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Difference between revisions of "2017-01-26 Patient Care FHIR Call"

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|colspan="2"| NIH/Department of Clinical Research Informatics
 
|colspan="2"| NIH/Department of Clinical Research Informatics
 
|-
 
|-
−
| || Stephen Chu
+
| X || Stephen Chu
 
|colspan="2"| The Australian Digital Health Agency (ADHA)
 
|colspan="2"| The Australian Digital Health Agency (ADHA)
 
|-
 
|-
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|colspan="2"| EMI Advisors LLC
 
|colspan="2"| EMI Advisors LLC
 
|-
 
|-
−
| || Eric Haas
+
| X|| Eric Haas
 
|colspan="2"| Haas Consulting
 
|colspan="2"| Haas Consulting
 
|-
 
|-
−
| || Rob Hausam
+
|X || Rob Hausam
 
|colspan="2"| Hausam Consulting LLC
 
|colspan="2"| Hausam Consulting LLC
 
|-
 
|-
−
| || Laura Heermann-Langford
+
| X || Laura Heermann-Langford
 
|colspan="2"| Intermountain Healthcare
 
|colspan="2"| Intermountain Healthcare
 
|-
 
|-
−
| || Emma Jones
+
| X|| Emma Jones
 
|colspan="2"| Allscripts
 
|colspan="2"| Allscripts
 
|-
 
|-
−
| || Russ Leftwich
+
| X|| Russ Leftwich
 
|colspan="2"| InterSystems
 
|colspan="2"| InterSystems
 
|-
 
|-
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|colspan="2"| Cerner
 
|colspan="2"| Cerner
 
|-
 
|-
−
| || Michelle M Miller  
+
| X || Michelle M Miller  
 
|colspan="2"| Cerner
 
|colspan="2"| Cerner
 
|-
 
|-
Line 107: Line 107:
 
|colspan="2"| Intermountain Healthcare
 
|colspan="2"| Intermountain Healthcare
 
|-
 
|-
−
| || Joe Quinn
+
|X || Joe Quinn
 
|colspan="2"| Optum
 
|colspan="2"| Optum
 
|-
 
|-
−
| || Simon Sum
+
|X || Simon Sum
 
|colspan="2"| Academy of Nutrition and Dietetics
 
|colspan="2"| Academy of Nutrition and Dietetics
 
|-
 
|-
Line 118: Line 118:
 
| || Serafina Versaggi
 
| || Serafina Versaggi
 
|colspan="2"| Dept of Veterans Affairs
 
|colspan="2"| Dept of Veterans Affairs
 +
|-
 +
| X|| Tracey Coleman
 +
|colspan="2"| Allscripts
 +
|-
 +
| X|| Amit Popat
 +
|colspan="2"| Epic
 
|-
 
|-
 
|colspan="4" style="background:#f0f0f0;"|
 
|colspan="4" style="background:#f0f0f0;"|
Line 142: Line 148:
 
#Agenda review
 
#Agenda review
 
#Approve previous meeting minutes [[2017-01-12_Patient_Care_FHIR_Call]] and [[2017-01-25_Patient_Care_FHIR_Call]]
 
#Approve previous meeting minutes [[2017-01-12_Patient_Care_FHIR_Call]] and [[2017-01-25_Patient_Care_FHIR_Call]]
−
#*'''Motion:''' <moved>/<seconded>
+
#*'''Motion:''' Russ/Emma
 
#Prior Action Item Follow-up   
 
#Prior Action Item Follow-up   
 
# gForge change request
 
# gForge change request
Line 157: Line 163:
 
* Sun. Mar. 20 All QA applied  
 
* Sun. Mar. 20 All QA applied  
 
The "following week" STU 3 is published!
 
