2014-09-16 PA WGM Minutes

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Patient Administration Work Group Meeting - Tuesday September26, 2014

Tuesday Q1

HL7 Patient Administration Meeting Minutes

Location: Hilton Chicago, Room #1704

Date: 2014-09-16
Time: Tuesday Q1
Facilitator Line Saele Note taker Alexander de Leon
Attendee Name Affiliation
X Line Saele Helse Vest IKT Norway
X Alex de Leon Kaiser Permanente
X Irma Jongeneel HL7 Netherlands
X Brian Postlethwaite Health Connex, Australia
X Steve Fine Cerner
X Juda Mykkanen HL7 Finland
X Alexander Henket NIctiz, The Netherlands
X Ewout Kramer Furore, The Netherlands
X Ross Freeman Jericho Systems, USA
X Orlando Concha Jericho Systems, USA
X Virginia Lorenzi New York Presbyterian Hospital, USA
X Pamela Scicluna Health Connex, Australia
X Wes Rishel Retired
X David Pyke Cognaissance, Canada
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  • V3 Work - Scheduling Topic
  • V3 Work - Encounter Topic
  • V3 Work – CMET alignment with D-MIMs

Supporting Documents

Minutes

Minutes/Conclusions Reached:
.
Introductions.
The WG started with the FHIR DSTU 2. Ewout Kramer, representing the FMG, outlined that this WG has been referenced as being one of the most industrious in developing their FHIR content.
Then the WG began by reviewing the resource content for DSTU 2:

  • Appointment,
  • AppointmentResponse,
  • Slot,
  • EpisodeOfCare,
  • HealthcareService.


The wg revisited resource names.
One is the “Schedule” datatype. As covered in at least 2 previous Working Group Meetings (and many a telecom), PA WG would like that datatype renamed so that it can be used to better define the resources around appointments. Specifically, the WG would like to use “Schedule” for the currently named “Availability” resource. This fits better with what the domain experts and users recognize for what can contain slots.

This was discussed with Ewout. To summarize, the WG stated that the members have talked with Lloyd who was open to the idea and with the Orders and observations work group who also endorsed the idea if a more appropriate name could be determined for scheduled occurrences of a healthcare event or procedure.
Action Item: Follow up with the FMG to find out if the Schedule data type can be renamed so PA may use the name in their current “Availability” resource. Owner: Ewout Kramer Due: 9/16/14.

Another has to do with “Contact”. We currently have it as a resource element Contact, wherein contact is used as a sub element of Patient and is also a datatype. Ewout clarified that they are different. The datatype defines the method of contact telecom, whereas the contact sub element is the person to be contacted. The feeling is that the datatype should be changed, perhaps to “telecom”. There was a discussion about perhaps using “contactPoint” as the name of the datatype, but the feeling was that “telecom” is a better name. Raise a tracker. Tracker item: # 3533.
Action Item: Follow up with the FMG to find out if the “contact” datatype can be renamed “telecom”. Also, would like to add a “preferred flag” specifically for meaningful use requirement on Patient. This is part of v2. Primary would be added to indicate this. Owner: Ewout. Due: 12/6/2014

Irma asked if there were more considerations for QA . There is a list of QA considerations on the FHIR website. These should be looked at.
The PA will need to review the QA considerations for the DSTU 2 resources, although Ewout stated that the FMG understands that these resources will not necessarily be fully fleshed out in this timeframe.
Irma asked whether the PAWG was clear on what is needed for the profile. The WG is producing a profile for CCDA around ServiceDeliveryLocation. This was done in an EXCEL spreadsheet. Iryna Roy produced this based on the Genomics profile. This is done in a spreadsheet as a method to produce the XML which is the end product.
The QA guidelines for DSTU 2 can be found at http://wiki.hl7.org/index.php?title=DSTU_2_QA_guidelines .
The WG reviewed the guidelines. Our resources seem to be fairly in order. The value sets as well.
Ewout asked if we had been reviewing the FHIR discussion forum. We have not consistently but should and will do so moving forward.
Irma asked about another profile we might have. ServD which is for a services directory, spec might produce one.
Ewout provided a timeline from in-meeting discussion in a skype.
Highlights of this schedule include:

