g5CJOJQJaJ% OQfgh4567DEm7Elm123568թ~nbbbSKGKGhQjhQUh{Mh8CJOJQJaJh8CJOJQJaJhQ&hh5CJOJQJaJhQ&hb5CJOJQJaJh{Mh>CJOJQJaJhQ&CJOJQJaJh{Mhp/t5CJOJQJaJhbCJOJQJaJh{Mhp5CJOJQJaJhb5CJOJQJaJh{MhpCJOJQJaJh{Mhp/tCJOJQJaJ24578:;=>\]^_`abcdefghijklmngd>89;<>?EFNOQRXYZ[]^vwxh{Mh8CJOJQJaJh~hQ&hQmHnHuh>jh>UhQjhQUnopqrstuvwxgd> 3 0&P1h/ =!"#n$n% Oh+'0  0< \ h t Act Repostory CQ Proposal Rene Spronk, HL7 NetherlandsNormalVISN22Microsoft Office Word@G@ȏGl@Skl@Skl:      = !"#$%&'()*+,./012346789:;<?STABCDEFGHIJKLMNOPQRKVWXYZ[\_`abcdefghijklmnopqrstuvwxyz{|}~՜.+,D՜.+,@ hp  Ringholm GmbH,  Act Repostory CQ ProposalAct Repostory CQ Proposal TitleTitel` 8@ _PID_HLINKSA$Y  http://www.nictiz.nl/? _Toc81036417? _Toc81036416?  _Toc81036415? _Toc81036414~mailto:rene.spronk@ringholm.nl_1188294535 FПSSData 1Table CompObjj@@@ NormalCJ_HaJmH sH tH DA@D Default Paragraph FontVi@V  Table Normal :V 44 la (k@(No List H@H  Balloon TextCJOJQJ^JaJ4@4  #8Header  !4 @4  #8Footer  !   z >?JLt53(-Hgacvx.K g K b v !!!v:!!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!!v:!!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!v:!>?JLt53(-Hgacvx.K g K b v 000000000000000000000000000000000000000000000ي0ي0ي0ي0ي0ي0ي0ي00ي0  ي0JLt53(-Hgacvx.K g K b v 000000000000000000000000000000000000000000000000000000000000000000000000000000000000 00g     3: =3:iu :::   _w #8@NN NN @@UnknownGz Times New Roman5Symbol3& z Arial5& z!Tahoma"qh:f:f:f  !>4 3QHP)?2<Summary of responses for Query by parameter from John TravisVISN2VISN2ObjInfoWordDocument. 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Use Cases: - Publishing/output of the "legal" medical record or a subset of it for fulfillment of a disclosure - Querying for documents for a specific patient ID - Querying documents that I in a particular role as practitioner need to be able to retrieve and take action on such as for review or signature * For care providing roles such as attending, admitting, referring, consulting * For more taxonomy type descriptions of providers - cardiologist, neurologist, radiation oncologist, etc - Querying documents for a group of patients as a list that I need to take action on or have a role towards - author, authenticator, etc - Querying documents based upon department/nursing unit/clinic location/practice setting - Querying documents based on supervisory relationships I have to others who may have been in an author or co-signer role relative to the documents - such as residents or medical students I supervise or other clinicians in my group I may need to act in supervision of or on behalf of - Query based on document type/category both for a patient and across patients such as to support * Query of all documents for a particular body part/region for a patient (possibly also across patients - all studies of this particular kind) * Query of all documents based on diagnosis/problem - for a patient and across patients * Query of all documents for this procedure or clinical act being performedbased on a specified nomenclature value (e.g. LOINC) - for a patient and across patients - Query by document status - Query by document identifier - Query by personnel ID (all documents assigned to personnel) - Query by author - Query by institution and by institution type - Query by document format type - Query by date range and date/time range or boolean comparison against date and date/time Useful Parameters - Patient/Person Name - Patient/Person ID - Encounter ID - Document identifier - Date/Date Range - Time/Time Range - Document Type -Status (final, transcribed, modified, amended), - My Activity as Requestor to be performed (create/dictate, resolve deficiency, sign, review)or where a document has had a status change sincemy last query (new status, new activity, modified body), user/role information (to distinguish specific authors, reviewers or subordinates) - 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MEDICOLEGAL AGREEMENTS Draft: 1-20-04 version, 2.2 (Updated 04-02-04), (updated 9/14/05) Definition of Medicolegal Agreements These documents are legal agreements related to healthcare that permit or require formal acknowledgment or acceptance by the patient and other participants in the healthcare process (e.g. witness, notary of public, practitioners, or other health care workers). General Behaviors of Medicolegal Agreements Patient-centric Each document may contain signatures by the patient or surrogate/representative for the approval, acceptance, acknowledgement, or validity There may be a need for additional approvals or acknowledgements Documents may be context, event or time-limited. Medicolegal agreement may use a predefined template that contains specific text to address the agreement that may require healthcare entity approval. Title or purpose of each agreement may include one of the following terms: Consent, Release, Authorization, Acknowledgment, Requests, Agreements, and Directives. The degree of specialization of such medical/legal agreements may be variable by healthcare entity policy and/or care delivery setting. General Behaviors of Medicolegal Agreements Patient-centric Each document may contain signatures by the patient or surrogate/representative for the approval, acceptance, acknowledgement, or validity There may be a need for additional approvals or acknowledgements Documents may be temporal Medicolegal agreement may use a predefined template that contains specific text to address the agreement. Typically