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Contents 1 DEEDS Update and Revision 1.1 Data Elements for Emergency Department Systems 1.2 Changes 1.3 Vision 2 Wishlist 3 Major changes for release 1.1 3.1 Status of This Update

[edit] DEEDS Update and Revision

[edit] Data Elements for Emergency Department Systems

Data Elements for Emergency Department Systems (q.v. CDC DEEDS page) is undergoing major revisions to bring it in line with existing SDOs, conform with HIPAA, follow NCVHS guidance and reflect the modern emergency care clinical environment.

[edit] Changes

Changes include deprecating "DEEDS_ID" as a terminology/identifier. Replacement of NDC with RxNorm for drugs, elimination of any DEEDS defined/specific codes, addition of some identified missing elements (e.g. cranial nerve exam), and use of standard reference terminologies for identifiers for response sets. A new DEEDS ID system will be implemented, with each element given a meaningless identifier, and mapped to existing controlled terminologies, such as LOINC or SNOMED-CT Observable Entities. Many, many existing data elements are deprecated, particularly all those which fall into the pattern of:

1. Some event or observation
2. ID of the person responsible
3. The type of provider responsible
4. The time/date stamp

or

1. "first ED" something

These will all be rolled into a single element, which will not have distinct identifiers for the various components. The "first ED something" pattern will be deprecated in favor of simply understanding that the first ED anything will be the head of a list (or element 0 in an array), and everything in DEEDS will have the ability to capture the identity of the person performing it, the identity of anyone supervising, the legal authenticator and time-stamps of the observation, signature acts and availability to the system.

An enumeration of those elements slated for inclusion in release 1.1 will be posted within the next few weeks.

Please see the DEEDS 1.1 Elements page for more background.

--KevinCoonanMD 19:11, 19 April 2007 (PDT)

[edit] Vision

Goals of this update:

1. Describe a process and procedures for future updates and revisions
2. Provide standards-based DEEDS element identifiers
3. Provide standards-based DEEDS answers
4. Add a limited number of new elements
5. Reference a rapidly evolving chief complaint model
6. Begin migration to technology independent description of the data elements

[edit] Wishlist

Please use this talk/discussion or the DEEDS Wishlist page to indicate data elements which you need/want, or any other guidance or advice. These are intended to provide those who are not taking an active role in the redesign process a mechanism to provide input to the update and revision team.

[edit] Major changes for release 1.1

• Limited number of new data elements (see next section for details)
  • New chief complaint/presenting problem model
  • Component model for Glasgow coma score
  • Missing physical examination attributes
• Mapping of section and element numbering and identifiers to external controlled terminologies
• Identification of elements which have existing definitions and identifiers which are as close as possible to the meaning in the DEEDS model
• Replacement of internal code tables for values with identifiers from external controlled terminologies

1. 1. We will be attempting to do some basic harmonization and support for the IHE Emergency Department Encounter Record as time/resources permit.

[edit] Status of This Update

This update is currently in preparation and this document is provided for comment only. DEEDS is a work in progress and it will see frequent updates and revisions. This particular revision of the DEEDS document in particular should not be taken to be any sort of recommendation or specification for implementation.

Furthermore, this is only an incremental change, and implementers are encouraged to defer design and planning until after version 1.3 is released, or plan to modify their work as the revisions evolve. The DEEDS Workgroup encourages all implementers to become active participants. Many changes will require on-going input from stakeholders and technical experts. Forthcoming updates will have a more formal object model as well as an XML Schema published to help resolve any ambiguity introduced by this version. DEEDS will remain an abstract description of a shared model and the use of a particular publication artifact (e.g. XML Schema, UML Diagram, or Entity-Relationship Diagram) is simply to convey the model in as unambiguous and understandable a format as possible. Future work by the Workgroup and the EC-SIG is geared to creation of detailed specifications and standards through HL7.

This revision is not complete or final. This is a step in the transition to a version approved by a recognized standards organization. However, there is a clear case for early release of changes which are clearly identifiable to allow comment and input from interested parties.

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