2015-10-08 PA WGM Minutes

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Patient Administration Work Group Minutes - October 8, 2015

Thursday Q1

HL7 Patient Administration Meeting Minutes

Location: Georgia 12 Conference Room

Date: 2015-10-08
Time: Thursday Q1
Facilitator Line Saele Scribe Alex de Leon
Attendee Name Affiliation
X Irma Jongeneel HL7 Netherlands
X Alex de Leon Kaiser Permanente
X Line Saele HL7 Norway
X Brian Postlethwaite HealthConnex, Australia
X Alexander Henket HL7 The Netherlands
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  1. HAVE project/TEP joint with PHER

Minutes

Minutes/Conclusions Reached:
Introductions
PHER/PA joint session.
TEP/HAVE Presentation
EDXL - HAVE
Hospital Availability Exchange
Elysa Jones Patti Aymond presented having to do with the emergency management and hospital readiness issue. Concerned with patient initial encounter to admission to hospital.
Data sharing. EDXL family of standards. Providing a common language or interface for data exchange acorss disparate emergency systems.
2008 v1.0 HAVE was used in response to Haiti earthquake 2010.
2.9 Public review complete . minor comments
EDXL - TEP
Tracking of Emergency Patients
Tracks emergency events and capability to communicate this. Family reunification efforts. Tracking of emergency clients. Google created Person Finder Information Format (PFIF). This was incorporated into the TEP standards.
EDXL –DE
Use case 1 Out of scope - Hospital to Hospital – both using HL7
Use case 2 EMS to Hosital - EDXL-TEP/HL7 Transform ADT 14 and RAS/O17
Use case 3 Hospital to EMS to Hospital ADT A14 RAS/017, unless there is the infrastructure for HL7 to HL7 communication, which then would be out of scope as in use case 1.
Use case 4 Large scale disaster – Hospital ADTA03, ADTA14 – RAS017.
Use case 5 TEP HL7 transform – A03 ADT14 RAS 017.
The WG continued with the completion of the PSS for the HAVE specifications.
The WG clarified that the results of any balloting of the HAVE specification will be PA/HL7 endorsement not necessarily the specification itself. So, PA will provide to OASIS representatives, the results of the ballot to endorse or not endorse, and provide the reasons why if there is no endorsement. The PSS included text having to do with publication of the standard within HL7. This brought up questions about the publication and whether this was permitted or not from ISO, ANSI, etc. perspectives. It is suggested by the WG that the OASIS representatives review and consult with Karen V. from HL7 headquarters for direction.
Action: Contact Karen (HQ) for guidance on publication process of the HAVE specification and what the options are for PSS. Owner: Elysa/Irma Due: Lunch
The WG continued with the crafting of the PSS for HAVE specification endorsement.
Action: Send presentation and PSS to the PAWG. Owner: Elysa to Alex.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • Action: Contact Karen (HQ) for guidance on publication process of the HAVE specification and what the options are for PSS. Owner: Elysa/Irma
  • Action: Send presentation and PSS to the PAWG. Owner: Elysa to Alex.
Next Meeting/Preliminary Agenda Items
  • .

Thursday Q2

HL7 Patient Administration Meeting Minutes

Location: Room # 1367

Date: 2014-05-05
Time: Thursday Q2
Facilitator Irma Jongeneel Scribe Alex de Leon
Attendee Name Affiliation
X Irma Jongeneel HL7 Netherlands
X Alex de Leon Kaiser Permanente, USA
X Brian Postlethwaite Kaiser Permanente, USA
X Daniel Lowenstein EPIC
X Alexander Henket Nictiz
X Iryna Roy HL7 Canada
X Christian Hay GS1
X Younjian Bao GE Healthcare
Quorum Requirements Met (Chair +2 members): Yes

Agenda

Agenda Topics

  1. FHIR - Joint meeting with Financial Management

Minutes

Minutes/Conclusions Reached:
Introductions
Joint with Financial Management The two workgroups discussed the joint resources that are being worked on. This seems to encompass a proposed “Account” and “BillibleItem” resources. Before moving forward, there seemed to be a need to discuss the overall billing process. The financial management subject matter experts reviewed the billing processes.

One item discussed was the need to a Person resource that has attributes necessary for a subscriber or guarantor, which would be neither a Patient nor a RelatedPerson Resource, and is not the Person Resource, which supports patient matching. This PA requirement seems to stem from the view of FHIR as a persistence data model rather than as a transactional data model, indicating that FHIR needs to provide guidance on this topic.

Meeting Outcomes

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

Thursday Q3

HL7 Patient Administration Meeting Minutes

Location: Room # 1367

Date: 2014-05-05
Time: Thursday Q3
Facilitator Irma Jongeneel Scribe Alex de Leon
Attendee Name Affiliation
X Irma Jongeneel HL7 Netherlands
X Alex de Leon Kaiser Permanente
X Christian Hay GS1
X Brian Postlethwaite HL7 Australia
X Prashant Trivedi EPIC
X Iryna Roy HL7 Canada
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  1. FHIR - representative from PC will join

