2015-11-23 Rx Conf Call

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Attendees to be updated

  • Melva Peters (Chair)
  • Marla Albitz (Scribe)
  • John Hatem
  • Scott Robertson
  • Jose Texiera
  • Daniel Zhang

CLOSED--IHE Meeting in Amsterdam

  • Joint out of cycle meeting with IHE and IG Rx group
    • Group to decide if Rx WG would travel to Amsterdam to participate.
      • Who of the co-chairs can attend?
        • Tom can attend.
        • Melva and Scott would need to justify the travel, active projects to engage with.
        • Marla, Michelle and John cannot attend.
        • Tom suggested the possibility of an out of cycle meeting to justify the trip. Another option is to dial in which is common for IHE.
          • Melva does not think calling in will work as the time difference.
    • Note that group can see the potential for the meeting, but need specific actions and outcomes
 Completed Action item: John to socialize the idea of an out of cycle meeting for the IHE Amsterdam meeting.
  • Determine that an out of cycle meeting is not likely
  • Determined we will not be attending this meeting

FHIR Workflow Meetings Status

ACTION:  Scott - find / asked for / create(?) a 1-pager explanation of what the business need and proposed solution.
  • Update from Scott: Team meet 11/23, did not meet last week, will not be meeting next week - team has been working on identifying use cases.

FHIR Ballot Discussion Items

    • A = Dosage Related
    • B = Terminology
    • C = Misc
    • D =
    • E = Examples
    • F = Multiple indications/reason for order
    • G = Status
    • H = Medication Related
    • I = Mappings

8778 – dosage based on body surface area

 Completed Action item: #8778 John to find out the context and meaning of “mustUnderstand”. Will follow-up with submitter (Lee Surprenant).   John sent email to Lee on November 16, 2015.  11/16 - email sent.  no response yet
  • Update from John - response to John's question of what 'mustunderstand' means? - response: "mustUnderstand" is that if we do use an extension for this concept, then we would mark it as Must-Support (because a system not understanding the max dose properly would be extremely bad) and also as a Modifier Extension (because it changes the interpretation of the dose element).
  • Issue is still open, needs more discussion.
  • Next step, to ask Lee to the call to explain the use case to insure correct understanding
Action: John to invite Lee Surprenant to the meeting to discuss

8442 – MedicationPrescription – clarify datewritten and prescriber – group discussed final decision noted in GForge item

 Completed Action item: Jose will take a look at this off-line (8442). Concerned about one-to-many relationship implied in solution. Will bring investigation conclusions back to group. Jose’s findings could impact 5827, 8276, 8378, 8526, 8783
  • Discussion of versioning resulted in a group understanding that this issue is an infrastructure issue, not Rx specific.
  • Also can be remedied with additional documentation
Action: Jose to create new change request to address the documentation work only and separate from the infrastructure issue.

11/16 - When changes are applied, the original resource is not altered, the changes are incoproated into a clone of the original resource (with a relationship to the the original resource). From the HFIR resource perspective, these are separated resources. From the system perspective, there may only be a single "database entry" which is modified. Getting difficult to keep track of the constructs and proposed solution.

 Action item:  Jose will develop a resolution for consideration at the next call. Principly 8442, could impact 5827, 8276, 8378, 8526, 8783
Action item: Marla to complete 7830 - consult with Mike Henderson
  • PSS for FHIR content
Action:  Melva to draft
  • Timing discussion
    • how to represent "to be taken 10 minutes before meal"
    • DSTU2 guidance still incorrect (verified during call)
    • handled by change request # 8697
      • adding new offset guidance to handle this.
      • targeted for DSTU 2.1
COMPLETED Action item: Melva to enter change request to change examples to reflect this new timing data type change.
Action: Melva to confirm if changes to be made will support "take one tablet 3 times day, 30 minutes before meals.

5925 & 8021 (grouping A)

Action item: Tom to review spreadsheet John forwarded on 11/9 .  Tom volunteered on the 11/2 call to look at this.
Completed Action item: John will review spreadsheet to see which resource elements/attributes may be affected.
  • John started presenting his review/work on the call.
  • Will continue reviewing and vote (if applicable) on the next call.


  • No listserv items to discuss this week

ARB Project

  • ARB update
  • Link to meeting minutes: [1]
  • Update from John - did not meet the last two weeks, will meet again after Thanksgiving

Other business

Completed Action Item COMPLETED: Melva to reach out to Kai on his Art Décor v3 entries.
  • Melva will send medication normative issues to Kai.
Action Item: Marla to enter change request for RXA-25 v2 FHIR mapping issue.
Action Item: Marla Reach out to Mike Henderson and Jose about final touches to the v2-FHIR mappings (perhaps even outside of the FHIR resources)
  • Need a chair for December 14th meeting since Melva will be unable to attend.

Next meeting

  • Monday November 30, 2015 at 4pm Eastern - John to chair