requires organizational approval Title or purpose of each agreement may include one of the following terms: Consent, Release, Authorization, Acknowledgment, Requests, Agreements, and Directives The degree of specialization of such medical/legal agreements is highly variable by healthcare delivery setting. Types of Medicolegal Agreements: 1. Consent for a Therapeutic Intervention (would medical treatment be a better term?)Medical Treatment. Definition: A consent for a therapeutic intervention (medical treatment) provides a patient with information relevant to making a decision about a treatment. When appropriate, the information should also address foreseeable consequences of a decision or lack of a decision. Broad general categories of medical intervention treatment agreements are diagnositicdiagnostic or therapeutic.Treatmenttherapeutic. Treatment is defined as anything done for therapeutic, preventive, palliative, diagnostic, cosmetic or other health-related purpose, and includes a course of treatment or plan of treatmentcare. (Treatment doesnt include assessment, an evaluation/exam to determine the nature of a problem, taking a health history, admission, or a treatment that poses little or no risk of harm to the individual). Reference: The College of Physicians and Surgeons of Ontario (Policy on Consent to Medical Treatment). http://www.cpso.on.ca/policies/consent.htm Characteristics/Content: This type of consent requires a description of therapeutic intervention (the medical treatment) (e.g. admission, drug intervention, invasive procedure, participation in clinical trial or diagnostic procedures). Typically this type of consent includes information on risks, complications, side effects, outcomes/benefits and signatures: patient (or surrogate/representative), provider, and witness (not always required). A consent may also include: alternatives, convalescence, and anticipated events if intervention is not done (if applicable. Examples: a. Drug i.e. psychotic, I.V. contrast b. Invasive surgery includes OR procedures (endoscopy) and Non-OR procedures (lesion removal in physicians office) c. Clinical Trails/Research d. Non-Invasive transfusions i.e. blood products e. Anesthesia f. Immunization g. General consent to treat (omnibus) h. Refusal of therapeutic intervention 2. Authorization for Release of Information/Disclosure Definition: This type of document is utilized to obtain authorization from an individual to disclose their confidential personal health information to a third party. Characteristics/Content: An authorization form is and/or includes: Patient specific and describesDescribes information to be disclosed, The party or parties to whom the disclosure is to be made, limitationsIn limitations to of use, patient specific, partyParty(s) allowing disclosure, limited Effective time period or event, and purposePurpose of use/disclosure. ,Signature of signed by the patient/ipatient or authorized ndividual,individual which may be witnessed or notarized if required. Written in plain language The authorization should include statements of: The individuals right to revoke it, Exceptions to the right to revoke it, How to revoke it. Either that the patients treatment is not conditioned upon signing the form or of the consequences of refusing to sign the form. The potential for re-disclosure by the recipient. The Authorizations are not typically signed by providerprovider does not typically sign authorizations. The entity must give the individual a copy of the signed authorization. Examples: Authorization for Disclosure of Information: Psychotherapy notes Marketing Legal purposes Completing disability applications Reference: 45 CFR parts 160 & 164 Health Insurance Portability and Accountability Act. (HIPAA)  HYPERLINK "http://www.hhs.gov/ocr/hipaa/finalreg.html" http://www.hhs.gov/ocr/hipaa/finalreg.html 3. Other Administrative ConsentsAgreements Definition: An administrative consent agreement is a type of consent that does not directly impact medical care or treatment but informs the individual that an action will be taken upon their approval. Characteristics/Content: These typetypes of consents agreements contain a description of what is being consented to, in some cases, permits certain types of media to be used (i.e. photo, video), and are often used to mitigate financial or medical liability. Generally, the patient or his representative will sign, the provider is may not be required to sign, it is preferable to have the patient sign, and is possible to have a witness sign it may or may not be witnessed. Examples: Release of limb Consent to photograph or videotape Organ donation not end of life (kidney for relative, bone marrow)Organ donation Organ Donation (This may be accomplished by completing an organ donation card and carrying it in your wallet. A second card may be placed with important papers (such as a living will, insurance papers, and so on.) Most hospitals or other major health care centers have organ donor information available.) Autopsy Refusal of Treatment (Discharge against medical advice (AMA)). Transfer or discharge to another healthcare entity (advising of the need, plan, and alternatives) Admission Request for confidential communication (i.e. consent to communicate with patient via voicemail, e-mail, etc.) 4. Acknowledgement/Notification Definition: An acknowledgment or notification is a type of document in which the