Information in the Terminology TSR attachment to Neurology: Traumatic Brain Injury (TBI) Screening Rule artifact

[ssebast2]

@preston @linophth I noticed the following information in the Issues tab of the Terminology TSR excel spreadsheet. Is that okay to publish or would you prefer that we edit peoples names? Now that I look back at the Neurosurgery artifacts, similar information and Replies are also present in those Terminology TSRs.

It is completely up to you. I just wanted to provide an opportunity for you to consider this.

I temporarily removed the Terminology TSR from the Neurology: Traumatic Brain Injury (TBI) - Polytrauma Interdisciplinary Rehab Clinic Order Set artifact, which was just published a few minutes ago until you are able to respond to this question.

Thanks, Sharon

Neurology: Traumatic Brain Injury (TBI) Screening Rule artifact Tab	Opened by	Instance Request	Issue	Reply	Status
Performance	Deb Konicek	Persistent Dizziness and Balance Disorder	Split into 2 concepts: Persistent Dizziness & Persistent Balance Disorder		Closed
Performance	Deb Konicek	Peristent Vision Changes Light Sensitivity	Split into 2 concepts: Persistent Vision Changes & Persistent Light Sensitivity		Closed
Performance	Deb Konicek	Peristent Numbness And Or Tingling	Split into 2 concepts: Persistent Numbness & Persistent Tingling		Closed
Performance	Deb Konicek	Peristent Memory Cognitive Problems	Split into 2 concepts: Persistent Memory Problems and Persistent Cognitive Problems		Closed
Performance	catherine staes	Mild Traumatic Brain Injury   Please check my syntax	I removed the note in red		Closed

Neurosurgery Terminology TSR:

Opened by	Instance Request	Issue	Reply	Status
Deb Konicek	Symptoms acute, subacute and chronic	Regarding how to specify units of measure to differentiate between days, weeks, months, or will that be specified as part of ISO 8601?	3/23/2018 Kirsten: In accordance with Dr. Cambell's guidance during the ANF call yesterday, I used the measure.semantic "P14D; ISO 8601 prior to statement time". The P14D prefix defines 14 days in the ISO 8601 syntax. Using the upper/lower bounds tries to capture "less than" 2 weeks. I propose to do it this way consistently until we can verify it with Dr. Campbell. I added this to the "Dr. Campbell Parking Lot" list.	Closed
Scott Wood	Col Y: Symptoms Subacute (less than 3 months)	These intervals seem to be 1) ambiguous in some cases and 2) have gaps in others. 1) For example, it is unclear how to represent onset at 3 weeks. As you did with Col X, it seems that we may need to drop down to the next finer resolution (such as weeks) to capture the value. 2) I read the coding for the timing interval in Y as [0 months < onset < 3 months], which also captures the interval for Col X (i.e. not mutually exclusive) and can't specify 3 weeks exactly (but maybe it is not intended to capture at that resolution?). Similarly, I read the interval for Col Z as [3 months < onset], so there is no way to capture an onset of exactly 3 months.	3/26/2018 Deb: Per Dr. Campbell's guidance on the IA:CDS call today, please see the current timing interval decisions for Symptoms Acute, Subacute and Chronic.	Closed
Scott Wood	Col AH: Cognitive behavioral therapy	Shouldn't this also be a "History of…" statement? Please double-check the white paper. If so, needs a timing interval.	3/26/2018 Deb: Did go back and review the WP listing of data elements found within the Prior conservative therapies section of the H&P.  This one was the only one described by Cognitive without the "History of" Changed description of term and added timing interval.	Closed
Scott Wood	Col AL: History of Chronic Pain	Topic incorrectly coded as History of Epidural	3/26/2018 Deb: Correctly changed to focus of Chronic pain.	Closed
Scott Wood	Col AT: History of Rehabilitation	This coding, 52052004, Rehabilitation Therapy, seems overly general as it includes both physical rehab and substance rehab. In the context of the IR's in this area of the TSR, it seems that they are coding substance rehab specifically, such that someone who has undergone physical rehab could be incorrectly coded as having a history of substance abuse. If the white paper is ambiguous, then we need to note that for the white paper team.	3/26/2018 Deb: Per strict current editorial policy of not making assumptions and to only encode what is represented within the actual IR stated description, leave this as general Rehabilitation Therapy as stated in White Paper and IR.	Closed

[linophth]

I will forward this to leadership in my office to see how they want to handle this. Specifically, I will ask the terminology and the informatics architecture leads.

[ssebast2]

Sounds good. Thanks Linda!

[preston]

Just my $0.02, but I think we should continue to leave them as-is unless there is personal information or something else that clearly needs to be removed/redacted. This is good information that adds a lots of context and detail to the consumer: the thinking that went into terminology and modeling of the artifact.

