2015-02-16 PA Call Minutes

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Patient Administration Call

Meeting Information

PA Work Group Meeting

Minutes
Phone Number: +1 770-657-9270
Participant Passcode: 986210

Meeting Number:
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Date: Monday

February 16, 2015
Time: 12:00 PM (US Pacific Time, GMT -7)
Quorum Met (Chair+2, Yes/No)? Yes

Facilitator Irma Jongeneel Scribe Peter Bernhardt
Attendee Name Affiliation
X Irma Jongeneel HL7 The Netherlands
X Brian Postlethwaite Health Connex, Australia
X Daniel Lowenstein EPIC, USA
X Peter Bernhardt Relay Health, USA

Agenda

Agenda Topics

  1. FHIR Value sets within the domain of and maintained by PAWG
  2. Review of v2 mappings for Appointment
  3. FHIR emails


Supporting Documents


Minutes

FHIR Value Sets
Last week, we asked Wendy Huang (facilitator for terminology) who we could direct questions about fitness for use in the resources under our jurisdiction. We decided to have each QA resource take first pass on verification of value sets. For those that are still open, we could provide a list to Wendy for further investigation. Section Terminologies-Value Sets reference could be improved to show owner of a given value set.

V2 mappings for appointments
Skipped this item to focus on other items on agenda.

HL7 FHIR email Items
"RE: maintaining order within FHIR resources for list items"

  • Russell McDonnell e-mail regarding identifying primary language. Echos Gforge tracker item

What changes (extensions or in standard) to satisfy this? We discussed adding a standard extension to Communication property of Patient. See tracker item 3743 for related gForge item regarding "needs interpreter".
As for preferred language, see gForge 5412: we agreed at SA meetings to change the Communication property to add a standard extension that would indicate proficiency and another to indicate if interpreter is required.

Next step: Daniel will respond to email thread with reference to 5412.

"RE: How to get Mother and Child in one message"

  • Grahame recommended PA make a standard extension.

Is this a PA or Patient Medical Records concern? We discussed using Group resource to have grouping that would express mother/child relationship (and other relationship configurations). Other options: RelatedPerson for relationship of mother to baby's Patient record, and then relate mother's Patient record to her RelatedPerson record via a Person record for mother.
Reviewed Encounter to see if this fits. Discussed using one encounter for mother, and another for the baby. Considered options for relating mother/baby: 1) making baby encounter as "partOf" mother’s delivery encounter, or 2) make mother a Participant of baby's Encounter as a RelatedPerson. We favored the second approach as this makes sense both for the immediate use case and for the longer term as the mother will naturally be a RelatedPerson for the baby’s Patient record.

Next step: Daniel to respond to email thread, recommending using Participant element of Encounter for baby to identify mother as a RelatedPerson.

"Re: SPb laboratory bus: questions"

  • Lab Routing, Organizations, Departments. Any action needed from PA?
  • Designating which encounter diagnosis is primary. Standard extension?

Don't have enough information to offer recommendation on use of location in diagnostic ordering. In Encounter.indication support diagnosis related to encounter. Do we need a change to encounter to support primary / non-primary distinction for Encounter.indidication? Reviewed DG segments 1-6 from V2. Discussed adding standard extension to indicate primary diagnosis. Also reviewed Encounter.reason as place to provide primary diagnosis. But reason is a CodeableConcept and not a reference to a resource as with indication.

Next steps: Daniel to respond to email thread to ask if Encounter.reason would suffice for this use case, or if this belongs in Encounter.indication and needs to be able to express ordering for structured data analysis. And Brian (?) will update indication mappings to include additional information from V2.

The WG ran out of time and will take up the rest of the agenda topics next week.

  • Gforge tracker items
    • 5209 / 5210 - "modeling of relationship" between Encounter, Episode Of Care, Referrals. Line - any luck scheduling time with PC?
    • 3743 - "needs interpreter". Standard? Standard extension?
  • DSTUv2 QA for Appointment discussion items
  • Review of v2 mappings for Appointment

Meeting Outcomes

  • Next step: Daniel will respond to email thread with reference to 5412.
  • Next step: Daniel to respond to email thread, recommending using Participant element of Encounter for baby to identify mother as a RelatedPerson.
  • Next steps: Daniel to respond to email thread to ask if Encounter.reason would suffice for this use case, or if this belongs in Encounter.indication and needs to be able to express ordering for structured data analysis. And Brian (?) will update indication mappings to include additional information from V2.
Next Meeting/Preliminary Agenda Items
  • Next telecom meeting: 02-23-2015

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