patient is signingsigns that they have received documentation or information from an organizationhealthcare entity. Content/Characteristics: Acknowledgments are patient specific and include the patient signature. The documentation on the form is the notification from a care provider and the patient verifies/acknowledges s thaeyt received information by their signature. Example: b. Receipt of Patient Bill of Rights and Responsibilities. c. Notification of exposure (e.g. communicable diseases, radioactive materials) d. Notification of dischargePatient discharge (post care) instructions. (patient e. Right to of Advance Directives/Limitation of Treatments information. f. Acknowledgement of receipt of Notice of Privacy Practices g. 5. Clinical Release/Approval Definition: A clinical release/approval is a paper or electronic document, which is often initiated by the patient to be signed by a clinician (e.g. to request an exemption from complying with a law/regulation due to a medical condition.). The document is often initiated by the patient and authorized by a clinician. This mayA also this may apply for the removal of a restriction once conditions have been met and approved by the clinician. Characteristics/ Content: This type of document is often a standard form that must be filled out by the physician or provider. Typically it contains the physician/provider signature. It is recommend that if a clinician signs the document that the organizationhealthcare entity retain the original and once compliance has been met return the document. Examples:: a. Release from seat-belt use b. Obtain handicap-parking permit Release from seat-belt use Smoking in the healthcare entity (JCAHO EC.1.30) Epileptics to drive (indicating seizure free) Fitness for duty 6. Request/ApprovalPatient right of exercise regarding protected health information. Definition: This document is utilized for the exercise of the patients rights with respect to their protected health information per state and/or federal health information privacy law or regulations.when a patient or patients representative is requesting the entity to perform an action and each request requires the entity to respond . Generally these documents are non-clinical in nature. Characteristics/Content: This type of document includes information on the request, the individuals signature and date. The document may also include the care providers response to the request or the response may be found on another document. Generally these documents are non-clinical in nature. Example: Request for health information (medical record) MR amendment and healthcare entity /response Request for restriction (access, disclosure, directory info, anonymity) and healthcare entity response /response Request for accounting of disclosures and healthcare entity response/response Request for confidential communication (alternate address & phone number) and healthcare entity response/response Request to Restrict Access and healthcare entity response/response Request to Remain Anonymous and healthcare entity response /response 7. Legal Transfer of Power Agreements Definition: These documents transfer decision-making authority from the patient to a third party. The process for obtaining, The scope, the and content, and process for obtainingof these documents are is defined and/or controlled by prevailing law. Characteristics/Content: These documents may describe under what circumstances these powers are transferred and/or revoked to a third party and including any restrictions or limitations. They include the patient or legal authoritys signature and date. They may include a notarized and/or witness signature. Once executed it is incorporated into the patients health record. Examples: Power of Attorney General Power of Attorney (Typically over financial issues) Health Care Power of Attorney (The durable power of attorney for health care is theDurable Power of Attorney over Health Care affairs legal document that names a patient's health care proxy. Once written, it should be signed, dated, witnessed, notarized, copied, distributed, and incorporated into the patient's medical record.) (The precise terminology for this type of document is specified by the state in the US Realm). Limited scope or Special Power of Attorney (A power of attorney for a limited purpose. Revocations of Transfer of Power Agreements. 8. Advance DirectivesEnd of Life Directives Definition: Advanced care directivesDirectives of this nature allow patients to make their own decisions regarding end of life the care decisions they would prefer to receive ifshould they develop a terminal illness, or contract a life-threatening injury, or a complication of medical treatment. Advanced care directives are also used to designate someone the patient trusts to make decisions about medical care, if the patient becomes unable to make (or communicate) these decisions. Characteristics/Content: These documents directives describe the circumstances of when to enact the patients wishes regarding the end of life decisions.under which care services should be withheld or handled in a specific manner. In order to be considered valid these documents are signed by the patient or their respresentative and authenticated by a witness or notary. The healthcare entity has a mechanism for healthcare professionals and designated representatives to honor end of life directives within the limits of