CC# (PARAPHRASE OF SUBMISSION COMMENT) - RESPONSE BY POHR TEAM 102 (What does "selected billing diagnosis" refer to?) - Example added: During an encounter, if a provider specifies a billing diagnosis of Hypertension, then the system allows easy addition of Hypertension to the problem list. 111 (How is "substantially similar determined?) - New wording: The system SHALL provide the ability to display a warning when a new problem list entry and an existing entry have similar wording, suggesting possible duplication. Example: If Diabetes Mellitus, Type II and Diabetes Mellitus, Adult Onset are both listed, this will be flagged by the system. 114 (clarifying definition of "source") - The following language is added to #114: The source includes the name, role and practice setting of the person entering the problem. In the case of importing, the system records the original source information. If this is not available, then the system records the name, role and setting of the importer. Example: Person = Dr. WIlliam Osler; Role = Physician, internal medicine; Setting = Johns Hopkins Outpatient Clinic. 115 (capture the source (author) automatically) - Authorship questions are addressed in CC# 104 & 105. Note that FHIR concepts of recorder and asserter are addressed at https://www.hl7.org/fhir/condition.html . 118 (How is "relevant to current inpatient" determined?) - New wording: The system SHALL provide the ability to capture, maintain and render the problems that are being managed or monitored during the current hospitalization. These may specified by an inpatient provider or other clinician, or by the system through an automated process. Example: Full problem list includes: sepsis, hypotension, diabetes, h/o colon polyps, h/o basal cell carcinoma, cataracts; problem list relevant to current hospitalization includes: sepsis, hypotension, diabetes. 120 - wording changed to "a" instead of "the". 124 (how are "substantially similar" problems defined) - see above response on #111 126/127 (Is "threshold" date-based? a duration?) - After discussion with VA re their submission on these CCs, changes will be considered for future use. Problems of long-term clinical significance, e.g. treated cancers, will be treated as active even if time threshold is exceeded. Note FHIR classification scheme for problem status, at https://www.hl7.org/fhir/valueset-condition-clinical.html . 128/129 (is this similar to 126/127? Example needed) - See response re 126/127 130/131 (Is root/manifestation the only link between problems or just an example?) - Root-manifestation is the primary example for linking problems, but other linkages might be considered. 133/134 (Preferred sort order should be clarified) - Language to be added to 133: "The system shall allow the user to save the preferred sort order or auto-track user's preference." 135 ("determine and capture" might be too specific re association between organ systems and specialties) - No change needed, per discussion with submitter. 137 (second sentence re active problems as system default should be its own CC) - no change needed. 138 (duplicative of #118 except for word "display") - Persuasive.