2013-01-14 PA WGM Minutes

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Patient Administration Work Group Minutes - Monday January 14, 2013

Monday Q1

HL7 Patient Administration Meeting Minutes

'Location:

Date: 2012-01-14
Time: Monday Q1
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Alex de Leon Kaiser Permanente
X Line Saele HL7 Norway
X Helen Drijfhout HL7 Netherlands
X Toril O. Reite HL7 Norway
X Peter Goldschmidt AHRQ/WDG
X Christian Hay GS1
X Barry Guin EPIC
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics
Welcome/introductions

Supporting Documents

Minutes

Minutes/Conclusions Reached:
The week's agenda was reviewed by the WG:

Peter Goldschmidt joined the group and asked if we could change the agenda to allow him to present this quarter since he has a commitment in Q2, where he is scheduled to present.

Toril motioned, Helen seconded to change the agenda to allow for the presentation Service Delivery Location this quarter. Vote: 6/0/0

Peter then proceeded to give an update to the work being done with service delivery location.

The AHRQ (Agency for Healthcare Research and Quality) along with the Patient Safety WG have tried to address the importance of documenting locations in a way that are interoperable within the healthcare environment. There is a program to develop common formats for locations in healthcare which is being coordinated with SNOMED (so axis are consistent with the schemes that are being developed). In ICD 11 there is an effort to capture location for service delivery location as well as where accidents occur. There are breakdowns consisting of natural environments and build environments. Natural environments would include mountains, rivers, etc. Build environments would be, essentially man-made sites, such as facilities. These could be self standing or located in another facility (e.g. healthcare site in a prison, clinic in shopping mall, etc.). Specific location codes along with their types are being developed. One area is to capture where a patient incurs the healthcare issue, for instance, if a patient falls within a facility. Today it is not being done consistently. This is one of the goals of the scheme. This scheme would be unique in that the coding structure would allow you to roll up into a facility along with qualifications (not only where this is but what type of location this is). Peter is here presenting to the PAWG, to assure that we coordinate our Service Delivery Location activities with the work being done in this realm. At this time, the codes are more internal however, this would eventually be shared with a wider community. The WG clarified that this effort which Peter is presenting is not an HL7-specific effort, but is being coordinated with work already done or currently being done in wider communities.

The WG thought it would be good to have some examples to see what the scheme is like. Peter will send us examples of the location type codes so that we could publish. This may be able to provide Peter with some feedback. There is another effort within AHRQ to identify the “owners” of the various departments in a facility, for example.

Action: Follow up with Peter Goldschmidt on any available examples of location type codes and their metadata (such as location code type, location owner, etc.) that can be shared with the PAWG, especially those involved in any Service Delivery Location efforts. Alex

The WG continued with the items on the published agenda: Mission and Charter.

Christian Hay motioned (barry seconded) to approve the mission and charter.

Vote: 6, 0, 0

After revuew, a motion was made by Helen seconded by Christian to accept the Decision Making DMP. Discussion:

Vote: 5, 0, 0
Motion Passed.

The WG continued with the 3-year work plan and the addressing the Provider Registry and Organization Registries.

Christian Hay will present Q2 on Wednesday regarding GS1.

Meeting Outcomes

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


Monday Q2

HL7 Patient Administration Meeting Minutes

Location:

Date: 2011-01-16
Time: Monday Q2
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Alex de Leon Kaiser Permanente
X Line Saele HL7 Norway
X Helen Drijfhout HL7 Netherlands
X Barry Guinn EPIC
X Nat Wong HL7 Australia
Quorum Requirements Met (Chair + 4 members): Yes

Agenda

Agenda Topics

  1. V3 Work – Regarding GS1
  2. V3 Service Delivery Location/FHIR

Supporting Documents

Presentation

Minutes

Minutes/Conclusions Reached:

Line reviewed that since Peter presented service delivery location in Q1 and Christian Hay has asked for another time, we will work on 3 year work plan and the infractions of the PBS metrics. Christian Hay will present GS1 on Wednesday Q2.

The WG continue with the 3 year work plan and infractions. First the WG addressed the Identity Document Topic. The last note we have from Irma is that there are implementers for this. We should create a PSS. We think that this needs to be withdrawn, but we need to consult with Irma.

Person and Patient are on the same project ID (576).

From the PSS:
This is a follow on to Project 490 (Registry Enhancements for Social Services) that was completed in January 2010. This project takes the results of Project 490 and applies them as a DSTU Update ballot to the Person Registry topic in the Patient Administration DSTU. Project 490 addressed an extensive use case from the Youth Healthcare program of the Netherlands. The Patient Administration work group found that its existing Person information model required a number of design changes as well as RIM and vocabulary harmonization changes to support the use case. A revised information model was published as Draft for Comment in the 2010 January ballot, the Patient Administration work group reviewed the model at the January 2010 Working Group Meeting and voted to apply the changes to the Person Registry topic.

Action: Check with Alexander Henket to see if these changes have been applied.

489/736 Encounter Topics – this should have been consolidated into one topic.

Action: Ask Alexander whether the DSTU includes consolidation of this into one topic. Ask Lynn/Don how to consolidate these into one Encounter Topic (in case it has not).

Encounter R2 – according to the 3 year work plan, this is a work item, but has no project id.

Action: Ask Irma what we might do with the implementation of the harmonized encounter model from Norway.

359 and 360 Provider and Organization Registries – In reviewing the projects there seems that there are no interested parties for this work (release 2) to the current normative standard. Therefore discontinuing the project seems like a good option.