the law and the entitys capabilities. and acknowledged by the providers staff. This may include specific procedures, care, or treatments such as the following: CPR, if cardiac or respiratory arrest occurs Artificial nutrition through intravenous or tube feedings Prolonged maintenance on a respirator, if unable to breathe adequately alone Blood cultures, spinal fluid evaluations, and other diagnostics tests Blood transfusions Disposition of body after death (e.g. for cadaver dissections). Donation of organs. Examples: Organ donation b. Living Will - A written, legal document that conveys the wishes of an individual in the event he/she becomes terminally ill and incapable of communicating. A living will may indicate specific care or treatment the person does or does not wish to have implemented in the event of a terminal illness. This document is generally created externally to the healthcare entity. Advanced Directives/Limitations of treatments are generally created with the healthcare entity in the context of an active episode of care and the absence of an existing living will or health care proxy. Reference: JCAHO Comprehensive Accreditation Manual for Hospitals 2005. Accreditation standard RI.2.80 This may include specific procedures, care, or treatments such as the following: CPR, if cardiac or respiratory arrest occurs Artificial nutrition through intravenous or tube feedings Prolonged maintenance on a respirator, if unable to breathe adequately alone Blood cultures, spinal fluid evaluations, and other diagnostics tests Blood transfusions Disposition of organs (organ donation). 9. Financial Agreements/Authorization Definition: These are fFinancial Aagreements are between the individual and the healthcare entity dealing with claim payments, risk management, and the binding and non-binding arbitration process. These are agreements outline each partys rights and obligations. Characteristics/Content: These types of agreements help determine who has financial responsibility for the health services and to determine the ability to pay if the patient is the responsible party. Generally, the patient and/or his representative along with the healthcare entitys representative will sign. Examples: Agreement to bill medical spending account Agreement to financial counseling Agree to enter into a credit agreement Agree to arbitrate (binding & non-binding) Advanced Beneficiary Notice Payment Plan Recourse for default on agreement. Approval to perform a credit check. Limitations to use of information (Fair credit reporting act). Privacy disclaimer. Complex documents: 1. Multipurpose Compound Document A multipurpose single document that has multiple purposes signed once by the patient. Examples: Consent for treatment, release of information to the payer; opt out of patient directory combined in one form with one signature. 2. Compound Document Set: Collection of documents in which each part is signed by the individual Document Set. Multiple purposes for d Examples: Consent for treatment, release of information to the payer, opt out of patient directory combined in one form with one signature. 10. Other International Categories We have set aside a category for other types of medicolegal agreements that are found in non-US healthcare settings. We ask for assistance from the international community in identifying additional types of documents. This category will be deleted if unnecessary. This segment identifies patient consent information relating to a particular message. It can be used as part of existing messages to convey information about patient consent to procedures, admissions, information release/exchange or other events discussed by the message. It may also be used in messages focusing on recording or requesting consent and for consents related to employees or service providers. The segment will be used in conjunction with various other segments to identify the practitioner (PRA/STF) or patient (PID) the consent is for, the various individuals involved in the consent (ROL) as witnesses, consenting person (not always the patient), translators, consulting providers, etc., and the specific procedures being proposed (PR1). Note the following section is for further discussion and location in chapter. This refers more toward the structure of the document rather than nature or purpose. (For discussion at the January 2006 WGM) Complex documents: Multipurpose Compound Document A multipurpose single document that has multiple purposes signed once by the patient. Examples: Consent for treatment, release of information to the payer; opt out of patient directory combined in one form with one signature. Compound Document Set: Collection of documents in which each part is signed by the individual Document Set. Multiple purposes for d Examples: Consent for treatment, release of information to the payer, opt out of patient directory combined in one form with one signature. Justification Segment-what changes do we need? The issue of patient consent has become more important, particularly in the tracking of consent for the release of or exchange of information. The pieces of information recorded when dealing with a patient consent tend to be similar, regardless of the purpose of the consent. This segment combines these pieces of information so that they can be used for consents of any type. Fields does each type of agreement need to have these fields designed or will generic