2017-01-31 Patient Care FHIR Call

Meeting Information

Patient Care FHIR Resources Conference Call Location: Conference Call Phone Number: +1 770-657-9270 Participant Passcode: 943377 WebEx: https://intermountainmeetings.webex.com/intermountainmeetings/j.php?MTID=m285042c1dfaad164ef45fcf2b7aa8619		Date: 2017-01-31 Time: 5-6:30pm ET
Facilitator	Michelle M Miller	Note taker(s)	Michelle M Miller
Attendee	Name	Affiliation
X	Elaine Ayres	NIH/Department of Clinical Research Informatics
X	Stephen Chu	The Australian Digital Health Agency (ADHA)
	Evelyn Gallego	EMI Advisors LLC
	Eric Haas	Haas Consulting
X	Rob Hausam	Hausam Consulting LLC
X	Laura Heermann-Langford	Intermountain Healthcare
X	Emma Jones	Allscripts
X	Russ Leftwich	InterSystems
	Tony Little	Optum 360
	Jay Lyle	Ockham Information Services LLC, VA
	Russell McDonell	Telstra Health
	Lloyd McKenzie	Gevity (HL7 Canada)
	Larry McKnight	Cerner
X	Michelle M Miller	Cerner
	Lisa Nelson	Life Over Time Solutions
	Viet Nguyen	Lockheed Martin, Systems Made Simple
	M'Lynda Owens	Cognosante
	Craig Parker	Intermountain Healthcare
X	Joe Quinn	Optum
	Simon Sum	Academy of Nutrition and Dietetics
	Iona Thraen	Dept of Veterans Affairs
	Serafina Versaggi	Dept of Veterans Affairs
	Tracey Coleman	Allscripts
	Amit Popat	Epic
X	Gary Gartner	Allscripts
Quorum Requirements Met: yes

Agenda

Agenda Topics

1. Agenda review
2. Approve previous meeting minutes 2017-01-30_Patient_Care_FHIR_Call
   • Motion: Stephen/Elaine
3. Prior Action Item Follow-up
4. gForge change request

Supporting Information

STU 3 Timeline

From FHIR_Ballot_Prep

• Sun. Feb. 5 Ballot reconciliation deadline - All ballot comments must be reconciled, tracker issue report must be clean
• Sun. Feb. 19 Publication substantive resource freeze
• Sun. Feb 26 Publication total freeze
• Mon. Feb 27 QA period opens
• Tue. Feb 28 FMM QA spreadsheet updated for all WG resources
• Sun. Mar. 13 QA period closes
• Sun. Mar. 20 All QA applied

The "following week" STU 3 is published!

Minutes

STU3 Action Items

• Review Tracker Issues - https://docs.google.com/a/lmckenzie.com/uc?id=0B285oCHDUr09Mzh3b09rMFhEV1E
• Resolve QA Warnings to have resource FMM > 0
• Resolve QA Information messages to achieve FMM = 3
• Update QA checklist for resources that we want to be FMM = 3
• Review workflow gap analysis per GF#10293
• Block Vote (see below) scheduled for Feb 2, 2017 for low hanging fruit, i.e. non-ballot comments
• Apply changes (all "substantive" changes have been applied, except allergy, care team invariant, and workflow patterns)

TOP Priority -- AllergyIntolerance, Condition, and Procedure -- QA Warnings/Information (desire FMM = 3)

• AllergyIntolerance
  • Rob Hausam is helping with RIM mappings (clinicalStatus and verificationStatus)
  • Rob Hausam is using data Elaine sent to see if we can curate the SNOMED CT Clinical Findings to a smaller subset. If not, then we'll update the binding for AllergyIntolerance.reaction.manifestation to use the same valueset-clinical-findings
    • Duplicate Valueset Names: manifestation-codes (SNOMED CT Clinical Findings) & clinical-findings (SNOMED CT Clinical Findings)
    • AllergyIntolerance.reaction.manifestation -- http://build.fhir.org/valueset-manifestation-codes.html
    • DiagnosticReport.codedDiagnosis (and profiles) -- http://build.fhir.org/valueset-clinical-findings.html

• Condition is clean on the QA report!
  • GF#12731 -- resolved
  • Discuss QA Checklist: GF#10635 QA 5a: Resource references exist in both directions for Condition and ClinicalImpression (Michelle Miller) -- deferred and asking for MnM exemption -- Lloyd responded saying "make an explicit call-out in the notes section for Condition about the unresolved issue. That should be sufficient" Proposed text to add: "A known issue exists with circular references between Condition and ClinicalImpression, which is due to the low maturity level of ClinicalImpression. The Patient Care work group intends to address this issue when ClinicalImpression is considered substantially complete and ready for implementation."

• Procedure is clean on the QA report!

HIGH Priority -- CareTeam, CarePlan, and Goal -- QA Warnings (desire FMM > 0 means we address all warnings)

• CareTeam - no QA warnings!

