97-13090. Automation of Medical Optional Form 523B

[Federal Register Volume 62, Number 97 (Tuesday, May 20, 1997)]
[Notices]
[Pages 27611-27612]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-13090]


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GENERAL SERVICES ADMINISTRATION

Interagency Committee for Medical Records (ICMR)


Automation of Medical Optional Form 523B

AGENCY: General Services Administration.

ACTION: Guideline on automating medical standard forms.

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Background

    The Interagency Committee on Medical Records (ICMR) are aware of 
numerous activities using computer-generated medical forms, many of 
which are not mirror images of the genuine paper Standard Form. With 
GSA's approval the ICMR eliminated the requirement that every 
electronic version of a medical Standard/Optional form be reviewed and 
granted an exception. The committee proposes to set data standards and 
require that activities developing computer-generated versions adhere 
to the required data elements but not necessarily to the image. The 
ICMR plans to review medical Standard/Optional forms which are commonly

[[Page 27612]]

used and/or commonly computer-generated. We will identify those data 
elements which are required, those (if any) which are optional, and the 
required format (if necessary). Activities may not add data elements 
that would change the meaning of the form. This would require written 
approval from the ICMR. Using the process by which overprints are 
approved for paper Standard/Optional forms, activities may add other 
data elements to those required by the committee. With this decision, 
activities at the local or headquarters level should be able to develop 
electronic versions which meet the committee's requirements.

Summary

    With GSA's approval, the Interagency Committee on Medical Records 
(ICMR) eliminated the requirement that every electronic version of a 
medical Standard/Optional form be reviewed and granted an exception. 
The following data elements must appear on the electronic version of 
the following form:

                                         Electronic Elements for OF 523B                                        
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                          Item                                                  Placement*                      
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Text:                                                                                                           
    Title Authorization For Tissue Donation............  Top of form.                                           
    Form ID: Optional Form 523B (12-94)................  Bottom right corner of form.                           
Data Entry Fields:                                                                                              
    Name of Hospital...................................                                                         
    Location of Hospital...............................                                                         
    Date of Authorization..............................                                                         
    Name of Deceased...................................                                                         
    Tissue Bank (Name of Hospital).....................                                                         
    Specify Tissue.....................................                                                         
    Signature of Witness...............................                                                         
    Full Address of Witness............................                                                         
    Signature of Person Authorized to Consent..........                                                         
    Full Address of Person Authorized to Consent.......                                                         
    Authority to Consent...............................                                                         
    Patient's Name (last, first, middle)                 Bottom left corner of form.                            
    Patient's ID No. or SSN............................                                                         
    Hospital or medical facility.......................                                                         
    Register No........................................                                                         
    Ward No............................................                                                         
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* If no placement indicated, items can appear anywhere on the form.                                             

FOR FURTHER INFORMATION CONTACT:
CDR Patricia Buss, MC USN; [phone].

    Dated: May 13, 1997.
CDR Patricia Buss, MC, USN,
Chairperson, Interagency Committee on Medical Records.
[FR Doc. 97-13090 Filed 5-19-97; 8:45 am]
BILLING CODE 6820-34-M