The "following week" STU 3 is published!
−
 
−
====FHIR Maturity Levels====
 
−
[http://hl7-fhir.github.io/resource.html#maturity]
 
−
Level 3 requires the artifact has been verified by the work group as meeting the [[DSTU_2_QA_guidelines]] and has been subject to a round of formal balloting; has at least 10 implementer comments recorded in the tracker drawn from at least 3 organizations resulting in at least one substantive change
 
−
 
−
{|border="1" cellpadding="2" cellspacing="0"
 
−
| width="25%" colspan="1" align="left" style="background:#f0f0f0;"|'''Resource''' <br/>
 
−
| width="10%" colspan="1" align="left" style="background:#f0f0f0;"|'''Current FMM Level'''
 
−
| width="10%" colspan="1" align="left" style="background:#f0f0f0;"|'''Goal FMM Level'''
 
−
| width="10%" colspan="1" align="left" style="background:#f0f0f0;"|'''QA Status'''
 
−
| width="10%" colspan="1" align="left" style="background:#f0f0f0;"|'''QA Reviewer'''
 
−
| width="10%" colspan="1" align="left" style="background:#f0f0f0;"|'''Implementation'''
 
−
| width="25%" colspan="1" align="left" style="background:#f0f0f0;"|'''Comments'''<br/>
 
−
|-
 
−
|| '''AllergyIntolerance''' || 1 || 3 || || Michelle|| Argonaut ||
 
−
|-
 
−
|| '''Condition''' || 2 || 3 || || Michelle|| Argonaut ||
 
−
|-
 
−
|| '''Procedure''' || 1 || 3 || || Michelle|| Argonaut || 
 
−
|-
 
−
|| '''CarePlan''' || 1 || 3 || || Michelle|| Argonaut ||
 
−
|-
 
−
|| Goal || 1 || 3 || || Michelle|| ||
 
−
|-
 
−
|| QuestionnaireResponse || 2 || 2 || || Lloyd || || Lloyd will QA to get to level 3
 
−
|-
 
−
|| Questionnaire || 0 || 2 || || Lloyd || || Lloyd will QA to get to level 3 
 
−
|-
 
−
|| CareTeam || 0 || 2 || NA || Michelle || || Aggressive goal (e.g. whether we'll get the implementations needed)
 
−
|-
 
−
|| FamilyMemberHistory || 1 || 2 || NA || NA || || Aggressive goal (e.g. whether we'll get the implementations needed)
 
−
|-
 
−
|| ClinicalImpression || 0 || 1 || NA || NA || || 
 
−
|-
 
−
|| ReferralRequest || 1 || 1 || NA || NA || || 
 
−
|-
 
−
|| ProcedureRequest || 1 || 1 || NA || NA || || 
 
−
|-
 
−
|| Linkage || 0 || 1 || NA || NA || || 
 
−
|-
 
−
|| Flag || 1 || 1 || NA || NA || || 
 
−
|-
 
−
|| Communication || 1 || 1 || NA || NA || || 
 
−
|-
 
−
|| CommunicationRequest || 1 || 1 || NA || NA || || 
 
−
|-
 
−
|}
 
−
 
−
Note:  Bold denotes top 20 resource based on [https://docs.google.com/forms/d/12GVflt2GLprr8E3_8dppkxBZXqTg2n_zdaWzo6qtags/viewanalytics| survey ] <br>
 
−
Note:  Contraindication and Risk Assessment are owned by CDS, not Patient Care <br/>
 
  
 
==Minutes==
 
==Minutes==
Line 228: Line 184:
 
* Review workflow gap analysis per [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10293 GF#10293]
 
* Review workflow gap analysis per [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10293 GF#10293]
 
* Block Vote (see below) scheduled for next week for low hanging fruit, i.e. non-ballot comments
 
* Block Vote (see below) scheduled for next week 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)
  
