March 22, 2012
9 PDT/11 CDT/12 EDT
Attending: Mike Zarski, Chair; Valerie Smothers, staff; James Fiore, Don Kooker, Purvi Maniar, Jennifer Michael, Alex Minkofsky, Amy Opalek, Brenda Ruff, Tarang Shah.
1 Review minutes of last meeting
The minutes were approved.
2 Review updates to specification
Valerie reviewed the updates to the specification. Extensibility was added to the CertificateIssuance element and the documentation now makes it clear that use of XtensibleInfo is deprecated. The CertificationMaintenance element was also added to indicate whether or not the certificate is maintained. The specification was also edited to note that board order is for actions against licenses by licensing boards, and representation of dual citizenship is now explicitly allowed.
3 Review updates to implementation guidelines
Valerie reviewed updates made to the Implementation guidelines. Several of the updates reflect updates made to the specification. The examples in section 3.1 now use the updated format for the domain attribute for UniqueID. Section 3.7 now has information about representing joint degrees and indicates that degree should be abbreviated with all punctuation removed.
4 Continue review of questions from ECFMG
Mike reviewed decisions made on the last call with regard to comments from ECFMG. Amy commented that with regard to representing degree names by abbreviation only, we may want to clarify. The same abbreviation can mean different things in different countries. For example, in India Do might mean Doctor of Ophthalmology. Mike agreed that was a valid consideration and suggested an optional element for the full title.
James asked about the discipline attribute for degree and whether it would be appropriate to put the full description there. Valerie commented that the discipline attribute was intended to describe the academic discipline for the degree, such as a major. She recommended adding a label attribute to the Degree element where the full title of the degree could be placed. Mike agreed that would accommodate the international differences in meaning.
Amy asked about the occupation status element and asked if the intent was to gather current occupation information or produce a cv.
Valerie commented that the element is repeatable. James added that the dates of the occupation are provided.
Amy commented that if the occupation is current , you don’t need an additional element. She added that there should be an option other than retired for describing a prior job. If we limit, we are locking people into those options. Dismissed is one example; there may be others
Valerie commented that the element is not required. Amy commented that if it is not required, we should not worry, but be open to any additional options suggested for that element.
Valerie commented that with regard to Amy’s question about Faculty Track, Paul Jolly had provided example values via email. The specification will be updated to include them.
EducationInfo.Degree (p. 18) & EducationInfo.Certificate (p. 19) – The date on which a diploma is issued may follow the date of graduation by a year or more, so it may be helpful to add an optional “award date” attribute to these elements.
Amy commented that it might be helpful to add an award date attribute. James asked if the end date defines that. Amy explained that in some countries, including India and Spain, you may graduate in one year and not receive the degree until a year later. There may be a verification process, or internship to complete. In Spain they only print diplomas at a national level, and it’s only done every year or two. That’s relevant for credentials verification purposes.
Mike asked Amy how graduation date is defined if it is different than the date the degree was awarded. Amy replied that the school verifies the start, end, graduation date, and the date on which the piece of paper is issued. Graduation date is when the student completed the curriculum. End date and graduation date are synonymous. James suggested a third element for degree issued. Valerie asked if diploma issued would be more specific. Amy commented that they use the terms interchangeably.
The group agreed to add DiplomaIssuedDate to degree type.
LicenseInfo (p.35) – Internationally, the term “registration” is often used in place of “licensure.” “Regulatory Authority” is a common international term to refer to those agencies that register or license physicians (or other health professionals) to practice. These terms could be included in the element description for clarity.
James recommended adding information to the implementation guide. Changing the name of the element would have big implications with regard to backward compatibility. Valerie agreed and recommended a section of the implementation guide for indicating registration/licensure outside of the US. Amy agreed.
LicenseInfo.License (p.35) – It would be helpful to include the following additional information as sub-elements of License:
- Profession – the name of the profession for which the license entitles practice (using health professions names outlined in ANSI/MEDBIQ LO.10.1-2008 Appendix 2)
- Jurisdiction – the name of the country or state/province in which the license entitles practice (using a standard code for country or state/province)
Amy commented that if someone is licensed in multiple professions, it would be helpful to reference which ones. Professions are outlined in healthcare lom. The other part is jurisdiction. While you may be able to extract information from the licensure entity it’s not clean to do it that way. It’s easier to have that separately defined.