• CarePlan
  • MnM exemptions requested for element names should be singular (addresses and replaces)

• Goal
  • MnM exemption requested for element names should be singular (addresses)
  • GF#10623
    • Rob Hausam was going to help with Goal.description - example binding to a new value set
    • MnM exemption requested for Goal.target.detail because target detail is a choice of data types (i.e. Quantity and CodeableConcept could have different value sets) - Observation.value[x] does not show this same QA warning.

MEDIUM Priority -- All other resources (except Linkage and ClinicalImpression) -- QA Warnings (desire FMM > 0 means we address all warnings)

• Flag -- no QA warnings!

• FamilyMemberHistory -- no QA warnings!
  • Rob Hausam / Stephen Chu will check to see if there is a SNOMED 445518008 or LOINC code to use

• Communication & CommunicationRequest
  • Update from Lloyd: Request status is always set by the initiator. It doesn't reflect fulffilment status at all - and we won't change it to include that. An order is active regardless of whether a given filler refuses to act on it. In theory, you can always look for another filler. And if you can't find another filler at the moment, you can leave the request active in the hopes a new one might come along
  • Category Need to provide a binding - GF#8564
    • Rob Hausam will check to see if v3 has existing codes. If so, use v3. If not, then add v3 codes: alert, notification, reminder, instruction

• ReferralRequest
  • GF#12750 -- resolved
    • ReferralRequest.type Need to provide a binding
    • ReferralRequest.reason Need to provide a binding
  • Discuss : Bindings/Value Sets
    • pc:ValueSetComparison Duplicate Valueset Names: v2-0284 (v2 Referral Category) & referralcategory (ReferralCategory) (name: [referrals, categories] / [referrals, categories]))
    • pc:ValueSetComparison Duplicate Valueset Names: v2-0283 (v2 Referral Status) & referralstatus (ReferralStatus) (name: [referrals, statuses] / [referrals, statuses]))
  • Discuss : ReferralRequest.description Element has a todo associated with it (This would be a good candidate for a 'markdown' data type.)
  • Examples
    • Stephen Chu ReferralRequest.context Search Parameter 'ReferralRequest.context' had no found values in any example. Consider reviewing the expression (ReferralRequest.context)
    • Stephen Chu ReferralRequest.group-identifier Search Parameter 'ReferralRequest.group-identifier' had no found values in any example. Consider reviewing the expression (ReferralRequest.groupIdentifier)

LOW Priority -- CareTeam, CarePlan, and Goal -- QA Information (desire FMM = 3 means we address all information)

• CareTeam
  • RIM Mapping

• Goal
  • RIM Mapping
  • QA Checklist: GF#10622 QA 4a: Consider whether Goal.category should be bound to codes from an external code system (Michelle Miller)

• CarePlan
  • RIM Mapping
  • Examples
    • CarePlan/activity/detail/definition Path had no found values in any example. Consider reviewing the path
    • CarePlan/activity/detail/quantity Path had no found values in any example. Consider reviewing the path
    • CarePlan/activity/detail/reasonCode Path had no found values in any example. Consider reviewing the path
    • CarePlan/activity/detail/reasonReference Path had no found values in any example. Consider reviewing the path
    • CarePlan/supportingInfo Path had no found values in any example. Consider reviewing the path
  • QA Checklist: GF#10621 QA 4a: Consider whether CarePlan.activity.detail.category should be bound to an external code system (Michelle Miller)

Draft Resources with FMM = 0 -- ClinicalImpression and Linkage

• ClinicalImpression -- keep as FMM = 0
  • Stephen Chu will work on examples to cover all elements
    • ClinicalImpression.action Search Parameter 'ClinicalImpression.action' had no found values in any example. Consider reviewing the expression (ClinicalImpression.action)
    • ClinicalImpression.previous Search Parameter 'ClinicalImpression.previous' had no found values in any example. Consider reviewing the expression (ClinicalImpression.previous)
  • PCWG: ClinicalImpression.code Need to provide a binding

• Linkage -- keep as FMM = 0
  • PCWG: Linkage A resource must have an 'entered in error' status
  • PCWG: Linkage All resources should have an identifier
  • PCWG: Linkage.item Element has a todo associated with it (Make this 2..*.)

Block Vote (Thurs, Feb 2)

Non-ballot comments

• GF#12585 Add Goal.target.measure invariant (Michelle Miller) Persuasive
• GF#12645 CarePlan.activity.reference includes ProcessRequest (Dave Carlson) Persuasive
• GF#12646 Add "careplan-title" extension (Dave Carlson) Persuasive with Mod
• GF#12668 ClinFHIR: extension-condition-partof - add support for referencing Condition (Michelle Miller) Persuasive
• GF#12669 Please add note element to careTeam (Emma Jones) Persuasive

Adjourn

Adjourned at 6:22pm Eastern.

Meeting Outcomes

Actions Michelle to log gForge to align ReferralRequest with v2

Next Meeting/Preliminary Agenda Items Agenda review Approve previous meeting minutes Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#> gForge change request

© 2012 Health Level Seven® International. All rights reserved.