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CCOW_TC_Jan2002_Minutes Powered By Docstoc
Rob Seliger, Sentillion
Dan Soule, Cerner
David Fusari, Sentillion
Zina Kagan, Oracle
Darrell Henson, cMore Medical
James MacLean, Affinitex
Eric Weaver, Sentillion
Michael Russell, Duke
Joan Miller, Siemens
Andrew Woyak, Medscape/Medicalogic
Blair Cockerline, University Of Washington
Heath Frankel, HL7 Australia
BJ Lawson, Mercury MD

Co-Chair election:
-The only person nominated was Barry Royer from Siemens and he is currently a co-chair. He
was unanimously reelected to another 2 year term as co-chair.

CCOW 1.4 ballot issues:
-all submitted issues were typos or clarifications, except one
-one issue was to add optional HL7 order identifier items to the DICOM Study subject. All agreed
with this recommendation, that it was not a substantive, and will be added to the CCOW 1.4 Data
Definitions document.

CCOW as it relates to HL7 V3.0:
-Mead Walker described the RIM and its structure
-It was discussed where CCOW could make use of HL7 3.0 concepts but more issues were
raised the more it was discussed:
  - Should the CCOW object model presented by Rob Seliger (still needs fleshing out) be
incorporated into the RIM?
  - How do CCOW objects like Patient and User map to the RIM abstract of Person (perhaps
through role)?
  - How can secure subjects be represented
-CCOW is already making use of object modeling concepts as well as an abstract architecture
and technology mappings. There was some discussion as to how CCOW could contribute to HL7
messaging and add component level breakdowns to help realize the slogan "HL7 is more than
messaging". It was observed that the RIM is mixing message passing with the domain model
and perhaps there were some component abstractions that could be called out in this area.
-Make use of V 3.0 data types but it is not clear that we can remain backwards compatible, here
are the data type used by CCOW and how they would be represented in 3.0:

NULL --> ANY (with the correct code for "no value" specified)
XPN --> EN
ST --> ST (3.0 ST may not be mappable to a 2.x ST since language and other info is specified in
the 3.0 ST)
NM --> QTY or REAL
TS --> TS
DLN --> II
DT --> TS (need to truncate fin when going from 3.0 to 2.x)
HD --> II
ID --> CS
ID --> CS
CX --> II
XAD --> AD
EI --> II

-Discussion around the use of an OID, since it is widely used in 3.0, and that it encapsulates type
and instance in the same value. For instance, 1.2 might represent Duke where 1.2.1.* represents
Duke employees whereas 1.2.2.* represents Duke patients. What does this mean for CCOW
subject items and CCOW subject item names.

Multi Facility:
-Many different use models were uncovered - facility here does not mean departmental but an
entirely different health care provider or corporation:
  1. One desktops simultaneously trying to use applications from multiple facilities to share
context where different context systems may exist.
  2. One desktop using apps from different facilities but apps from each facility do not share
context (stove piped), not sure if apps are used simultaneously.
-For scenario 1 agreements must be in place to allow this sharing to occur, many legal issues
-For both scenarios how do you get context systems from multiple vendors to interoperate.
-How does this get tied into Context Sessions, if at all.
-Still need the real world uses cases and what the users experience is/should/could be.

Multi Device:
-Had discussion on what it would mean to share context across multiple devices.
-Should devices be configured a priori to work together or can it be dynamic (proximity detection,
or an infrared signal)
-Much discussion about interesting dynamics but still need the real world uses cases and what
the users experience is/should/could be.

-BJ Lawson from Mercury MD showed a demo of their app sharing context with other apps on a
-This is accomplished by launching other app with the appropriate params.
-Follows master/slave model where only the high level app can set the context - in some cases,
work in progress may be lost.
-Tried to theorize how CCOW could work on Palm platform where only one app is active at a
time. Other platforms like CE might be done differently since it has threads. Seemed
theoretically possible by launching apps with appropriate launch codes and in the proper
-There may be use for the handheld to work with other devices to share context but this would be
covered under the Multi Device usage.

Candidate Subjects for 1.5:
-Following is the list of candidate subjects for 1.5, later those assigned will explore them, those
not assigned are not currently being pursued.
Device ID
Patient Demographics Annotation
User Role/Privileges Annotation
Device Info annotation
Patient Allergies Annotation
Information Request Action
Digital Signature Action
Eligibility Action
Charge Capture Action
Allergy Entry Action
Drug Allergy Interaction Action
Order Entry Action

-Discussed Device Info, is this a different class of subject, is it part of the CM, how is it set or
updated, how would mobile devices be handled?

-Not sure of market need for this.
-Lack of detailed knowledge among those present.
-Some exploration will be helpful.

Citrix Support:
-Issue was raised by Darrell Hansen about interoperability with web apps and apps deployed
through Citrix. Does something need to be added to CCOW to support potential network
addressability issues?
-This appears to be a context management system implementation and application deployment
issue but if something does need to be added to CCOW to support interoperability then those
specifics should be presented.

Work Assignments:
-Attend meeting on Thursday at the invitation of Mead Walker with the 3.0 methodology group to
discuss how 3.0 could make use of some of the component concepts used by CCOW. At a
minimum to at least set the stage for an interim meeting to discuss this issue. (James MacLean)
-Mobile Devices (Rob Seliger, BJ Lawson, Dan Soule, Mike Russell)
-Multi Facility, need narrative use cases from the user point of view (Eric Weaver, David Fusari,
Dan Soule, Darrell Henson)
-Multi Device, assume pre-associated devices, no dynamic device associations (no names on flip
-SOAP, only do an example of the CA and SB interfaces (David Fusari, Darrell Henson, Dan
Soule, Rob Wilmot)
-Device ID and Device Info Annotation subjects (Boyd Carlson (Duke), Rob Seliger, James
-Patient Demographics Annotation (Eric Weaver, Mike Russell, Darrell Henson)
-User Role/Privileges Annotation (James MacLean, David Fusari, Mike Russell)
-Allergy Entry, Allergy Annotation (Mike Russell, rob Seliger, Darrell Henson)
-Order Entry (Andy Woyak, Eric Weaver, Dan Soule, Mike Russell)

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