2011-02-22 Rx Conf Call

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Rob Hallowell (chair), Hugh Glover (notes), Julie James, Melva Peters, Scott Robertson, Wendy Huang, Vassil Peytchev, Ana Estelrich, Tanya Achilles, Tom de Jong, John Hatem

Report on Action Items

Outstanding from 2011-01-25

  • Minutes
    • Rob will post minutes and embed presentations within it.
  • Progress with Successful Ballots:
    • Topic Editors (mainly Jean-Henri and Hugh) will make the necessary content changes (park until 27th Feb)
  • Pharmacy Intro for the Wiki
    • Hugh - will use any introductory material people can provide to try drafting an introduction.
    • John and Tanya may have some content and send it if possible
    • Hugh to ask Tom if there is any Dutch content
    • Hugh to see if the UK MIM might have useable content

Completed from 2011-02-08

  • All action items were completed

OOC Report

The meeting was attended by 8 people and pretty much kept to the posted agenda.

Medication Statement and Administration - We worked through the existing material, then identified all the "normal" business flows. This lead to some slight struggling with definitions and identification of some edge cases especially admin schedules for infusions. We then constructed the static models required and were able to produce a trial publication of the new ballot pack.

Institutional Setting - We again looked at the dynamic model particularly looking the IHE profile, HL7 v2 material and some French and Norwegian storyboards (that were being translated on the spot). We identified some issues around the Promise and Give actions (discussed below). We looked at the basics of the dynamic static models and began to edit the existing ballot material.

Actions - see 2011-02_Out_of_Cycle_Meeting

The OOC meeting raised questions about the Encoded Order and the use of the v2 "Give" segment. These were discussed during the call as follows:

Discussion of RDE Equivalents / the Encoded Order Rob: the v2 RDE segment gets used in 2 ways: a) As a promise, the source is the pharmacy system and the target is the ordering system or others who are interested b) Same message content but as an order not as a promise. The source is the pharmacy system butthe target is another pharmacy system or some form of auto dispenser. The underlying use case is where the first pharmacy system passes on the order to another system.

Tom: How does this relate to administration from ward stock where there is effectively no order to dispense? Scott - there was an original order and although a pharmacy system will not go through the full message cycle they will still have to produce an acknowledgement and a copy of some form of order will probably be sent for billing purposes. Rob: the main point is about taking an original order and making it into a dispensible order by specifying any further details that are required. By definition any ward stock is already "dispensed" and orders that are based on ward stock are therefore likely to already be "dispensible". John: there may still be some clarification on dosage, but typically the order will be actioned without waiting for that clarification. Vassil: In emergency normal processes are not followed (the group felt this was covered)

John: The exact operation of the order and its fulfilment seem to vary a little by jurisdiction but the components are still the same.

Rob: there are other interactions that in v2 would be based on RDE: a) Pharmacy to Robot (agreed its a request) b) Administration system to "others" recording that patient education has been given is a v2 RDE John: teaching patient how to do an injection for themselves is an example Melva: Patient Education is covered by professional services (there was agreement it wasn't directly a pharmacy use case)

Hugh: The conclusion seems to be that RDE translates to Promise in only the one case where Pharmacy sends a "confirmation" back to the original ordering system. IN all other cases the RDE seems to be a "request".

Discussion of Give Message Tom: In v2 there is an GIV segment, but it has no definition and its not clear what it would be used for Rob: has doubt that its ever actually used - need to look at actual systems to see if this is a real example Scott: doesn't think RAS and GIV are used Vassil: Thinks GIV is used but needs to check Rob, Scott, Vassil - investigate for discussion next week

Harmonisation Proposal There is a Canadian proposal for addition of 2 codes to Medication Abort Reason Code covering cases where a prescription has become obsolete, or should have been cancelled after an error but was not. In both cases an abort has to be forced and the vocabulary identifies such cases.

The proposal will be circulated for discussion on March 1st

The proposal has to be completed by 6th March

Ballot Plans

Rob need to submit Notification of Intent to Ballot forms by Sunday27th

  • For Medication Statement and Administration Rob needs a summary of the changes that mean a ballot is required. Action: Hugh
  • IDMP - Rob needs changes and project description. Action: Hugh

Agenda for 1st March

  • Report on action items
  • Canadiaan harmoinisation proposal
  • OOC Review
  • Remaining ballot resolution
  • AoB