2012-09-11 PA WGM Minutes

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Patient Administration Work Group Meeting - Tuesday September 11, 2012

Tuesday Q1

HL7 Patient Administration Meeting Minutes

Location: Annapolis (Hosted by Patient Care)

Date: 2010-10-05
Time: Tuesday Q1
Facilitator Note taker
Attendee Name Affiliation
X Line Saele Helse Vest IKT Norway
X Alex de Leon Kaiser Permanente
X Irma Jongeneel HL7 Netherlands
X Helen Drijfhout HL7 Netherlands
X Christian Hay GS1
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  • Joint w/Patient Care (hosted by Patient Care)
  • V3 Work - Harmonization of Encounter and Care Provision model

Supporting Documents

Minutes

Minutes/Conclusions Reached:

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • .
Next Meeting/Preliminary Agenda Items
  • .

Tuesday Q2

HL7 Patient Administration Meeting Minutes

Location: Guest Room 547

Date: 2010-10-05
Time: Tuesday Q3
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Line Saele Helse Vest IKT Norway
X Irma Jongeneel HL7 Netherlands
X Alex de Leon Kaiser Permanente
X Amy Mayer HL7 Australia
X Helen Drijfhout HL7 Netherlands
X Christian Hay GS1
X Peter Goldschmidt AHRQ/WDG
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  1. V3 Work - Service Delivery Location

Supporting Documents

Minutes

Minutes/Conclusions Reached:

  • The WG had reserved this time for specific representation (Peter Goldschmidt). Without his immediate attendance, the WG decided to work on preparation for the FHIR discussion in the next quarter.
  • First the WG discussed the expected resources as defined in the FHIR website.
  • During this discussion, Peter showed up. The WG continued then with the Service Delivery Location discussion. He brought a concern regarding coding locations. His organization, Agency for Health Care, Research and Quality, developed a standard set of location codes to support patient safety. They are attempting to coordinating with SNOMED location codes. Their efforts are around site of service codes. His interest is in seeing how this subject has been handled by this WG, if it has.
  • Peter is here to assure that we harmonize efforts. Irma noted that each implementation would, today, have it's own code set for service delivery location. For patient safety sake, Peter's efforts have tried to define standard service delivery locations. The WG suggested that Peter bring back the service delivery locations that his efforts have defined as part of their patient safety concerns to share with the HL7 community at large, through the PAWG. He is interested in feedback from the community for his list as well. The WG asked if Peter would bring an update to the next WGM. He confirmed, so the WG will set aside time in the next meeting for this.
  • Irma suggested that we discuss this with Wendy, the vocab facilitator to see when she is available to discuss this and to plan for the next meeting in Phoenix (January).
  • The WG then moved on to try to prepare for FHIR.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • .
Next Meeting/Preliminary Agenda Items
  • .

Tuesday Q3

HL7 Patient Administration Meeting Minutes

Location: Constellation C

Date: 2010-10-05
Time: Tuesday Q3
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Line Saele Helse Vest IKT Norway
X Irma Jongeneel HL7 Netherlands
X Alex de Leon Kaiser Permanente
X Ewout Kramer Furore
X Graham Grieve Health Intersections
.
Quorum Requirements Met (Chair + 2 members): Yes/No

Agenda

Agenda Topics

  • FHIR Discussion

Supporting Documents

Minutes

Minutes/Conclusions Reached:

  • MnM/FHIR hosting PA - PA related FHIR resources

Presentation by Ewout Kramer on the prepared work between May 2012 and September 2012. Content of that has been to investigate and propose FHIR resources that would lie in the PA domain.

Introduction to FHIR not really necessary since everybody present indicates that he feels comfortable with the FHIR basics.

Principle in the FGIR design process is to find the 80-20 line, where everything in the 80% goes into the FHIR core and the remaining 20% goes into extensions.

Presentation lists the current expectation of what will be resources: Person, Agent, Animal, Patient, Organization, Service Delivery Location, Place, Group. Irma asks whether this list is open for discussion as well. Ewout: Yes absolutely. However it may not be viable to handle everything this quarter.