  • Dec 5 ready for January Ballot
  • Dec 12-Jan12 January ballot
  • March 30 to process changes from ballot including discussion in the San Antonio WGM
  • During March 30, Before April 15 there is a QA review.
  • Mid April ballot opens.
  • May WGM
  • July Target for reconciliation

There was a question regarding the changes or reconciliation. It was clarified that the intent is that all content will be included and DSTU 2 will be fore new resources and QA of all materials. Thereafter, there will be updates to the DSTU 2, but DSTU 1 is all but done. Any maintenance on that material is covered as part of FHIR DSTU 2.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • Action Item: Follow up with the FMG to find out if the Schedule data type can be renamed so PA may use the name in their current “Availability” resource. Owner: Ewout Kramer Due: 9/16/14.
    .
  • Action Item: Follow up with the FMG to find out if the “contact” datatype can be renamed “telecom”. Also, would like to add a “preferred flag” specifically for meaningful use requirement on Patient. This is part of v2. Primary would be added to indicate this. Owner: Ewout. Due: 12/6/2014
Next Meeting/Preliminary Agenda Items
  • .

Tuesday Q2

HL7 Patient Administration Meeting Minutes

Location: Hilton Chicago, Guest Room #1704

Date: 2014-09-16
Time: Tuesday Q2
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 Brian Postlethwaite Health Connex, Australia
X Alexander Henket Nictiz, The Netherlands
X Christian Hay GS1, Switzerland
X Pamela Scicluna Health Connex, Australia
X Rene Spronk Ringholm
X Grahame Greive HL7 Australia
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  1. V3 Work - Service Delivery Location
  2. FHIR works

Supporting Documents

Minutes

Minutes/Conclusions Reached: Irma proposed to review the request from Jonginder that we move the schedule to accommodate the discussion around V2 joint messages. After discussion
For the joing meeiting with PHER we were going to discuss the joint efforts. Introductions
Address implementer’s feedback.
First, since Grahame was present representing the FMG, the group decided to address some of the items that were raised last quarter. First we addressed the schedule datatype.
The WG continued with explaining the use of Schedule (proposed rename of Availability)
The WG offered the 2 names of Timing and Recurrance as possible names for what is currently called the Schedule datatype. Grahame offered “timetable” as a possible alternative.
Grahame asked to create a task for the rename of the Schedule datatype to timetable and rename the Availability resource to Schedule.
Contact contains telecom. The WG continued with discussion on Contact as a sub-element of Patient and the same name of contact as a data type.
Brian created a tracker item for schedule data type to re named to timetable or other name. This tracker will include the rename of our resource Availability to Schedule. Tracker Item#: 3536
The WG continued with review of the remainder of the Gforge tracker items.
After looking at the model, it appears that removing the Accommodation sub-element would be the best way to simplify and still represent needs for implementers.
There was a suggestion to add a “status” element on the location and create a query parameter for location status.
A motion was made by Irma to remove the accommodation for hospitalization. Brian seconds.
Discussion: None
Vote: 10/0/2
Motion passes. Tracker # 3399
Follow up: Look into location type to support “bed. There was a suggestion to add a “status” element on the location and create a query parameter for location status. Type goes for the full location.
I Tracker issue 3462
.