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Introductions
FHIR - Encounter/Appointment/ReferralRequest
Joint Patient Care/Patient Administration
The WGs started with the review of the referral request. This will be the subject of the FHIR workflow discussion which may or may not change the resource. However, the WGs continued on with what has been defined so far in DSTU 2:
http://hl7.org/fhir/referralrequest.html
Michelle from Patient Care brought up a potential need to support “chaining” of referral requests wherein the 832 X12 claim might need this chain sequence, not just the communication of the individual referrals on one encounter or episode of care.
Gforge item # 3893 refers to this subject and Is assigned to Patient Administration Gforge item # 3891 notes that the referral request was referred to us by Financial Management.
So the depicting of chaining seems to be a requirement for claims. Brian noted that the ReferralRequest is actually a resource owned by Patient Care.
Therefore, Patient Care can work to depict this within their work group.
The WG then began talking about referrals will relate to Encounter and EpisodeOfCare. Irma was concerned that the structures might be overly complex. BillableItem does not exist but will be sort of a linker of items that can be linked including Encounter, EpisodeOfCare, device, etc. Encounter will be related to the EpisodeOfCare, that might be linked to a ReferralRequest that is different from the header of the claim.
Gforge item # 4873 - I would propose a change to encounter that allows us to track the encounter.class for each period of time (similar to what is done with accommodations/beds).
For example, if a patient shows up in the emergency department, then encounter.class begins as emergency. However, if that patient ends up getting admitted as an inpatient, then the encounter.class changes to inpatient. Just as the patient's location (bed) over time is modeled, same should be done for encounter.class as well.

This was previously discussed, but no resolution was made by the work group. The work group previously discussed putting an element “class” in the StatusHIstory subcomponent of Encounter to retain changes of EncounterClass where encounters spanned changes in EncounterClass.
After much discussion options came up
about how to track the history. Right now the Encounter has a StatusHistory subcomponent that only has the elements of “status” and “period”. Other option is to have another subcomponent called classhistory, but this was discouraged as more history items might come up which then would add another subcomponent.
Putting status into Status history seems to be one option. Another one is to use location to derive the history of ER to inpatient. The final option seems to be to create (instead of StatusHistory) EventHistory subcomponent. The items that seem to be of interest in this situation are “location”, “status” and “class”.
Brian moves to change the StatusHistory to EventHistory and add the class element to this subcomponent with guideance on how to use the event history, when the elements change or any extensions that might be used to track those. Alex seconded.
Discussion: There was a discussion on perhaps to include location history on the event history. This was not considered viable and better kept separate. The location already has a period which can be used for history retrieval. A discharge event could be planned.
Vote: 10/0/0 (for/against/abstain)
Motion passes.

Meeting Outcomes

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

Thursday Q4

HL7 Patient Administration Meeting Minutes

Location: Room # 1367

Date: 2014-05-05
Time: Thursday Q4
Facilitator Irma Jongeneel Scribe Alex de Leon
Attendee Name Affiliation
X Irma Jongeneel HL7 Netherlands
X Barry Guinn EPIC
X Nat Wong HL7 Australia
X Christian Hay GS1
X Alexander Henket E. Novation
X Alex de Leon Kaiser Permanente
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  • Wrap up
  • Approve next ballot
  • FHIR Planning
  • Address PBX matrix
  • Work Group Health
  • 3 year work plan

Supporting Documents

Minutes

Minutes/Conclusions Reached:
The WG reviewed the agenda items.
Approval of the next ballot – We are not sure that there is any content for ballot. HAVE spec is too soon to plan and Alexander H will find out if there is any content to reaffirm.
Alexander H has found that there are currently approx. 10 tracker items for v3. We may choose to deal with those right now.
FHIR Planning
QA
Alexander H will be working on any missing RIM mappings
Alex d. will work on any missing v2 mappings.
Irma will assist if/when needed.
The source for these are the QA list on the FHIR wiki website. Brian will send what we are to do for this as that list is quite long.
We will deal with any outstanding gforge tracker items.
New work –
The further development of the BillableItem and Account resources.
Brian and Alex d will work on making sure that the elements discussed in joint sessions in Paris are reflected on the HL7 FHIR website in the current Account resource. This will be the work to share with Financial Management in telecons to be scheduled.
Action: Schedule joined telecons with FM to discuss the BillableItem and Account resource.
BillableItem will need to be developed.
Action: Follow up with Brian on timeline and priorities.
Based on this planning, we will set up recurring conference calls as needed.
During discussions, it seems we will retain the weekly calls until we see that we might need, especially since we have joining with FM and there are some specific items to discuss (e.g. v2 tables, etc.).
Action: Irma will send an email to core team to solicit a good day for our weekly telecons.
PBS Metrics
We are currently healthy. The WG checked the website. We have the “healthiest workgroup” ribbon.
The WG reviewed the PBS metrics. While there are no red spreadsheet cells indicating that there are issues, there were some yellow ones.
Action : Line to follow up with Lynn about some of the idle or closed projects.
Action : Alexander H. to write up a recommendation on how to address the v3 contents, including Patient, Encounter. This will be discussed in an upcoming telecom.
Motion was made by Alex d to adjourn the meeting. Line seconds.
Vote: 6/0/0 (for/against/abstain)

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • Action: Follow up with Brian on timeline and priorities.
  • Action: Line to follow up with Lynn about some of the idle or closed projects.
  • Action : Alexander H. to write up a recommendation on how to address the v3 contents, including Patient, Encounter. This will be discussed in an upcoming telecom.
Next Meeting/Preliminary Agenda Items
  • .

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