work? Do we need to change consent to agreement? Consent Type: In concert with giving consent, some programs may allow patients to request varying degrees of participation in a given program. I.e. if consent program relates to a patients entire medical record being available online they might have the opportunity to only reveal certain portions of that history such as the drug history only.. Consent Form ID: Some institutions may have a set of pre-defined consent forms. Identifying the specific form identifies the details the subject is consenting to, as well as what information is on the form. Consent Text: When recording consents electronically it is important to know the specific text that was presented to the consenting person. Subject-specific Consent Text: Sometimes consent forms have areas where details of the procedure or information distribution that are specific to a given consent instance are recorded, i.e. a variation on a common procedure, or an explicit listing of documents to be released. As this is part of the consent document, it needs to be recorded. It is helpful to keep this information separate from the standard template consent text, as in most circumstances people viewing the consent will want to know Whats different from usual. Background Text: In most cases in the health field, consent must be informed consent. This means that the consenting individual must understand and appreciate the implications of what they are consenting to. Most consent processes involve providing background material describing the reasons for the proposed service, expected benefits and potential risks. It is important to have a record of what information was presented to the subject at the time of consent. Subject-specific Background Text: The reasons, expected benefits and risks may vary from subject to subject. It may be necessary to inform the subject of background information that only applies to their particular circumstance. Subject-imposed Limitations: At the time of consent, the subject may wish to make modifications or add limitations to their consent. These modifications and limitations must be recorded. Consent Mode: The manner in which consent can be given may vary greatly within a specific program, from program to program, or from organizationhealthcare entity to organizationhealthcare entity. Therefore, the standard must allow applications to identify how consent was obtained (i.e. verbally, written, etc.). Consent Status: Consent can be pending (subject hasnt been asked yet), given, refused, revoked or even completely bypassed. Consent Status identifies what the status of a subjects consent is (or was at a given point in time). Consent Discussion Date/Time: For informed consent, a knowledgeable person must discuss the ramifications of consent with the subject. In some instances, this discussion is required to take place prior to the provision of consent. This ensures that the subject has sufficient time to consider the ramifications of their decision. To ensure that guidelines are followed, it is imperative to record when the consent information was initially discussed with the subject. Consent Decision Date/Time: Related to the above, there also needs to be a record of the time the subject actually made their consent decision. Consent Effective Date/Time: Not all consents take effect at the time the consent decision is made. They may not become effective for some time, or in certain circumstances they may even be retroactive. Use this field to record the effective time. . Consent End Date/Time: For most programs requiring voluntary participation, the decision to participate is not final and therefore may be revoked in the future. Therefore, when a patient makes the decision to revoke their consent, the date and time on which the decision was made must be recorded in order to provide a complete history of the consent. Alternatively, the initial consent may only have been granted for a limited period of time (i.e. 24 hours, 1 week, 1 year). If Consent End Date/Time is null, this should be interpreted as indefinite. Subject Competence Indicator: One of the issues involved in informed consent is whether the subject is judged to be competent to provide consent on their own behalf. Factors involve age, mental capacity, and current state of health/awareness. A professional judgment about whether the subject is deemed competent must be made and recorded. Translator Assistance Indicator: To obtain informed consent, the patient must understand what they are consenting to. For subjects who do not understand the commonly used language of the institution, or who are unable to hear/read/speak, translation services may be required. Translation Type: To obtain informed consent, the patient must understand what they are consenting to. For subjects who do not understand the commonly used language of the institution, or who are unable to hear/read/speak, translation services may be required. An indication of what type(s) of translation were/will be performed is required. Informational Material Supplied Indicator: As part of the informed consent process, additional material in the form of pamphlets, books, brochures, videos, etc. may be provided to the patient. An indication of whether this has been done is required. (Details on the materials provided will be sent using a separate segment.) Consent Bypass Reason: There may arise situations in which