James asked if the licensure entity defines the jurisdiction. Amy replied yes, but the name of the entity is not the same as the jurisdiction. If you tried to pull out people licensed in Pennsylvania, it’s easier to search for a jurisdiction element PA. Some states have more than one licensing entity. It’s more data driven to have a separate subelement.
James commented that the licensure entity covers code and description. Amy asked where the code comes from. James replied that it isn’t predefined. You can define a code.
Mike commented that there can be ambiguity if the licensing board doesn’t contain a geographic location. You shouldn’t have to do additional work to determine the jurisdiction. That doesn’t happen often in the US, but it may come up in other places.
Valerie commented that if you applied the professional profile to multiple health professions, you would have to add more and more boards to a query to come up with a list of professionals licensed in Pennsylvania.
Amy added that it would be helpful to know what profession a person is licensed in. We should describe what the license permits you to do and where.
James questioned whether further definition of domain would solve the issue. Valerie commented that the domain is the owner of the code; the documentation should be updated to reflect the idd format.
Mike commented that in Australia, Queensland may be the licensing authority, but the doctor could have the ability to practice anywhere in the country. Amy added that having codes for the jurisdiction would add a further layer of standardization making it easier to extract information.
James asked if healthcare professions are enumerated in the healthcare lom schema. Valerie replied no, they are enumerated in the specification as a recommended list. Some organizations, such as the VA, use another list created by the Department of labor.
Mike suggested presenting the proposal for review on the next call. We will distribute information to the working group ahead of time and allow others to weigh in if interested.
AcademicAppointmentInfo.FacultyAppointment.Rank (p. 57) – Suggestions for additional valid values:
- Adjunct Professor
- Junior Lecturer
- Senior Lecturer
Amy commented that she queried information submitted by physicians and found four additional job ranks not covered. They all occurred multiple times. Demonstrator is someone that does anatomy demonstration.
Valerie asked of the distinction between junior and senior lecturer might muddy the waters given that we already have a lecturer value. Amy replied it might. Adjunct professor and demonstrator would be new. The group agreed to add Adjunct Professor and Demonstrator as valid values for Rank.
AcademicAppointmentInfo.ChairAppointment (p. 60) – In many countries, a Chair is more likely to be referred to as a Department Head. Could the description be modified to include this term?
The group agreed to include Department Head in the in element description.
PersonalInfo.Citizenship.pointInTime (p. 72) – “Entry to professional school” would be more inclusive as a valid value than “entry to medical school.”
Valerie commented that would be changing a value not just adding a new one. James commented it is just a string in schema. Valerie replied that should be corrected.
Amy recommended making it less restrictive. Jen questioned what if an individual has a carreer path involving multiple professions. For example, if a PA becomes a physician, or a nurse that becomes something else.
Amy agreed that the whole categorization for applicant citizenship is problematic. The current values are not the best. It’s a problem with their data. She commented it would make more sense to have it bounded by time or year. She asked if anyone else is using these elements. No one replied.
Valerie commented that it would make sense to bring the schema up to date in a way that is not so medical specific. The group agreed to change the value to entry to professional school and to create an enumerated list in the schema.
5 Open discussion
Mike asked Valerie to provide an update on conference. Valerie replied that the full agenda is online. The working group will meet May 2 at 10 :30 AM at the Turner building at Johns Hopkins.
- Add a label attribute to the degree element.
- Add Paul Jolly’s examples fo faculty track to the specification.
- Add DiplomaIssuedDate to degree type.
- Add a section of the implementation guide for indicating registration/licensure outside of the US.
- Update the licensure entity domain attribute to use the idd format.
- Add Adjunct Professor and Demonstrator as valid values for Rank under FacultyAppointment.
- Update ChairAppointment to indicate that it also includes Department Head.
- Change the attribute value for Citizenship pointInTime to Entry to professional school and create an enumerated list in the schema.
- The proposal for license profession and jurisdiction element will be presented to the working group via email prior to the next call.