Alex motioned, Toril seconded to discontinue the Provider and Organization registries release 2 project.

Vote: 4, 0, 0

V3 PM CMETs – 3 year work plan says we should have gone normative in sept 2012.

Action: Check with Alexander to see if these went normative.

Human Resource and Regulatory – No PSS ID nor work to be done.

Action: Ask Irma about anything the WG needs to do about these.

The WG then worked to address the Appointment and Slot topics (Project 292) – Based on the last WGM, the WG decided to ask through the listserve for any interest/implementations. None has been received. On the bases of no responses being received, the WG considers retracting these topics.

Nat moves, Alex seconded, to retract these topics.

Vote: 4, 0, 1

Action: Find out which of the topics are normative or other and do the necessary.

Human Resource, Regulatory and Provider Registry Service, – in the absence of a formal project scope statement, the WG is considering removing this work item. However, the WG considers it worthwhile to ask whether other WG members might know about this (Irma Jongeneel, Alexander H., Iryna Roy, etc.). Nat suggested that we send out to the listserve a message soliciting interest or information on these.

Action: Send an email to the PAFM Listserve asking for any knowledge and/or interest in any of the following topics - Human Resource, Regulatory or Provider Registry Service.

Meeting Outcomes

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

Monday Q3

HL7 Patient Administration Meeting Minutes

Location:

Date: 2012-01-16
Time: Monday Q3
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Alex de Leon Kaiser Permanente
X Line Saele HL7 Norway
X Helen Drijfhout HL7 Netherlands
X Sasha Bojicic HL7 Canada
X Nat Wong HL7 Australia
X Barry Guinn EPIC
Quorum Requirements Met (Chair + 4 members): Yes

Agenda

Agenda Topics

  1. FHIR PA Ballot for comment - status.

Supporting Documents

Minutes

Minutes/Conclusions Reached:
The WG proceeded to address comments in a consolidated spreadsheet sent out to the PAFM listserve:
Comments-FHIR_R1_O2_2013JAN.xls”

  1. 652 The WG addressed this comment having to do with the potential need to have a place for photos . As workgroup, we agree but understand that this is a much larger discussion.
  2. 169 Neg/Major – Organization appears to be Boolean rather than code. After discussion, the WG decided that this was not persuasive with mod. We can come up with more status codes and inactive seems to us to be within 80%
  3. 162 Don’t like the term “Agent” - In person discussion. However Helen noted that she sent out resource diagrams. Within Baltimore, the WG decided to change “Agent” to provider. Graham was amenable therefore the WG voted to retain the provider.
  4. 185 Introduction section to give context to Org resource as well as instructions for use of relationships. The WG agrees.
  5. 198 Will be addressed within FHIR joint group.
  6. 208 Person vs Patient – Fold into one?

The WG spoke briefly to Irma about the identity document. She says that this should be retracted.

Meeting Outcomes

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

Monday Q4

HL7 Patient Administration Meeting Minutes

Location:

Date: 2012-01-16
Time: Monday Q4
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Alex de Leon Kaiser Permanente
X Line Saele HL7 Norway
X Helen Drijfhout HL7 Netherlands
X Barry Guinn EPIC
X Nat Wong HL7 Australia
X Sasha Bojicic HL7 Canada
X Lizzie DeYoung MITRE/OASIS
X Elysa Jones OASIS/HL7 PHER
Quorum Requirements Met (Chair + 4 members): Yes

Agenda

Agenda Topics

  1. FHIR PA Ballot for Comment - Status (cont.)

Supporting Documents

Minutes

Minutes/Conclusions Reached:

  • Item #606 Multiple patient birth indicator – The ballot material has not been updated with the development information. This multiple patient birth indicator is part of SubjectOfCare. Persuasive.
  • Item #607 Patient deceased time/date - This was added as part of subject of care but not included in the ballot. The WG previously decided that date of death was to be included in SubjectOfCare, however, the time of death was being considered as an extension. The discussion is ongoing for time. The WG decided this was persuasive with mod, to be in line with the SubjectOfCare decision.
  • Item #608 Patient Merged – The FHIR specification does indeed have explanation of linking instead of merges, stating:

“In this specification, patient records are never merged. If multiple patient records are found to be duplicates, they are linked. In a RESTful context, this is done using the "link patients" transaction described below. In other contexts, equivalent functionality will be needed. When patient resources are linked, one may be chosen as the "master" - the correct record. In this case, the active status of all the other resources is set to false, and all the content is moved to the active record by updating it directly.”
However this within a section named 3.11.2: Managing Patient Registration
The WG suggests that the specification clarify further, perhaps creating a section called identity management, or some other specification formatting for clarity.

  • Item #596 There are two negative minors addressing the changing
  • Item #642 Agent – Licensed medical providers… should be clarified.


The WG then shifted gears due to a visit from the Organization for the Advancement of Structured Information Standards (OASIS ) organization regarding Tracking of Emergency Patients (TEP) messaging standards. Their visit had to do with beginning a joint project having to do with their standard which tracks patients in the field within an emergency setting. The project is the translation of messages from their TEP standard to HL7 standards. Today their effort is to translate to both v2 and v3 messages. The result of this project will be an implementation guide and a joint copywritten method of translation of these messages.
The work is review of the TEP working draft and the review and comment of the implementation guide. Sponsoring would require more input from us, therefore the WG is more inclined to be involved as an interested party.

Alex, Barry second, motions that the WG be identified as an interested party and, as such, review the TEP working draft standard and review and provide comments on the implementation guide.

Vote: 7, 0, 0

Meeting Outcomes

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

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