an action must be performed without patient consent (i.e. retrieving an unconscious patients drug history, performing life saving surgery, etc.). This field indicates the rationale for accessing information without obtaining the required consent. Consent Disclosure Level: Identifies whether the subject was provided with information on the full background information on the procedure, the subject is giving consent to, i.e. has all information needed for informed consent been provided. Consent Non-disclosure Reason: Identifies why information was withheld from the patient (i.e. telling the patient may cause a worse outcome than performing the procedure). Use Case(s)Insert additional use cases by agreement type? Are current cases still useful? A patient decides to participate in a voluntary electronic drug history program. The patient records this decision in writing (Consent Mode) on a pre-designed consent form (Consent Form ID and Version) after their health care service provider has explained the benefits and drawbacks of their participation. In providing consent, the patient can also decide on the degree to which they will participate in the program (Consent Type). The consent decision (Consent Status) is recorded under the patients name (use ROL segment) and the number of the paper-based form that the patient signed is recorded in the electronic consent gathering function (Consent Number). The patients consent is effective from the day of the decision (Consent Effect Date/Time), but this consent can be terminated at the patients discretion at a given date in the future (Consent End Date/Time). Several months later the patient is rushed into an emergency health care facility with what appears to be a drug reaction. While checking the patients drug history, health care service providers find that the patients drug history has controlled access. The patient is unable to provide access to this information given their physical state, so the health care service provider circumvents the consent process (Non-consent Access Reason) in the interests of the patients immediate well-being. A patient is seeking a therapeutic abortion. Because she is under 18, the practitioner must evaluate her competence to provide consent. The patient is deemed to be competent (Patient Competence Indicator). Local legislation mandates that the patient be counseled at least 24 hours prior to receiving the procedure. The patient is counseled, and the time recorded (Consent Discussion Date/Time). They are also given a pamphlet to take home and read (Informational Material Supplied Indicator). They return the following day and sign the consent form (Consent Decision Date/Time) A deaf patient is admitted for labor and delivery. It becomes apparent the patient will require a cesarean section. A translator is required (Translator Assistance Indicator) who can translate sign language (Translation Type). The translator explains the details of the procedure the patient is being asked to consent to (Consent Text), the intention to use epidural anesthetic (Subject-specific Consent Text), the general risks associated with doing the procedure, as well as those with not doing the procedure (Background Text) and benefits associated with the epidural (Subject-specific Background Text). The patient agrees to the procedure, subject to the condition that she not be given any blood products for religious reasons (Subject-imposed Limitations). An employee signs a consent form authorizing (Consent Status) a hospital to request their driving records from the local Department of Motor Vehicles (Consent Type). A patient signs a consent form to have basic diagnostic and billing information sent to their insurer. The consent indicates that information may only be given to parties that are bound by HIPPA guidelines (Trust Agreement Restriction Type) CON Consent Segment Medicolegal Agreement segment Does CON/consent throughout 9.1.4 need to be changed to Agreement? The consent segment provides details about a specific consent by a patient or staff member. HL7 Attribute Table CON Consent Segment  XE "HL7 Attribute Table: CON "  SEQLENDTOPTRP/#TBL#ITEM#ELEMENT NAME14SIR01776Set ID - CON2250CWEO HYPERLINK \l "usertab496" 049601777Consent Type340STO01778Consent Form ID 4180EIO01779Consent Form Number564KFTOY01780Consent Text664KFTOY01781Subject-specific Consent Text764KFTOY01782Consent Background864KFTOY01783Subject-specific Consent Background964KFTOY01784Consenter-imposed limitations102CNEO049701785Consent Mode112CNER049801786Consent Status1224DTMO01787Consent Discussion Date/Time1324DTMO01788Consent Decision Date/Time1424DTMO01789Consent Effective Date/Time1524DTMO01790Consent End Date/Time161IDO013601791Subject Competence Indicator171IDO013601792Translator Assistance Indicator181IDO029601793Language Translated To191IDO013601794Informational Material Supplied Indicator20250CWEO049901795Consent Bypass Reason211IDO050001796Consent Disclosure Level22250CWEO050101797Consent Non-disclosure Reason23250CWEO050201798Non-subject Consenter Reason24250XPNRY01909Consenter ID25100ISRY054801898Relationship to Subject TableCON Segment Field Definitions CON-1 Set ID (SI) 01776 Definition: This field contains the number that identifies this segment instance within the message. For the first occurrence of the segment, the sequence number shall be one, for the second occurrence, the sequence number shall be two, etc. CON-2 