‹ Home
Exported

eCR/RCKMS Community of Practice

The purpose of the eCR/RCKMS Community of Practice Basecamp is to provide staff from state, local, territorial, and tribal public health agencies with a venue to participate in peer-to-peer discussions pertaining to using RCKMS. This Basecamp is not intended for formal communications about RCKMS or eCR and will not be moderated by CSTE staff. For technical issues or assistance with RCKMS, please visit www.rckms.org to submit a ticket. Disclaimer: The statements and responses posted on the eCR/RCKMS Community of Practice are solely the views of the authors and do not necessarily represent the official views of CDC or CSTE.
Becky Lampkins, Manager, Surveillance/Informatics Program at CSTEMeredith Lichtenstein, CSTELaura ErhartNancy Barrett, Epi 4/PH Informatics SpecialistRita Altamore, EpidemiologistDavid DiCesareWalter Kemper, ELR Coordinator, NC DHHS Div of Public HealthAmanda Payne, Senior Consultant at J Michael ConsultingJohn Satre, Informatician at Iowa Department of Public HealthShaily Krishan, Program Manager at CSTEJudie HyunKathy Turner, Deputy State Epidemiologist at IDSara Robinson, ID Epi Program Director at Maine CDCMisty Johnson, Informatician, WI DHSCrystal Snare +376 others
Sara Mader Sara Mader
Hello,
One question/topic that has come up for WI is regarding the diagnosis and active problem specifications.  In RCKMS, for example, it will say diagnosis of Vaccinia disease (in this example within the orthopoxvirus spec).  And then in the report it lists all the snomeds and ICD 10 codes that make up that diagnosis category.  And for some it can be very broad including many conditions that may or may not line up (according to my epi's).  Is there any future possibility (or maybe possible now and I just don't know how) to allow states to remove some of the specific codes?  What have other states done?  Are other states turning off almost all diagnoses?  Are states looking at these codes specifically when they make decisions?

Also does it say anywhere in the RR or eCR what LOINC/SNOMED/ICD10 code it triggered off of?  I can see the rule determination in the RR but do I have access to more specifics than that? (Or maybe I don't know where to look)
Thanks!
Sara 
6 Notified 251 people

Comments & Events

Allison Seidel, Lead RCKMS Authoring Support Agent (ASA) Allison Seidel, Lead RCKMS Authoring Support Agent (ASA)
Thank you, Sara! We will add this to the open discussion portion of the agenda.
Notified 1 person
Michael Schneider, Epidemiologist at Connecticut Department of Public Health Michael Schneider, Epidemiologist
Hi Sara,

Connecticut is definitely starting to look at the codes associated with the criteria (partly due to an issue with Vaccinia disease eCR). We have not found a way to take specific codes out of the criteria, but have just been making the logic sets more specific.

Also, we have not found a way to get the specific trigger code from the RR. Instead, we use the criteria (and then find the associated SNOMED/LOINC/ICD10) from the RR to point us in the right direction when looking at the eCR.
Hope this make sense!
example of Apnea below(RR is first picture, eCR is second picture with ICD10)
image.png 19.9 KB • Download

image.png 19.7 KB • Download
Notified 2 people
Allison Seidel, Lead RCKMS Authoring Support Agent (ASA) Allison Seidel, Lead RCKMS Authoring Support Agent (ASA)
I wanted to post the responses we sent to Sara to reference for everyone. We will also keep the discussion on the open agenda portion to get input from other jurisdictions, thank you!

Question 1
For reference for the question about receiving additional codes (for example: Stevens-Johnson syndrome (SJS)) related to Vaccinia disease:
 
In RCKMS, there 2 value sets that contain the SJS codes:
 
Vaccinia disease or adverse event (Disorders) (SNOMED)  | 2.16.840.1.113762.1.4.1146.1606
Vaccinia disease or adverse event (Disorders) (ICD10CM)  | 2.16.840.1.113762.1.4.1146.1607 

The content team is reviewing the 2 SJS codes- ICD10CM (L51.1) and SNOMED (73442001), do any Epidemiologists at jurisdictions have any feedback on other codes in these value sets?
 
In order to remove specific codes for value sets used in RCKMS, this is done by the content team terminologists (as it relates to defining trigger codes & tool specifications available to users). The best method to request (non-urgent) code addition/ removal from RCKMS value sets is to submit a ticket to RCKMS with the value set & code information.
 
If jurisdictions have any local filtering mechanisms to divert reports at the trigger code level (after you have received eICR/ RR), you may also explore that.

Question 2
The RR does show what criteria matched to report the eCR. To determine what the trigger code is within the eICR, you can follow the instructions at the bottom of the attached document (eCR Triggering) for the eICR xml file. The example on the file is how to find Pertussis in an eICR file, so you will need to know the SNOMED/ICD10/LOINC code you are looking for, which can be found in in the condition details report in RCKMS (image below) or for the condition within the Content Repository files.
Condition Details Report.png 53.6 KB • Download

eCR Triggering.pdf 339 KB • Download
Notified 3 people
Sara Mader Sara Mader
Michael and Allison, thank you for the tips and background.  I am going to look further into your suggestions and look forward to discussing it at the call too.
Thanks
Sara 
Notified 3 people
Annie Fine, CSTE Annie Fine
Why is a diagnosis of vaccinia included in the MPOX criteria or is it just use for the generic orthopox criteria?  Seems like in a mpox condition you would only want the GENERIC orthopox codes, not specific ones that are not monkeypox. Sorry if I am adding confusion here. thx
Notified 254 people
Shaily Krishan, Program Manager at CSTE Shaily Krishan, Program Manager
Hi Annie, Vaccinia is not included in the MOnkeypox reporting specifications. The Orthopox Reporting specification contains optional diagnosis & lab rules for Monkeypox, Cowpox, Vaccinia & Smallpox. The original question is about a code contained in the Vaccinia diagnosis value set.
Notified 254 people