This wiki has undergone a migration to Confluence found Here

2015-11-05 Patient Care FHIR Call

From HL7Wiki
Jump to navigation Jump to search

Meeting Information

Patient Care FHIR Resources Conference Call

Location: Conference Call
Phone Number: +1 770-657-9270
Participant Passcode: 943377
Live Meeting:

Date: 2015-11-05
Time: 5-6:30pm ET
Facilitator Michelle M Miller Note taker(s) Michelle M Miller
Attendee Name Affiliation

X Elaine Ayres NIH/Department of Clinical Research Informatics
X Stephen Chu
Eric Haas Haas Consulting
X Rob Hausam Hausam Consulting LLC
X Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
X Russ Leftwich InterSystems
X Jay Lyle Ockham Information Services LLC, VA
Jim McClay Univ of Nebraska Medical Center
X Russell McDonell Telstra Health
X Lloyd McKenzie Gevity (HL7 Canada)
X Larry McKnight Cerner
X Michelle M Miller Cerner
Lisa Nelson Life Over Time Solutions
Viet Nguyen Systems Made Simple
Craig Parker Intermountain Healthcare
X Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
X Farrah Darbouze Office of the National Coordinator for Health IT
X Perri Smith
X Vijay Shah JBS International
X Jenny Brush
X Lauren Caruso
Quorum Requirements Met: yes


Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes: 2015-10-29_Patient_Care_FHIR_Call
    • Motion: Stephen/Elaine Abstain - 5, Negative - 0, Approve - 9
  3. SDC
  4. Prior Action Item Follow-Up
  5. gForge change request

Supporting Information

DSTU 2.1 Timeline
FHIR Resources owned by Patient Care

  • AllergyIntolerance (1) -- frozen
  • Procedure (1) -- frozen
  • Questionnaire (1)-- potential normative candidate
  • Questionnaire Answer (1)-- potential normative candidate
  • Condition (1) -- possible normative only if it doesn't have substantive changes after working through health concern, negation, and alignment with OpenEHR
  • CarePlan (1) -- probably not enough wide spread implementation to be considered normative, but Lloyd will check with community to see if there are any planned implementations coming up in the next 18 months
  • Goal (1) -- probably not enough wide spread implementation to be considered normative
  • Referral Request (1)-- probably not enough wide spread implementation to be considered normative
  • FamilyMemberHistory (2) genomics / Jonathan Holt – Vanderbilt - interested in contributing to this resource -- possible normative, but may not have wide spread implementation to be considered normative
  • Procedure Request (2)
  • Flag (2)
  • ClinicalImpression (3)
  • Communication (3)
  • CommunicationRequest (3)

Note: Contraindication and Risk Assessment are owned by CDS, not Patient Care
Note: Substantive changes to frozen resources in DSTU2.1 are prohibited unless FMG explicitly approves the substantive change



SDC Overview for Patient Care

SDC is socializing the SDC FHIR profile to raise visibility prior to upcoming (January) connectathon.

It is possible to query for all questionnaires.

There is a DataElement resource in FHIR, so data element registry could be (and is within SDC profile) a FHIR server that allows both maintenance of data elements as well as ability to query them. When form designer is authoring forms, load data elements that exist and reference in forms.

DataElement is currently defined to allow complex data elements (data elements with multiple components), so you can talk about multiple data elements tied together in context of a larger data element. For simple data types there will only be one repetition of DataElement.element. For complex data types, multiple repetitions of DataElement.element will be present defining a nested structure using the "path" element. Patient Care asked for some examples.

Some data elements, such as laterality (left), don't stand alone.

When XML is passed, then responsibility on EHR to render and display properly. Some vendors might prefer getting HTML file. Add to profile.

Questionnaire references value set, which can have extensions for the context specific display

Prior Action Item Follow-Up

Adverse Event

Adverse Event Proposal

Elaine has a draft resource proposal for AdverseEvent inspired by the ISO 27953 standard for Adverse Event

Elaine asked whether Patient Care should be the owner. Other interested work groups: RCRIM, Pharmacy, CDS, Public Health, Emergency Health

AdverseEvent is broader than just regulatory, but the focus is administrative reporting function more so than a clinical care process. Breadth will span governmental/regulatory, clinical trials reporting, and internal safety management processes. Patient Care already has a lot of content, so Lloyd's FMG leaning is to bring in additional work groups to help with content -- and it is fairly well defined.

Elaine can forward to RCRIM, but they might need some guidance given their experience with FHIR. RCRIM developed v3 resource.
Jay/Elaine moved to ask RCRIM to own AdverseEvent: Abstain-0, Negative-0, Approved-11
Stephen suggested referencing the WGM meeting minutes and presentation, which RCRIM attended

Is there a current PSS for Patient Care to do FHIR work? Stephen did one for Referrals. Elaine/Jay thought there was a broader one, but didn't know terminal point.

Based on existing v3 standard.

Individual Case Safety Report (ICSR): limited scope (administration or use of one or more products or substances)
Individual Occurrence Report (IOR): Elaine's name for broader scope (falling out of bed, slipping on a wet floor, inappropriate use of restraints)

CDC is another content source.


Stephen and Rob will build out the Representing_Negation, but need to consider a better name than negation. Suggested alternative name is exclusion instead of negation

Next step: contribute examples to Representing_Negation

gForge Change Requests -- Problem statement: currently, group will either ONLY contains groups or questions; many questionnaires have both questions and groups; can't repeat an element that has a choice of data types; instead, need to have nesting structure that is either a question or group; need a way to support pictures/images; where is the title and code for questionnaire (inside first group);


Adjourned at 6:52 pm Eastern Time

Meeting Outcomes

  • Elaine will ask RCRIM to own Adverse Event
  • Lloyd will solicit feedback from implementer community on which resources should be prioritized and who has plans to implement care plan
  • Lloyd will talk to MnM about the possibility of renaming notes to annotation
  • Everyone is invited to contribute examples to the Representing_Negation
Next Meeting/Preliminary Agenda Items
  1. Agenda review
  2. Approve previous meeting minutes
    • Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#>
  3. gForge change request

© 2012 Health Level Seven® International. All rights reserved.