2013-03-04 Rx Conf Call

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  • Hugh Glover (Chair), Jean-Henri Duteau, Gaye Dolin,Stephen Chu,Christof Gessner,Ed Ambinder,Rick Geimer,Zabrina Gonzaga,Tom de Jong, Julie James (scribe). Apologies from John Hatem

Minutes follow ...

Standing Items

List Serve Discussions

Dose timing (Oncology IG related)

  • See email G Dolin <<Medication Activity (substanceAdministration) timing in CDA vs HL7 Pharmacy Model>> today 20130304 17:56 UTC

This contains various xml snippets showing different ways of expressing the same dose instructions information. This is not really a “model” issue it’s about implementation of the GTS datatype in the effectiveTime attribute on the SDADM class. Canada has done a similar thing to the Netherlands in its implementation, constraining/simplifying GTS to cover the most usual dose timing patterns.

  • Issue: Having two effectiveTimes – not strictly legal in the Pharmacy models which have a restriction of a single effectiveTime, because the datatype is a complex one. The “A” (intersection) operator cannot operate over two effectiveTime attributes.

CDA folk point out that this pattern follows the CCDA specification, which follows this pattern. Suggest that the Pharmacy WG document this issue on the CCDA Comment page. We should also send the examples to MnM just to check the interpretation of the implementation of the datatype (J-H).

  • Issue: Chemotherapy regimens are very complex and GTS is very complex. Chemotherapy regimens are dealing with medications that have the potential to be very toxic. Putting together two very complex things is possibly not wise. Many national implementations have decided, for safety reasons, NOT to describe these complex chemotherapy regimens in structured form as the risks for implementations getting it wrong is too high and therefore free text should be used.
  • Issue: The low and high values as shown do not include all the days (as in the description) – as suggested to Yan last week, we suggest putting 0000 in all the low values and 2359 in all the high values to include the full days.
Tom will write up some of these things for the Timing page on the wiki.
J-H to raise this with MnM regarding the two effective time attributes

Normative Edition Publishing

List from Don

Don sent the co-chairs a list of all the things that could be in the Normative Edition for Pharmacy. Melva has sent a list to Don already, but double-checking is helpful.

  • 1.Pharmacy CMETs R1 could be IN but we haven’t requested it to date. DO PUBLICATION REQUEST
  • 2.Dispense/Supply R2 – is going to be re-balloted so NO
  • 3.Medication Order R2 – is going to be re-balloted so NO
  • 4.Medication Statement Service Profile – Hugh has submitted a request – NEED TO CHECK THIS
  • 6,8,9,10,11 IDMP related and not to be included
  • 12.Knowledgebase Queriees – WILL BE IN
  • 13.Medication Statement R1 – WILL BE IN
  • 41.CPM Medication CMETs R11 – may need to do a recirculation ballot; will not go in
J-H will chase these up


The Pharmacy WG reviewed the set of Harmonization Proposals and have no comments on any. The Nutrition proposals were reviewed in O&O with Pharmacy input.

Motion to notify Harmonisation that “the Pharmacy WG reviewed the set of Harmonization Proposals and have no comments on any” was proposed by Tom and seconded by Julie. Motion passed 5:0:0

FHIR Resources

  • Planning document from FHIR Management Group

Hugh circulated a FHIR Resource spreadsheet which gives a set of tasks for FHIR Resource development, whose aim is to provide guidance as to when development tasks should be done. It’s not an attempt to micromanage but to provide an early warning for any resources that may miss the ballot. Next week, the group can review this (J-H will lead as Hugh not available) and make comments etc.


  • US Time Change - Daylight Saving

Next week’s call will be an hour earlier for all participants not on US time.