2016-03-21 Rx Conf Call

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Attendees to be updated

  • John Hatem (Chair)
  • Scott Robertson
  • Melva Peters (Scribe)
  • Chris Nickerson
  • Marla Albitz
  • Michelle Miller
  • Daniel Zhang

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

  • Defer further discussions until April conference calls.

[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 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

FHIR tracker items to be discussed this week

  • Tracker 9295 - MaxDosePerPeriod - There is justification to add maxLifetimedose - currently supported by Cerner and Epic - this would be added as an attribute on MedicationOrder - to convey the total lifetime dose that should not be exceeded by the patient
    • Motion to add maxLifetimedose attribute as a quantity Data type to the Medication Order - moved by Melva - seconded by Michelle - 6/0/0
Action:  Melva to add a new tracker item to consider - total accumulated lifetime dose
Action:  Melva to update the tracker item with decision - Complete
  • Tracker 9296 - Consider new statuses (Proposed, Draft, Under Review) for MedicationOrder and MedicationAdministration.
    • discussion of the granularity - have draft already and Proposed is part of workflow discussion
    • suggest that we leave as is for now
Action: post a question to the list serve to seek information - John will start the discussion for the question 
Action:  Update tracker item to "under discussion - seeking more information" - Complete
  • Tracker 9286 and 5827 - Review the need for status on a Medication Resource.
    • Setup a discussion with Lloyd re: modelling for these items before we make a decision
  • Tracker 8783 - Medication Order Status resolution - review the 2 questions in the tracker item.
    • Consider along with 9296
  • Tracker 8526 - Reason(s) for discontinued medications.
    • Motion: Moved by Melva and seconded by Scott - no change is needed to existing resources based on the discussion 6/0/0
Action:  update spreadsheet and tracker item
  • Tracker 8378 and 8276 - consider adding the reason for all statuses changes on MedicationPrescription.

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

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).

FHIR Workflow Meetings Status DEFERRED

  • Status - there were no workflow meetings week of March 14th.
  • Discussion of Pharmacy Workflow Mockup (John)
    • Pharmacy has been providing input into the workflow meeting discussions. One suggestion is that Pharmacy create a Pharmacy specific workflow case similar to the one that is being created for lab. This work has not started yet, but John will start working on this in April.

Joint Meeting with ISO/IHE Pharmacy DEFERRED

  • Room is available courtesy of Canada Health Infoway - waiting for a response from Michael Tan

Template Work DEFERRED

  • Kai to let Pharmacy know when ready for review

Other business

Next meeting

  • Monday, March 28, 2016