Bigger questions:

  • Do we need Patient next to Person? What distinguishes a Patient?
  • Scenario 1: Patient = all personal info relevant to patients. Name, patient id, personal relationship, addresses etc.
  • Scenario 2: Patient = specific additional administrative information

Discussion: Alexander de Léon: in Kaiser we have Members that can become Patient. Does that justify having a Person separate from Patient Woody Beeler: coming from Mayo we used to have multiple systems where the same people are and we spent lots of resources and money figuring out when to update what. So I would argue that not having a Person is bound to get you into trouble eventually. You can create several roles that largely share the same attributes because they are the same Person, but you cannot formally see that they are. Grahame Grieve: we are trying to get away from people "having to" separate Person and Patient. Logically it presents a problem for systems. Ewout Kramer: would you tie observations on Patient or on Person? In shared care context you could loose track of observations tied into Patient.

With the result for what made it into core versus what made it into extension the discussion was spurred: If you have something in core you could still profile it out, so why would you put something in extension? Lloyd McKenzie: an extra requirement/question you need to ask is: do we expect a core element to be populated around the world in the same way? If the answer is no, than extension is better.

Alexander de Léon: why would you abbreviate "dob" and fully name the rest? Not everybody necessarily understands "dob" as an acronym. Lloyd McKenzie: the style guide for naming has not been finalized by MnM yet

Irma Jongeneel: proposing to stick to core and leave extension be for the moment. We have too many people coming in with smaller use cases Woody Beeler: not sure if I agree with that, for acceptance sake Grahame Grieve: I think I agree with Irma that we at least in the first round need to be agile

Alexander de Léon: I'm a little confused as to what is asked from this point on Ewout Kramer: we tried our best to get a good proposal to the PA committee to vet on and get it out there.

Lloyd McKenzie to Ewout: revisiting how you worked through. You said that you started from the D-MIM, but you should also consult V2 and other models to be sure that you are complete and to find out appropriate naming.

Looking at the resolution for family, member, contact "RelatedParty" discussion on whether or not having multiple codes on the RelatedParty is possible. You could say that someone is father AND contact. Answer is that it is technically possible, but currently decided to be undesirable. Alexander Henket: questionable whether or not systems could actually produce/persist multiple roles on one person Second question is whether or not the Name/Role/Contacts/Period attributes and the Person resources thing is a choice or not. Answer by Lloyd that this is not technically possible in FHIR. There's no choice in the syntax.

Next steps:

  • Build Person, Patient. Full definitions, vocabulary
  • Organization, Agent, Location, Group
  • Who tracks ballot comments?
    • Woody: for the moment we should have MnM receive the comments, triage them, and refer to the right WG
  • Discussed PSS and filled it out
    • Ewout Kramer: project facilitator
    • Alexander Henket: modeling facilitator
    • Wendy Huang: vocabulary facilitator
    • Health Intersections / Thrasys implementers

Motion to pass the PSS postponed to later this week

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • .
Next Meeting/Preliminary Agenda Items
  • .

Tuesday Q4

HL7 Patient Administration Meeting Minutes

Location: Guest Room 547

Date: 2010-10-05
Time: Tuesday Q4
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Line Saele Helse Vest IKT Norway
X Chris White Thrasys
X Alex de Leon Kaiser Permanente
X Amy Mayer HL7 Australia
X Helen Drijfhout HL7 Netherlands
Quorum Requirements Met (Chair + 3 members): Yes

Agenda

Agenda Topics

  1. V3 Work - Ballot Reconcilliation

Supporting Documents

Minutes

Minutes/Conclusions Reached:

  • The WG looked at the comments received for the ballot. The only one comment came on the Person Registry; however, this was an affirmative with the comment having to do with Person Universal Identifier, stating


Until we get a universal identifier for individuals, we are inviting excessive expenses and predictable and consequential breeches. The ballotted material accomodates such identifiers, but unfortunately does not require them. The resulting demographic matching has a 3-sigma accuracy, which is unacceptable in an HIE environment.


The WG takes note of the comment and will consider the ballot as passed.

The WG continued to discuss FHIR, having a representative from the FHIR "Connectathon".

The WG considered when we could discuss the FHIR in the remainder of this meeting. Tomorrow, Q1 seemed the best option, since we have no V2 proposals nor updates.

Helen moved, Alex seconded, to use Q1 for FHIR continued discussion, as there does not seem to be v2 work to discuss. Discussion: this seemed the best option to have the domain experts present and discuss the PA resources.

Vote: 4/0/0

Helen moved to adjourn. Vote: 4/0/0 Meeting adjourned at 4:45

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
Next Meeting/Preliminary Agenda Items
  • .

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