National symposium studies vocabulary control of chief complaint

National experts researching the use of chief complaints in emergency department situations gathered at the "Towards Vocabulary Control for Chief Complaint: A National Symposium" on October 18, 2006. The symposium was held in conjunction with the Fifth Syndromic Surveillance Conference in Baltimore, MD.

The focus of the symposium was to discuss methods of improving how patients' primary reasons for seeking care are reported in hospital emergency departments across the country -- with the goal of improving the quality of chief complaints, thereby improving the aspects of clinical care, education, hospital operations, research and public health surveillance that depend upon it.

The symposium was structured around three major topics:

• Understanding the problems and barriers encountered during use of chief complaints for clinical care, hospital operations, research, and public health surveillance;
• Envisioning the characteristics and uses of a future improved chief complaints; and
• Planning the means and actions needed to create the future.

"One of the most important accomplishments of the symposium was gathering nationally-known experts into the same room to discuss what they'd like the chief complaint data element to look like, and the actions we need to take to make it happen," said Dr. Stephanie Haas, Francis Carroll McColl Term Professor at SILS and symposium organizer.

Outcomes of the symposium included recommendations for comparing existing controlled vocabularies with participants' needs and requirements, a research agenda for exploring important vocabulary attributes such as size and granularity, and plans to establish an administrative structure to oversee the ongoing work.

A white paper detailing the symposium recommendations and proposed actions is forthcoming.

Those participating in the symposium included clinicians, researchers, public health officials, and officials from state and federal health agencies from around the nation.

Members of the organizing committee included:

• Wendy Chapman, Department of Biomedical Informatics, University of Pittsburgh
• Jenny Cook, Injury Prevention and Research Center, University of North Carolina at Chapel Hill
• Stephanie W. Haas, School of Information and Library Science, University of North Carolina at Chapel Hill
• Jennifer Kerwick, Department of Emergency Medicine, University of North Carolina at Chapel Hill
• Bill Lober, Department of Health Sciences, University of Washington
• Kathleen McNeil, Department of Emergency Medicine, University of North Carolina at Chapel Hill
• Debbie Travers, School of Nursing , University of North Carolina at Chapel Hill
• Anna Waller, Department of Emergency Medicine, University of North Carolina at Chapel Hill

Discussion groups and leaders included:

Clinical Care, Education and Emergency Department Operations

• Laura Heerman, Director of Nursing Informatics at Intermountain Healthcare in Salt Lake City.
• Judith Tintinalli, Professor and Chair of the Department of Emergency Medicine at UNC at Chapel Hill

Surveillance

• Catharine Burt, Chief, Ambulatory Care Statistics Branch, Center for Disease Control and Prevention's National Center for Health Statistics
• Kenneth Mandl, Assistant Professor of Pediatrics at Harvard Medical School, Affiliated Faculty at Harvard-MIT Division of Health Sciences and Technology, with joint appointments in the Children's Hospital Boston Informatics Program and Division of Emergency Medicine.

Research

• Marc Gorelick, pediatric emergency physician at Children's Hospital of Wisconsin and Medical Director of its Emergency Department
• Anna Waller, Associate Professor, Department of Emergency Medicine, UNC at CH, Director of the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NCDETECT).

Standards

• James McClay, Assistant Professor, University of Nebraska Medical Center

• Edward Barthell, Executive Vice President for Infinity HealthCare Inc., Chief Medical Officer of EMSystem, leader of the non-profit National Institute for Medical Informatics, and the American College of Emergency Physicians' Frontline of Medicine project.

Stephanie W. Haas, Professor, School of Information and Library Science, UNC at Chapel Hill provided introductions and moderated discussions.

Daniel Pollock, medical epidemiologist and emergency physician at the Centers for Disease Control and Prevention, synthesized the day's discussions into a set of recommendations and actions for the future.

The symposium was sponsored by SILS, the University of North Carolina at Chapel Hill's Department of Emergency Medicine, Injury Prevention Research Center, and the North Carolina Disease Tracking and Epidemiology Collection Tool (NC DETECT) and offered in coordination with The International Society for Disease Surveillance. The program was funded in part by the National Library of Medicine and T-System.