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: 2013-09-24
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 Brian Postlethwaite Health Connex
X Alexander Henket Nictiz, The Netherlands
X Pamela Scicluna Health Connex
X David Hay Fire Management Group
X Steve Fine Cerner
.
Quorum Requirements Met (Chair + 2 members): Yes/No

Agenda

Agenda Topics

  • Coordination with FHIR Core Team

Supporting Documents

  • <<Azureweb FHIR development site>>

Minutes

Minutes/Conclusions Reached: FHIR Coordination The WG continued this quarter by explaining to our FMG representative the items of issue with regard to the QA process of PA FHIR resources.
First is the change of the “schedule” datatype so that ther is no ambiguity if the PAWG changes the current “Availability” resource to “Schedule”, to be more in line with how the appointments, schedules, slots, etc. are used by the business community within this domain.
David Hay let the WG know that the FHIR Management Group (FMG) had questions about how the appointment resources work together, when addressing this. He stated that they felt the information on the proposals were not clear enough with this regard and therefore they were not sure this change was necessary.
Brian explained how the following resources worked together:

  • Availability (aka Schedule) - A container for slot(s) of time that may be available for booking appointments.
  • Appointment - A scheduled appointment for a patient and/or practitioner(s) where a service may take place.
  • AppointmentResponse - A reply to an appointment request for a patient and/or practitioner(s), such as a confirmation or rejection.
  • Slot - A slot of time on a schedule that may be available for booking appointments.

The FHIR resource proposals will be updated to explain how the resources for appointment work together. David Hay (FMG representative) will do this and send it back to our FHIR facilitator for review. Then that will go back to FMG for approval. This will be submitted this week.
IT was decided to include the 7th resource that current DSTU2 PSS does not cover. This will be done also by David Hay. He will call this “the seventh resource” for now. We will come up with a name and update Dave later.
Action: Follow up with David Hay to review the FHIR proposals. Owner: Brian. Due: Sept 18 (end of this WGM)
Appointment vs. Encounter The WG continued with a review of issues regarding the distinction between Appointment resource vs. Encounter resource.
<< link to FHIR Appointment vs. Encounter WG … doc>> The WG continued with the description of encounter vs. appointment.
Daniel suggested that a Boundaries and Relationships section should be added for the Appointment resource as there currently is for the Encounter resource, which currently states that appointment information is out of scope for encounter. This should be looked at later on.
Action: Add a “Boundaries and Relationships” section to the appointment resource. Owner: Brian. Due: 05-Dec-14
In discussion about the use of appointments versus encounters, the WG discussed server vs. client uses. Servers would know how to present this information, while clients would need to know how to query for the information. For instance, if the client wanted to query for upcoming appointments, could they include past encounters. This brought the discussion regarding planned encounter. In discussion, it seems that the main difference is that more information is needed to establish a planned encounter than an appointment because these are used mainly for when it is fairly certain that the patient will be showing for some healthcare-related event, such as surgery.

This document will be used to update the FHIR material for Appointment.
Daniel stated that perhaps there should be more clarity around what servers should do to in the documentation.

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: 2013-09-24
Time: Tuesday Q4
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Line Saele Helse Vest IKT Norway
X Alex de Leon Kaiser Permanente
X Irma Jongeneel HL7 Netherlands
Quorum Requirements Met (Chair + 3 members): Yes

Agenda

Agenda Topics

  1. 3 Year Work Plan – FHIR

Supporting Documents

Minutes

Minutes/Conclusions Reached: The WG continued with the encounter versus appointment resources, specifically around the “status” of each. Daniel suggested the following missing statuses for appointment:

  1. Confirmed
  2. Arrived
  3. No Show,
  4. Left without being seen

It seems that all except for #1 could be included. The WG felt in the changing of states, confirmed would not fit and may be included in an extension.
The WG then continued to compare the statuses for each.
In the discussion, the question of the planned encounter was re-discussed. It seems that there is a need for it since the encounter has more information in it needed for things like upcoming surgeries where instruments, rooms, etc. need to be prepared.
<<Daniel Status Document>> Since we have more to discuss with Daniel, we have asked to meet with him. He is available tomorrow at 2PM and will join.
Meeting adjourned at 5:25

Meeting Outcomes

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

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