 
=== Defer Ballot Comments ===
 
=== Defer Ballot Comments ===
 +
Motion:  Russ/Rob H: 8-0-0
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=7185 GF#7185] 2015May core #244  - ClinicalImpression is poorly thought out (Clem McDonald) Waiting for Input
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=7185 GF#7185] 2015May core #244  - ClinicalImpression is poorly thought out (Clem McDonald) Waiting for Input
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10387 GF#10387] CommunicationRequest needs ability to describe the location that the communication is about (John Moehrke)  
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10387 GF#10387] CommunicationRequest needs ability to describe the location that the communication is about (John Moehrke)  
Line 241: Line 199:
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11357 GF#11357] Re-use the procedure value set instead of wrapping it - 2016-09 core #515  (Robert McClure)  
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11357 GF#11357] Re-use the procedure value set instead of wrapping it - 2016-09 core #515  (Robert McClure)  
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11358 GF#11358] Should not make a new value set ehre - use the Problem value set that also includes Events and SWEC concepts. - 2016-09 core #516  (Robert McClure)  
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11358 GF#11358] Should not make a new value set ehre - use the Problem value set that also includes Events and SWEC concepts. - 2016-09 core #516  (Robert McClure)  
−
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11359 GF#11359] Why only one medication in an activity? And the value set is problematic (but example) - 2016-09 core #517  (Robert McClure)  
+
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11359 GF#11359] Why only one medication in an activity? And the value set is problematic (but example) - 2016-09 core #517  (Robert McClure)
  
−
=== TOP Priority -- AllergyIntolerance, Condition, and Procedure QA Warnings/Information (desire FMM = 3) ===
+
=== TOP Priority -- AllergyIntolerance, Condition, and Procedure -- QA Warnings/Information (desire FMM = 3) ===
 
* AllergyIntolerance
 
* AllergyIntolerance
 
** Rob Hausam is helping with RIM mappings (clinicalStatus and verificationStatus)
 
** Rob Hausam is helping with RIM mappings (clinicalStatus and verificationStatus)
−
** Rob Hausam and Eric Hass have been asked for their opinion on the Duplicate Valueset Names: manifestation-codes (SNOMED CT Clinical Findings) & clinical-findings (SNOMED CT Clinical Findings)  
+
** 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  
 
*** AllergyIntolerance.reaction.manifestation -- http://build.fhir.org/valueset-manifestation-codes.html  
 
*** DiagnosticReport.codedDiagnosis (and profiles) -- http://build.fhir.org/valueset-clinical-findings.html
 
*** DiagnosticReport.codedDiagnosis (and profiles) -- http://build.fhir.org/valueset-clinical-findings.html
 +
** Review gForges in context of WGM discussions
 +
*** [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11020 GF#11020] Need use-case for reaction.certainty - 2016-09 core #39  (Jay Lyle) Resolved - Change required <p> Will move Reaction.certainty to an extension  at least for now.</p>
 +
*** [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11021 GF#11021] Increase cardinality of substance and make certainty relation to substance  not reaction - 2016-09 core #40  (Jay Lyle) DEFERRED
 +
*** [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11023 GF#11023] Why isn't AllergyIntolerance.reaction an Observation? - 2016-09 core #42  (Jay Lyle) DEFERRED
 +
*** [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11354 GF#11354] Substance identified in both AllergyIntolerance.code and reaction.substance is problematic - 2016-09 core #512  (Robert McClure) DEFERRED
  
−
* Condition is DONE!
+
* Condition is clean on the QA report!
 +
** QA Checklist:  [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10635 GF#10635] QA 5a: Resource references exist in both directions for Condition and ClinicalImpression (Michelle Miller) -- DEFERRED
  
−
* Procedure
+
* Procedure is clean on the QA report!
−
** Emma Jones is helping with examples (part of, complication detail)
 
−
** PCWG:  http://build.fhir.org/valueset-procedure-progress-status-codes.html (used by http://build.fhir.org/extension-procedure-progressstatus.html) is missing definitions for the codes.
 
  
 
=== MEDIUM Priority -- CareTeam, CarePlan, and Goal -- QA Warnings (desire FMM > 0 means we address all warnings) ===
 
=== MEDIUM Priority -- CareTeam, CarePlan, and Goal -- QA Warnings (desire FMM > 0 means we address all warnings) ===
  
 
* CarePlan
 
* CarePlan
−
** Stephen Chu is helping with examples to cover all elements
 
 
** MnM exemptions requested for element names should be singular (addresses and replaces)
 
** MnM exemptions requested for element names should be singular (addresses and replaces)
−
** PCWG:  WARNING:CarePlan.partOf Element has a todo associated with it (Each care plan is an independent request, such that having a care plan be part of another care plan can cause issues with cascading statuses. As such, this element is still being discussed.)
 
