by Nancy M. Lorenzi, Ph.D., and Robert T. Riley, Ph.D.
Overview of Conference Process
Conference planning began with an implementation plan, which
outlined the organizing committee, preconference activities,
conference process, and postconference requirements. The actual
conference involved four stages:
- Presentation process.
- Consensus panel process.
- Conference discussion process.
- Consensus-building process.
Presentation
To begin, Dr. Mullins convened the conference and welcomed the
participants. Dr. Lorenzi presented an overview of the process
developed for the conference. During the presentation process, a
keynote presentation to frame the issues was delivered.
Presentations were made about UMLS (Unified Medical Language
System) as a classification that could potentially link to all
coding systems. Three coding systems panels, each consisting of
three people, presented the strengths and weakness of the coding
scheme they were representing.
Consensus Panel
Before the conference, each consensus panel member was asked to
select one area in which to be the "primary reviewer." Four
people selected the three coding schemes plus UMLS; the fifth was
asked to be the primary person to look at the overview framing
issue that the conference was addressing.
During the presentations, one of the facilitators developed a
draft model of the consensus panel report. The draft consisted of
the process, an overview framing issue, vision, critical
elements, and where are we today.
With the draft report as a focus, the consensus panel members
discussed the preamble, framing issue, vision, and critical
elements. These required the most discussion time. Each person
was the primary reviewer for one of the coding schemes; once
everyone agreed on the vision and critical elements, outlining
the strengths and weaknesses went quickly. The conference
organizers included a transcription service as part of the
process. Thus, once panel agreement was reached, it was easy to
create the final consensus panel report that the total conference
would discuss. Transcriptionists captured each member's statement
of strengths and weaknesses as it was read. A disk of the report
was then taken to a quick-copy service, which produced a report
for all conference members.
Conference Discussion
The discussion process started early on the second day. Based on
the number of attendees and the appropriate group size for
discussion and participation, seven small groups were created.
First, one discussion leader/facilitator and one reporter were
chosen for each group. Each reporter had to have a laptop
computer or access to a laptop computer to capture the
information. After the discussion leader/facilitator and reporter
were selected and placed in an appropriate numbered group,
attendees were randomly assigned to groups.
After assembling in the appropriate group, participants were
asked to introduce themselves to all the people present and note
the names and addresses of the participants. In addition to
outlining any group issues that they considered important,
participants were asked to address the following five discussion
issues, created by the facilitator.
- Do you agree with the overview framing issue?
- Do you agree with the vision?
- Review the critical elements. Do you agree? Rate high,
medium, low.
- Review and discuss the coding systems.
- Review and discuss the "where to from here?"
comments.
All groups followed the five discussion issues, but each seemed
to focus more extensively on one or more of the items.
The goal of the conference was to incorporate all of the
discussion issues into the consensus panel report in order to
develop the total conference report. Therefore, the discussion
lasted for several hours.
Consensus Building
After the discussion process, the participants convened as a
total group to begin the consensus-building process. It was
decided early in the conference that anything attendees said
would be transcribed and projected onto the screen for everyone
to see.
Each of the seven groups was asked, in turn, for comments and a
summary of its discussion. Projecting the comments onto the
screen had both a positive and negative effect. The positive
effect was to build trust in the conference outcome, as all
participants could see their precise comments projected for later
incorporation into the final report. The negative effect was a
sensory overload, since people were both participating in the
discussion and also trying to read all the comments. In this
conference, disagreement among participants was handled by
agreeing to trust a small group to help resolve the issues. It
was agreed that representatives from each of the seven groups
would see the first draft of the total conference report and make
any necessary changes after an appropriate electronic discussion.
After the Meeting
After the meeting ended in New Orleans, a four-person edit group
reviewed all of the documents (the consensus panel report, the
reports of each of the seven discussion groups, and the printed
verbatim transcription of all discussions on the second day) and
extracted what "happened" during the meeting. This report was
made available to all attendees by direct E-mail. It was also
posted on the World Wide Web for review. Reviewers could give
approval or recommend changes (along with giving the rationale
for those changes). Most of the suggestions for change were
incorporated in this final document, which has now been approved
by all participants.
Return to Contents
AHCPR Publication No. 96-0069
Current as of November 1995
Internet Citation:
Highlights of Moving Toward International Standards in
Primary Care Informatics: Clinical Vocabulary. Conference Summary Report.
New Orleans, November 1-2, 1995. Rockville, MD: Agency for Health
Care Policy and Research. http://www.ahrq.gov/research/pcinform/
540 Gaither Road Rockville, MD 20850 