[linophth]

I just heard back from Keith Campbell: "I’m ok keeping names. I don’t know if there are any workplace privacy issues that would violate however. I don’t think we created any expectation of anonymity in the process../" I vote to leave it as is.

[ssebast2]

Thank you very much for checking @linophth. Is that the final word?

[linophth]

OK, here is the final decision for our office from @a-dru-desai . Can we replace all names with initials? The idea is to try to prevent sidebar conversations and edits, so we can track all comments on and edits to the documents.

[a-dru-desai]

Alternatively, just include the Instance Request, Issue and Status columns from that tab.

[preston]

@linophth We use full names all over the place, so I'm not sure why we'd want to start redacting only TSRs. We use full names in all white papers XML and artifact XML, as well.

[a-dru-desai]

The names in the CCWPs xml and the associated artifacts are there to show clear “lineage” of the SMEs who provided the clinical content/analysis. The TSRs are (to me) ‘working papers’ capturing terminology efforts, and I’d want to better assure that any Qs are funneled back to VA/KBS/CDS vs. being dispersed.

Mr. Apurva Desai, LL.M, M.S., PMP Health Systems Specialist Office of Knowledge Based Systems (10A7A) 571-389-7035 (direct)/202-430-0044 (cell)/571-248-1596 (alt)

From: Preston Lee [mailto:notifications@github.com] Sent: Thursday, November 29, 2018 11:00 AM To: OSEHRA/vha-kbs-knarts vha-kbs-knarts@noreply.github.com Cc: Desai, Apurva D. Apurva.Desai@va.gov; Mention mention@noreply.github.com Subject: [EXTERNAL] Re: [OSEHRA/vha-kbs-knarts] Information in the Terminology TSR attachment to Neurology: Traumatic Brain Injury (TBI) Screening Rule artifact (#461)

@linophthhttps://github.com/linophth We have fully names all over the place, so I'm not sure why we'd want to start redacting only TSRs. We use full names in all white papers XML and artifact XML, as well.

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[ssebast2]

The reason that I raised the question is because another contributor had a similar situation - where they realized that internal discussions/comments were present on one of the tabs of a working document, and they asked that the comments be removed and reposted. I concur with Apurva that you would want to retain the names of the SMEs that worked on the CDS in the white papers and other documentation. They deserve credit for the work and they are the individuals who would respond to any questions or comments. The Terminology TSRs are very valuable and informative, but since the comments relate to internal discussions as they resolved issues, their names fall in a different category.

[a-dru-desai]

So let’s redact, then.

Mr. Apurva Desai, LL.M, M.S., PMP Health Systems Specialist Office of Knowledge Based Systems (10A7A) 571-389-7035 (direct)/202-430-0044 (cell)/571-248-1596 (alt)

From: ssebast2 [mailto:notifications@github.com] Sent: Thursday, November 29, 2018 11:41 AM To: OSEHRA/vha-kbs-knarts vha-kbs-knarts@noreply.github.com Cc: Desai, Apurva D. Apurva.Desai@va.gov; Mention mention@noreply.github.com Subject: [EXTERNAL] Re: [OSEHRA/vha-kbs-knarts] Information in the Terminology TSR attachment to Neurology: Traumatic Brain Injury (TBI) Screening Rule artifact (#461)

The reason that I raised the question is because another contributor had a similar situation - where they realized that internal discussions/comments were present on one of the tabs of a working document, and they asked that the comments be removed and reposted. I concur with Apurva that you would want to retain the names of the SMEs that worked on the CDS in the white papers and other documentation. They deserve credit for the work and they are the individuals who would respond to any questions or comments. The Terminology TSRs are very valuable and informative, but since the comments relate to internal discussions as they resolved issues, their names fall in a different category.

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[ssebast2]

Okay. I will remove the names of respondents in the Reply column of the Issues tab in each Terminology TSR that is uploaded to an artifact, and just leave their response and the date (when it is available).

[linophth]

Note that people's names are often in more than 1 column, intermingled with the text.

[ssebast2]

@linophth It is a bit of a slippery slope, where you draw the line. The other organization's sensitivity was in the dialogue of the replies to issues (i.e., comments). It may become a LOE constraint to make changes across the entire spreadsheet. I've replaced individual's names with "Reply:" in the Reply column. If you want, I can also remove Column B entirely (Opened by) and the names of individuals in the TSR Submission Detail tab entered in the Submitted By, Assess By and Final Review By. Since they are more "formal" entries, they wouldn't be misinterpreted so they don't seem as sensitive.

It is up to you. Please let me know how you would like me to proceed.

[a-dru-desai]

All;

If all names in the reply column have been replaced with “Reply” and we take out the “Opened By” column, I think we’ve covered the bases per the start of this discussion this am.

Mr. Apurva Desai, LL.M, M.S., PMP

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[ssebast2]

Sounds good. Thanks everyone!