Consent Type (CWE) 01777 Components: ^ ^ ^ ^ ^ ^ ^ ^ The component descriptions presented here are provided for readability. The implementer should treat the component descriptions in Chapter 2 as the definitive content. Components: ^ ^ ^ ^ ^ ^ ^ ^ Definition: This field describes what the subject is consenting to, i.e. what type of service, surgical procedure, information access/release or other event. For values see  HYPERLINK \l "usertab496" User-Defined Table 0496 Consent Type. User Defined Table 0496 Consent Type ValueDescriptionComment001Release of Information/MR / Authorization to Disclosure Protected Health InformationRelease of Info/ Disclosure002Medical Procedure (invasive)Medical Treatment/ Procedure 003Acknowledge Receipt of Privacy NoticeAcknowledgement/ Notification004AbortionMedical Treatment/ Procedure 005Abortion/LaminariaMedical Treatment/ Procedure 006Accutane InformationMedical Treatment/ Procedure 007Accutane WomanMedical Treatment/ Procedure 008Advanced Beneficiary NoticeAcknowledgement/ Notification009AFP (Alpha Fetoprotein) ScreeningMedical Treatment/ Procedure 010Amniocentesis (consent & refusal)Medical Treatment/ Procedure 011Anatomical Gift (organ donation)Administrative 012Anesthesia - ComplicationsMedical Treatment/ Procedure 013Anesthesia - QuestionnaireMedical Treatment/ Procedure 014AngiogramMedical Treatment/ Procedure 015AngioplastyMedical Treatment/ Procedure 016Anticancer DrugsMedical Treatment/ Procedure 017Antipsychotic MedicationsMedical Treatment/ Procedure 018ArthrogramMedical Treatment/ Procedure 019AutopsyAdministrative 020AZT TherapyMedical Treatment/ Procedure 021Biliary DrainageMedical Treatment/ Procedure 022Biliary Stone ExtractionMedical Treatment/ Procedure 023BiopsyMedical Treatment/ Procedure 024Bleeding Time TestMedical Treatment/ Procedure 025BronchogramMedical Treatment/ Procedure 026Cardiac CatheterizationMedical Treatment/ Procedure 027Coronary AngiographyMedical Treatment/ Procedure 028"" "" w/o Surgery CapabilityMedical Treatment/ Procedure 029Cataract Op/Implant of FDA Aprvd LensMedical Treatment/ Procedure 030Cataract Op/Implant of Investigational LensMedical Treatment/ Procedure 031Cataract SurgeryMedical Treatment/ Procedure 032Cholera ImmunizationMedical Treatment/ Procedure 033Cholesterol ScreeningMedical Treatment/ Procedure 034Circumcision NewbornMedical Treatment/ Procedure 035ColonoscopyMedical Treatment/ Procedure 036Contact LensesMedical Treatment/ Procedure 037CT Scan - Cervical & LumbarMedical Treatment/ Procedure 038CT Scan w/ IV Contrast Media into VeinMedical Treatment/ Procedure 039CVS (Chorionic Villus) SamplingMedical Treatment/ Procedure 040CystospyMedical Treatment/ Procedure 041Disclosure of Protected Health Information to Family/FriendsRelease of Info/ Disclosure042D & C and ConizationMedical Treatment/ Procedure 043DacryocystogramMedical Treatment/ Procedure 044Diagnostic IsotopeMedical Treatment/ Procedure 045Drainage of an AbscessMedical Treatment/ Procedure 046Drug ScreeningMedical Treatment/ Procedure 047Electronic Monitoring of Labor - RefusalMedical Treatment/ Procedure 048Endometrial BiopsyMedical Treatment/ Procedure 049Endoscopy/Sclerosis of Esophageal VaricesMedical Treatment/ Procedure 050ERCPMedical Treatment/ Procedure 051Exposure to reportable Communicable DiseaseMedical Treatment/ Procedure 052External VersionMedical Treatment/ Procedure 053Fluorescein AngioscopyMedical Treatment/ Procedure 054Hepatitis B - Consent/DeclinationMedical Treatment/ Procedure 055HerniogramMedical Treatment/ Procedure 056HIV Test - Consent RefusalMedical Treatment/ Procedure 057HIV Test - DisclosureMedical Treatment/ Procedure 058HIV Test - PrenatalMedical Treatment/ Procedure 059Home IV Treatment ProgramMedical Treatment/ Procedure 060Home Parenteral Treatment ProgramMedical Treatment/ Procedure 061HysterectomyMedical Treatment/ Procedure 062HysterosalpingogramMedical Treatment/ Procedure 063Injection Slip/ ConsentMedical Treatment/ Procedure 064Intrauterine DeviceMedical Treatment/ Procedure 065Intrauterine Device/SterilizationMedical Treatment/ Procedure 066Intravascular Infusion of Streptokinase/UrokinaseMedical Treatment/ Procedure 067Intravenous CholangiogramMedical Treatment/ Procedure 068Intravenous Digital AngiographyMedical Treatment/ Procedure 069Iodine AdministrationMedical Treatment/ Procedure 070ISGMedical Treatment/ Procedure 071IVPMedical Treatment/ Procedure 072Laser PhotocoagulationMedical Treatment/ Procedure 073Laser treatmentMedical Treatment/ Procedure 074Lithium CarbonateMedical Treatment/ Procedure 075Liver BiopsyMedical Treatment/ Procedure 076Lumbar PunctureMedical Treatment/ Procedure 077LymphangiogramMedical Treatment/ Procedure 078MAO InhibitorsMedical Treatment/ Procedure 079Med, Psych, and/or Drug/AlcoholRelease of Info/ Disclosure 080Medical Treatment - RefusalAdministrative 081Morning-after PillMedical Treatment/ Procedure 082MRI AdultMedical Treatment/ Procedure 083MRI PediatricMedical Treatment/ Procedure 084MyelogramMedical Treatment/ Procedure 085Needle BiopsyMedical Treatment/ Procedure 086Needle Biopsy of LungMedical Treatment/ Procedure 087Newborn Treatment and ReleaseMedical Treatment/ Procedure 088Norplant Subdermal Birth Control ImplantMedical Treatment/ Procedure 089Operations, Anesthesia, TransfusionsMedical Treatment/ Procedure 090Oral ContraceptivesMedical Treatment/ Procedure 091Organ DonationAdministrative092Patient