  
 
* Goal
 
* Goal
Line 270: Line 231:
 
*** WARNING:Goal.description Need to provide a binding
 
*** WARNING:Goal.description Need to provide a binding
 
*** WARNING:Goal.outcomeCodeableConcept Element has a todo associated with it (Define a proper value set for this.)
 
*** WARNING:Goal.outcomeCodeableConcept Element has a todo associated with it (Define a proper value set for this.)
 +
** [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12718 GF#12718] - Rename Goal.outcomeCodeableConcept to Goal.outcomeCode (Rob H) Resolved - Change Required
  
 
=== MEDIUM Priority -- CareTeam, CarePlan, and Goal -- QA Information (desire FMM = 3 means we address all information) ===
 
=== MEDIUM Priority -- CareTeam, CarePlan, and Goal -- QA Information (desire FMM = 3 means we address all information) ===
Line 277: Line 239:
 
* Goal
 
* Goal
 
** RIM Mapping
 
** RIM Mapping
−
** Example - Goal/outcomeCodeableConcept Path had no found values in any example. Consider reviewing the path
+
** QA Checklist: [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10622 GF#10622] QA 4a: Consider whether Goal.category should be bound to codes from an external code system (Michelle Miller)
  
 
* CarePlan
 
* CarePlan
Line 286: Line 248:
 
*** CarePlan/activity/detail/reasonCode 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/activity/detail/reasonReference Path had no found values in any example. Consider reviewing the path
−
*** CarePlan/activity/reference 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
 
*** CarePlan/supportingInfo Path had no found values in any example. Consider reviewing the path
 +
** QA Checklist: [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10621 GF#10621] QA 4a: Consider whether CarePlan.activity.detail.category should be bound to an external code system (Michelle Miller)
  
 
=== LOW Priority -- All other resources -- QA Warnings (desire FMM > 0 means we address all warnings) ===
 
=== LOW Priority -- All other resources -- QA Warnings (desire FMM > 0 means we address all warnings) ===
Line 293: Line 255:
 
* ClinicalImpression
 
* ClinicalImpression
 
** Stephen Chu will work on examples to cover all elements
 
** Stephen Chu will work on examples to cover all elements
−
** PCWG:  WARNING:ClinicalImpression.code Need to provide a binding
+
*** 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
  
 
* Communication & CommunicationRequest
 
* Communication & CommunicationRequest
−
** PCWG:  WARNING: category Need to provide a binding
+
** PCWG:  category Need to provide a binding
 
** PCWG:  workflow could resolve [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10293 GF#10293]  
 
** PCWG:  workflow could resolve [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10293 GF#10293]  
−
*** WARNING: A resource must have an 'entered in error' status
+
*** A resource must have an 'entered in error' status
−
*** WARNING:CommunicationRequest.subject Elements with name 'subject' cannot be a reference to just a patient
+
*** CommunicationRequest.subject Elements with name 'subject' cannot be a reference to just a patient
  
 
* FamilyMemberHistory
 
* FamilyMemberHistory
−
** PCWG:  WARNING:FamilyMemberHistory.condition.onset[x] Element has a todo associated with it (Define/find appropriate observation code.)
+
** PCWG:  FamilyMemberHistory.condition.onset[x] Element has a todo associated with it (Define/find appropriate observation code.)
  
