2016-03-14 Rx Conf Call

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Attendees to be updated

  • Marla Albitz (Chair)
  • Melva Peters (Scribe)
  • Michelle Miller
  • Chris Nickerson
  • John Hatem
  • Jose Costa Texeira
  • Serafina V
  • Ioana Singureanu

Agenda Planning

  • Will focus on FHIR change requests, qa items, ballot comments for the next 3 meetings in order to try to get some of the FHIR changes managed


  • no discussions this week

Catalogue PSS

[Draft PSS Posting http://lists.hl7.org/read/messages?id=288115#288115]

  • discussion of the timing for this project - Jose raised concerns that this is a priority but Pharmacy is trying to focus on FHIR changes requests for the next few weeks
  • Jose has proposed to take to other work groups for input - Pharmacy indicated that he should not shop around the PSS until he finds a WG to take on this project
  • the project needs more work before it can been submitted for approval

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
  • Tracker 8526 - Reason for discontinuation for a drug - lack of efficacy - important for transfer of care
    • to convey from one provider to another
    • assumed to be applied to a MedicationStatement- entered by one provider
    • could also apply to the reason for discontinuing a MedicationOrder
      • codeableConcept - but also includes text
    • Could use ReasonNotTaken in MedicationStatement
    • Ioana will take back to CBCC to see if this meets the use case - may create a profile on MedicationStatement on how to use existing elements to convey discontinued medication
    • No changes needed to existing resources
  • Tracker 9164 - Remove RXA-25 Medication Administration V2 mapping of ID (Marla)
    • Motion to remove RXA-25 mapping by Melva - seconded by John - 5/0/0 Carried
  • Tracker 9294 and 8569 - Reason cardinality
    • Requirement to have multiple reason for prescribing - change to 0..*
    • Question about priority or sequencing - could do as done for Claim.Diagnosis - includes Sequence 1..1 and Diagnosis 1..1
      • this may not work for Reason - can be considered if this requirement is expressed
    • Motion to increase cardinality to 0..* by Melva - seconded by John - 5/0/0 - Carried
  • Tracker 5925 - has already been applied - no change required

NCCN template orders DEFERRED UNTIL APRIL 4, 2016

  • Lee Suprenant requested input on the ChemotherapyOrderTemplates work.
 Action: Lee will document the items that should be targeted for Pharmacy.
  • Lee requests time in the next call for further discussion or a separate call.
  • Lee completed categorization, needs next steps identified for the columns marked as "maybe".
  • On 2/8 - reviewed Lee's categorizations
  • Lee plans to continue to join our calls as we work through the list.
  • John recommended we would through the list before Lee takes the list to the FHIR workgroup.
  • 3/7 - continued to work through the list to determine what group should deal with each item (row).

Pharmacy FHIR Issues

Renaming MedicationOrder to MedicationRequest Discussion DEFERRED

  • From January 25 meeting: Lloyd shared the proposal to rename all request type resources to <resource>_Request. Seeking consistent name for all resources and term that encompasses larger swath of types of requests. An element beneath the tag instance would state the particular request, such as 'order'. This impacts the current Pharmacy Medication Order FHIR resource.
 Completed Action: Rx WG to discuss to determine if we agree or not. - agreed (with no vote) to comply with change but not needed to be made yet, per Lloyd
  • Lloyd suggested that we hold off on making the change, if we decide to make the change. Wait for FHIR Infrastructure group to workout additional details before we make the changes. May have impact on how other data elements are name or included.
  • Discussion: If we agree to the change, we'll need to review the description and other content for our resource to ensure that it accurately reflects the usage. This type of change will mean changes for implementers and it may not be as intuitive for implementers.
    • No decision to be made today. Will consider on a future call
 Action: to followup with Lloyd to find out status and/or next steps

FHIR Workflow Meetings Status DEFERRED

  • Status
  • Discussion of Pharmacy Workflow Mockup (John)
 Action: John to reach out to Lloyd to ask for timing of Pharmacy input for the FHIR workflow discussions.

Joint Meeting with ISO/IHE Pharmacy DEFERRED

Action:  Melva to check on availability of meeting room in Montreal - in progress

Template Work DEFERRED

  • Kai to let Pharmacy know when ready for review

Other business

Next meeting

  • Monday, March 21, 2016