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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
Authoring by Marisa Hopper ·

✅ Pertussis logic sets

We wanted to share a recent experience with the pertussis logic sets. We had authored the Pertussis logic sets in RCKMS with the default setting and that included the Provider/Facility CLIN set. 

This is a combination of symptoms which fit the clinical case definition for pertussis. 
Apnea   (O)                           
Cough (any duration)   (N)                  
Inspiratory Whoop  (O)               
Paroxysmal Cough (O)                       
Pertussis (as a diagnosis or active problem) (O)
Post-tussive Vomiting (O)

Unfortunately an issue we discovered is the SNOMED codes for Apnea include Obstructive Sleep Apnea (OSA), so any patient who presented with a cough and had a history of OSA would trigger a pertussis RR. 

This quickly became an issue and we opted to take that CLIN logic set off and have not had any more erroneous pertussis cases. 

There are of course several other solutions for this problem. For example we did not try to author without the Apnea specification, we also have not implemented any Rhapsody filters. 

We just wanted to share that experience. And you'll hear from us once we finish troubleshooting the Carbon Monoxide poisoning reporting specification...
Claudia Brogan, RCKMS Community of Practice Facilitator Thank you

Comments & Events

Shaily Krishan, Program Manager at CSTE Shaily Krishan, Program Manager
Hi Marisa, the RCKMS Content Team is looking into this, and I'll also follow up with you separately via email - Could you provide the specific Obstructive Sleep Apnea (OSA) code causing the issue?
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Claudia Brogan, RCKMS Community of Practice Facilitator Claudia Brogan, RCKMS Community of Practice Facilitator
Thank you, Marisa, for this description of your experience.  As we look forward to hearing about Shaily & the Content Team's examination of this, I just want to send a thumbs-up: this kind of post is a perfect example of what our CoP's Basecamp bulletin board can help with. We are all in this together~
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Shaily Krishan, Program Manager at CSTE Shaily Krishan, Program Manager
Hello Marisa, We have communicated with you separately since you submitted a ticket with details specific to your eICRs. 

I wanted to post this general information about the code for awareness: This issue is caused by an EHR terminology mapping issue.  The original SNOMED code sent to RCKMS is not in our value sets.  However, the EHR (Epic) has a terminology mapping engine (IMO) that is mapping that SNOMED code to a code that was in our value set (G47.33). G47.33 is a mapped or translation code for the 78275009 SNOMED code (meaning the EHR mapped it and thinks it is equivalent).  We do evaluate the translation codes in addition to the original code that is sent to us. The RCKMS team removed G47.33 from the Apnea value set 2.16.840.1.113762.1.4.1146.330, and therefore this should not reoccur.  
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