Permits, ConsentsAdministrative 093Patient Treatment Permit, Release & AdmissionAdministrative 094Penile InjectionsMedical Treatment/ Procedure 095Percutaneous NephrostomyMedical Treatment/ Procedure 096Percutaneous Transhepatic CholangiogramMedical Treatment/ Procedure 097Photographs Release of Info/ Disclosure098Photographs - EmployeeRelease of Info/ Disclosure 099Photographs - Medical ResearchRelease of Info/ Disclosure 100Photographs - news MediaRelease of Info/ Disclosure 101Psychiatric Admission - Next of KinMedical Treatment/ Procedure 102Psychiatric Information During Hospital StayRelease of Info/ Disclosure 103Public Release of InformationRelease of Info/ Disclosure 104Radiologic ProcedureMedical Treatment/ Procedure 105Refusal of TreatmentAdministrative106Release of BodyAdministrative107Release of LimbAdministrative108Rh Immune GlobulinMedical Treatment/ Procedure 109Rights of Medical Research ParticipantsAdministrative 110Request to Restrict Access/Disclosure to Medical Record/Protected Health InformationRelease of Info/ Disclosure111Request for Remain AnonymousRelease of Info/ Disclosure112Seat Belt ExemptionAdministrative 113SialogramMedical Treatment/ Procedure 114SigmoidoscopyMedical Treatment/ Procedure 115Sterilization - Anesthesia & Medical ServicesMedical Treatment/ Procedure 116Sterilization -Federally FundedMedical Treatment/ Procedure 117Sterilization FemaleMedical Treatment/ Procedure 118Sterilization - Laparoscopy/PomeroyMedical Treatment/ Procedure 119Sterilization - Non-Federally FundedMedical Treatment/ Procedure 120Sterilization - SecondaryMedical Treatment/ Procedure 121TranquilizersMedical Treatment/ Procedure 122Transfer - AcknowledgementMedical Treatment/ Procedure 123Transfer AuthorizationMedical Treatment/ Procedure 124Transfer Certification - PhysicianMedical Treatment/ Procedure 125Transfer/Discharge RequestMedical Treatment/ Procedure 126Transfer for Non-Medical ReasonsMedical Treatment/ Procedure 127Transfer - Interfaculty NeonatalMedical Treatment/ Procedure 128Transfer RefusalMedical Treatment/ Procedure 129Transfer Refusal of Further TreatmentMedical Treatment/ Procedure 130Treadmill & EKGMedical Treatment/ Procedure 131Treadmill, Thallium-201Medical Treatment/ Procedure 132TyphoidMedical Treatment/ Procedure 133Use of Investigational DeviceMedical Treatment/ Procedure 134Use of Investigational DrugMedical Treatment/ Procedure 135VenogramMedical Treatment/ Procedure 136VideotapeRelease of Info/ Disclosure1137Voiding CystogramMedical Treatment/ Procedure CON-3 Consent Form ID and Version (ST) 01778 Definition: Identifies a specific version of a consent form used to record the consent. A given version of a consent form implies a particular set of wording that appears on the form. CON-4 Consent Form Number (EI) 01779 Components: ^ ^ ^ The component descriptions presented here are provided for readability. The implementer should treat the component descriptions in Chapter 2 as the definitive content. Components: ^ ^ ^ Definition: Uniquely identifies a specific recorded consent. This may be the number assigned to an electronic consent, or may be the number on a printed consent form. CON-5 Consent Text (FT) 01780 Definition: Describes the specific procedures/information releases/events the subject is consenting to. CON-6 Subject-specific Consent Text (FT) 01781 Definition: Describes any additions or variations to the standard procedures/information releases/events from a standard consent that are applicable to the subject whose consent is sought. CON-7 Background Text (FT) 01782 Definition: Describes any additional information relating to the procedure/information release/event that needs to be understood by the subject for informed consent. May include the reason for the service, the expected benefit, risks, etc. CON-8 Subject-specific Background Text (FT) 01783 Definition: Describes any additions or variations to the standard additional information that needs to be understood by the patient for informed consent. May include a description of benefits and risks that are specific to the subject from whom consent is sought. May also include an indication that there are no subject-specific risks/benefits. CON-9 Consenter-imposed Limitations (FT) 01784 Definition: Describes any restrictions or limitations placed on their consent by the subject. CON-10 Consent Mode (CNE) 01785 Components: ^ ^ ^ ^ ^ ^ ^ ^ The component descriptions presented here are provided for readability. The implementer should treat the component descriptions in Chapter 2 as the definitive content. Components: ^ ^ ^ ^ ^ ^ ^ ^ Definition: The method in which a subject provides consent. HL7 Table 0497 Consent Mode ValueDescriptionCommentVVerbalWWrittenTTelephoneCON-11 Consent Status (CNE) 01786 Components: ^ ^ ^ ^ ^ ^ ^ ^ The component descriptions presented here are provided for readability. The implementer should treat the component descriptions in Chapter 2 as the definitive content. Components: ^ ^ ^ ^ ^ ^ ^ ^ Definition: Indicates whether consent has been sought and granted. HL7 Table 0498 Consent Status ValueDescriptionCommentAActive Consent has been grantedLLimited Consent has been granted with limitationsRRefused Consent has been refusedPPending Consent has not yet been soughtXRescinded Consent was initially granted, but was subsequently revoked or ended.BBypassed (Consent not sought)CON-12 Consent Discussion Date/Time (DTM) 01787 Components: