MEDICAL RECORD SIG MEETING MINUTES
                       JANUARY 14, 1993
                       ORLANDO, FLORIDA


Attendees:    See attached list.
Minutes By:   Cynthia Miller, RRA


The meeting was called to order by Wayne Tracy, co-chair of the
Medical Record SIG.

Wayne provided the group with a brief history of the Medical
Record SIG within HL-7 and explained the differences between a
SIG and a Technical Committee.

The proposed agenda (outlined in the September minutes) for the
meeting was reviewed with the group, and the group was encouraged
to add additional items to the agenda:

     o  1/2 hour Data Modeling Tutorial
     o  Review of the ASTM Security and Confidentiality Document
     o  Identify subgroups to review areas of interest

Peter O'Brien, co-chair of the QA/Data Modeling Technical
Committee, provided a brief tutorial on the concept of Data
Modeling and how it is used within HL-7.  Peter explained the
differences between Object and Entity Data Modeling, discussed
how the HL-7 Framework Document gives guidance to the data
modeling process.  Abstract Message Development and the reasons
for data modeling were also discussed by Peter.

Copies of the October 1992 draft of the ASTM Security and
Confidentiality document were passed out to the group.  The
newest draft of the document (November 1992) will be distributed
to interested individuals by Mark McDugall within the next week.
Wayne explained the document, the differences between ASTM and HL-
7, and the purpose of CPRI.  The group established that it will
be the responsibility of the Medical Record SIG to continue to
review and track ASTM documents and make recommendations to the
Technical Committee on formal HL-7 responses to ASTM.

Attendees were asked to review the ASTM document with the
following issues in mind:

     - Identify when/where messages need to be used to identify
            consent for release.

     - Message authorization attributes imbedded in many messages.


     - Preserving authorization and integrity of data transmission.

            Issues of electronic signature integrity.

The issue of computer systems security was discussed however, it
was decided that this is out of the scope of the Medical Record
SIG.  The Medical Record SIG will assume that it is acceptable
discussed elsewhere and addressed by individual systems.
Specific language to this effect will be drafted before the next
meeting.  (** Wayne who is suppose to do this???)

The group unanimously voted to request that the Control Committee
address the issue of unauthorized interception of HL-7 messages.

The group discussed the Medical Record SIG areas of interest
identified during the September 1992 meeting.  These included
existing message review, consents, attestations, and security.
It was decided that subgroups would be formed to perform work in
these areas prior to the May meeting in Boston.  The following
groups were formed:

     1.   Messaging Review Task Force: This group will map
          existing HL-7 Release 2.2 message segments to data
          models of other systems and develop a list of areas
          which are not addressed within HL-7. Elaine Lips, Linda
          Hernandez, and Kathy Blyler will serve on this task
          force.

     2.   Consents: This subgroup will review all issues related
          to patient consent for treatment, release of
          information, etc. as related to data transmission.
          Wayne Tracy will participate in this subgroup with
          additional members to be identified later.


     3.   Attestations: It was decided that this area will be
          discussed in detail at the May meeting. Attendees were
          asked to bring examples of manual or computer generated
          attestation forms for review. A data modeling session
          will be conducted to address the content of the
          attestation vs communication of presence, absence or
          status of the document.

     4.   Security: The security subgroup will look at issues
          related to system security and how the Medical Record
          SIG and the Control Committee can work together in this
          area. Task force members will include: Donna Craig, Pat
          Bow, Dean Ellis, and Scott West.


It was recommended that a document be drafted which outlines the
history of the Medical Record SIG, details the mission statement
and objectives of the SIG, explains current activities, and lists
issues which have been raised and their resolution.  It was felt
that this sort of document would be very informative for any new
attendees to the group.  It was decided that Wayne Tracy would
develop such a document for distribution at the next meeting.

It was also decided that the May meeting of the Medical Record
SIG will be held on Thursday afternoon.  This seems to allow for
the least number of conflicts with other areas of interest.


The agenda for the May meeting was drafted and includes the
following:

     o    Review of the November draft of the ASTM Security
          document, formulation of a formal response to the ASTM,
          and identification of other areas for review.
     
     o    Subgroup reports on progress made since last meeting.


     o    Attestation Data Modeling session


     o    New Business

Once formed, the subgroups spent the remainder of the session
working within their groups organizing and planning their
strategy.  The session was then adjourned.


Minutes submitted by Cynthia Miller, RRA, Chairman
Minutes verbally approved by Wayne Tracy, Co-Chairman

[Attendee list not submitted electronically -- WJR]