 
* ReferralRequest
 
* ReferralRequest
 
** PCWG: Bindings/Value Sets
 
** PCWG: Bindings/Value Sets
−
*** WARNING:ReferralRequest.type Need to provide a binding
+
*** ReferralRequest.type Need to provide a binding
−
*** WARNING:ReferralRequest.reason Need to provide a binding
+
*** ReferralRequest.reason Need to provide a binding
−
*** WARNING:pc:ValueSetComparison Duplicate Valueset Names: v2-0284 (v2 Referral Category) & referralcategory (ReferralCategory) (name: [referrals, categories] / [referrals, categories]))
+
*** pc:ValueSetComparison Duplicate Valueset Names: v2-0284 (v2 Referral Category) & referralcategory (ReferralCategory) (name: [referrals, categories] / [referrals, categories]))
−
*** WARNING:pc:ValueSetComparison Duplicate Valueset Names: v2-0283 (v2 Referral Status) & referralstatus (ReferralStatus) (name: [referrals, statuses] / [referrals, statuses]))
+
*** pc:ValueSetComparison Duplicate Valueset Names: v2-0283 (v2 Referral Status) & referralstatus (ReferralStatus) (name: [referrals, statuses] / [referrals, statuses]))
−
** PCWG: WARNING:ReferralRequest.description Element has a todo associated with it (This would be a good candidate for a 'markdown' data type.)
+
** PCWG: ReferralRequest.description Element has a todo associated with it (This would be a good candidate for a 'markdown' data type.)
 +
** Examples
 +
*** ReferralRequest.context Search Parameter 'ReferralRequest.context' had no found values in any example. Consider reviewing the expression (ReferralRequest.context)
 +
*** ReferralRequest.group-identifier Search Parameter 'ReferralRequest.group-identifier' had no found values in any example. Consider reviewing the expression (ReferralRequest.groupIdentifier)
  
 
* Linkage
 
* Linkage
−
** PCWG: WARNING:Linkage A resource must have an 'entered in error' status
+
** PCWG: Linkage A resource must have an 'entered in error' status
−
** PCWG: WARNING:Linkage All resources should have an identifier
+
** PCWG: Linkage All resources should have an identifier
−
** PCWG: WARNING:Linkage.item Element has a todo associated with it (Make this 2..*.)
+
** PCWG: Linkage.item Element has a todo associated with it (Make this 2..*.)
  
 
=== Block Vote (Thurs, Feb 2)===
 
=== Block Vote (Thurs, Feb 2)===
Line 326: Line 293:
  
 
=== Adjourn ===
 
=== Adjourn ===
−
Adjourned at <hh:mm am/pm> <timezone>.
+
Adjourned at 6:45pm Eastern.
  
 
==Meeting Outcomes==
 
==Meeting Outcomes==
Line 343: Line 310:
 
| width="100%" align="left" style="background:#f0f0f0;"|'''Actions''' ''
 
| width="100%" align="left" style="background:#f0f0f0;"|'''Actions''' ''
 
   
 
   
−
*
+
* Michelle to ask for exemptions from QA Checklist (Condition circular reference) and QA warnings (Goal bindings)
 +
* Michelle to schedule additional call on Monday
  
 
|-
 
|-

Latest revision as of 23:56, 26 January 2017



Meeting Information

Patient Care FHIR Resources Conference Call

Location: Conference Call
Phone Number: +1 770-657-9270
Participant Passcode: 943377
WebEx: https://cerner.webex.com/cerner/j.php?MTID=macd64a688fdc3410ab4178adab5820fb

Date: 2017-01-26
Time: 5-6:30pm ET
Facilitator Michelle M Miller Note taker(s) Michelle M Miller
Attendee Name Affiliation


Elaine Ayres NIH/Department of Clinical Research Informatics
X Stephen Chu The Australian Digital Health Agency (ADHA)
Evelyn Gallego EMI Advisors LLC
X 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
X Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
Serafina Versaggi Dept of Veterans Affairs
X Tracey Coleman Allscripts
X Amit Popat Epic
Quorum Requirements Met: yes

Agenda

Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2017-01-12_Patient_Care_FHIR_Call and 2017-01-25_Patient_Care_FHIR_Call
    • Motion: Russ/Emma
  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
  • Defer 12 ballot comments that won't get resolved by Feb 5 (see below for discussion today)
  • 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 next week 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)

Defer Ballot Comments

Motion: Russ/Rob H: 8-0-0

  • GF#7185 2015May core #244 - ClinicalImpression is poorly thought out (Clem McDonald) Waiting for Input
  • GF#10387 CommunicationRequest needs ability to describe the location that the communication is about (John Moehrke)
  • GF#10621 QA 4a: Consider whether CarePlan.activity.detail.category should be bound to an external code system (Michelle Miller)
  • GF#10622 QA 4a: Consider whether Goal.category should be bound to codes from an external code system (Michelle Miller)
  • GF#10623 QA: Goal CodeableConcept elements are missing a binding to a value set (Michelle Miller) -- QA WARNING!
  • GF#10635 QA 5a: Resource references exist in both directions for Condition and ClinicalImpression (Michelle Miller)
  • GF#11026 Relationship between Condition and Observation - 2016-09 core #45 (Jay Lyle)
  • GF#11209 Feedback on ClinicalImpression - 2016-09 core #363 (Riki Merrick)
  • GF#11355 CarePlan category value set is out of date or wrong - 2016-09 core #513 (Robert McClure)
  • GF#11357 Re-use the procedure value set instead of wrapping it - 2016-09 core #515 (Robert McClure)
  • GF#11358 Should not make a new value set ehre - use the Problem value set that also includes Events and SWEC concepts. - 2016-09 core #516 (Robert McClure)
  • GF#11359 Why only one medication in an activity? And the value set is problematic (but example) - 2016-09 core #517 (Robert McClure)

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
    • Review gForges in context of WGM discussions
      • GF#11020 Need use-case for reaction.certainty - 2016-09 core #39 (Jay Lyle) Resolved - Change required

        Will move Reaction.certainty to an extension at least for now.

      • GF#11021 Increase cardinality of substance and make certainty relation to substance not reaction - 2016-09 core #40 (Jay Lyle) DEFERRED
      • GF#11023 Why isn't AllergyIntolerance.reaction an Observation? - 2016-09 core #42 (Jay Lyle) DEFERRED
      • GF#11354 Substance identified in both AllergyIntolerance.code and reaction.substance is problematic - 2016-09 core #512 (Robert McClure) DEFERRED
  • Condition is clean on the QA report!
    • QA Checklist: GF#10635 QA 5a: Resource references exist in both directions for Condition and ClinicalImpression (Michelle Miller) -- DEFERRED
  • Procedure is clean on the QA report!

MEDIUM Priority -- CareTeam, CarePlan, and Goal -- QA Warnings (desire FMM > 0 means we address all 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)
    • PCWG needs to address GF#10623
      • WARNING:Goal.target.detail[x] Need to provide a binding
      • WARNING:Goal.outcomeCodeableConcept Need to provide a binding
      • WARNING:Goal.description Need to provide a binding
      • WARNING:Goal.outcomeCodeableConcept Element has a todo associated with it (Define a proper value set for this.)
    • GF#12718 - Rename Goal.outcomeCodeableConcept to Goal.outcomeCode (Rob H) Resolved - Change Required

MEDIUM 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)

LOW Priority -- All other resources -- QA Warnings (desire FMM > 0 means we address all warnings)

  • ClinicalImpression
    • 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
  • Communication & CommunicationRequest
    • PCWG: category Need to provide a binding
    • PCWG: workflow could resolve GF#10293
      • A resource must have an 'entered in error' status
      • CommunicationRequest.subject Elements with name 'subject' cannot be a reference to just a patient
  • FamilyMemberHistory
    • PCWG: FamilyMemberHistory.condition.onset[x] Element has a todo associated with it (Define/find appropriate observation code.)
  • ReferralRequest
    • PCWG: Bindings/Value Sets
      • ReferralRequest.type Need to provide a binding
      • ReferralRequest.reason Need to provide a binding
      • 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]))
    • PCWG: ReferralRequest.description Element has a todo associated with it (This would be a good candidate for a 'markdown' data type.)
    • Examples
      • ReferralRequest.context Search Parameter 'ReferralRequest.context' had no found values in any example. Consider reviewing the expression (ReferralRequest.context)
      • ReferralRequest.group-identifier Search Parameter 'ReferralRequest.group-identifier' had no found values in any example. Consider reviewing the expression (ReferralRequest.groupIdentifier)
  • Linkage
    • 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 6:45pm Eastern.

Meeting Outcomes

Actions
  • Michelle to ask for exemptions from QA Checklist (Condition circular reference) and QA warnings (Goal bindings)
  • Michelle to schedule additional call on Monday
Next Meeting/Preliminary Agenda Items
  1. Agenda review
  2. Approve previous meeting minutes
    • Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#>
  3. gForge change request

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