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2016-04-07 Patient Care FHIR Call

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Meeting Information

Patient Care FHIR Resources Conference Call

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

Date: 2016-04-07
Time: 5-6:30pm ET
Facilitator Rob Hausam Note taker(s) Elaine Ayres
Attendee Name Affiliation

X Elaine Ayres NIH/Department of Clinical Research Informatics
X Stephen Chu
X Eric Haas Haas Consulting
X Rob Hausam Hausam Consulting LLC
Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
Russ Leftwich InterSystems
Jay Lyle Ockham Information Services LLC, VA
Sarah Maulden VA
Jim McClay Univ of Nebraska Medical Center
X Russell McDonell Telstra Health
X Lloyd McKenzie Gevity (HL7 Canada)
Larry McKnight Cerner
X Michelle M Miller Cerner
Lisa Nelson Life Over Time Solutions
Viet Nguyen Systems Made Simple
Craig Parker Intermountain Healthcare
Scott Robertson Kaiser Permanente
Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
X M'Lynda Owens Cognosante
Quorum Requirements Met: yes


Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes: 2016-03-31_Patient_Care_FHIR_Call
    • Motion: Michelle/Elaine Abstain - 2, Negative - 0, Approve - 5
  3. Prior Action Item Follow-up
  4. gForge change request

Supporting Information

FHIR Resources owned by Patient Care
Maturity levels [1]

  • Questionnaire (2) -- Lloyd will QA to get to 3
  • Questionnaire Response (2) -- Lloyd will QA to get to 3
  • Condition (2)
  • AllergyIntolerance (1) -- Rob
  • Procedure (1)

Connectathon candidates

  • CarePlan (1)
  • Goal (1)
  • Referral Request (1)
  • FamilyMemberHistory (1)

Lower priority resources

  • Procedure Request (1)
  • Flag (1)
  • ClinicalImpression (0) -- goal to move to level 1 by next release
  • Communication (1)
  • CommunicationRequest (1)

Note: Contraindication and Risk Assessment are owned by CDS, not Patient Care


Prior Action Item Follow-up


Elaine Ayres provided the group with an update on the RCRIM Adverse Event resource. An e-mail requested participation from RCRIM, FHIR and Patient Care was sent out on April 4th per [2]. Volunteers to participate on this project are contacting Elaine. Sub-group calls will be set up

Negation Update

Rob Hausam provided an update on both TermInfo and Negation calls held on 4/6/16. Rob presented several options:
1: Continue with current structure of resource using a coded concept data type (both for positive and negated statements) with current value set binding e.g. SNOMED-CT substances and negation codes. But the coded element should be renamed from AllergyIntolerance substance to AllergyIntolerance code
2: Alternative is a two element solution. Narrow the binding on the code element for positives. Represent negatives as a separate element. May use an exclusion code. Jay Lyle also proposed a code and value solution. This will start with the allergy and intolerance resource but also looking at broader applicability. An element called Negation code or negation claim – can use a SNOMED code e.g. no allergy to latex or if it is an exclusion code – just use substance (latex).

Current value set of “no known” will need to add latex. If using a list of substances the use of a defined value set has been proposed. The question of potential overlap is possible, and needs to be considered for this option.

gForge Change Requests CarePlan.category to search Move: Michelle/Lloyd 8/0/0 Episode of Care linkage Is episode of care more broad or less broad than encounter? Episode of care is considered by group to be more broad. Passing back to PA. Author not defined consistently across resources. Recommend goal.source but extensive discussion about alternatives for who initiated the goal and who actually entered it into the care plan. The concept of negotiated was also discussed. The Care Plan DAM uses the term “expressed by” e.g. goal.expressedby Will enter a separate GFORGE on the negotiated concept. Also need to have the cardinality as a separate discussion. Move – rename goal. author to goal.expressedby. Michelle/Emma 8/0/0


Adjourned at 06:28 PM Eastern.

Meeting Outcomes

  • Input from Viet, Russell, and Rob on Michelle's drafted ClinicalNote_FHIR_Resource_Proposal
  • Daniel Lanphear (submitter of gForge 8458) to draft new resource proposal for transfusion.
  • Rob to help fill in value sets for CareTeam status and type
  • Michelle to update CareTeam scope to clarify CareTeam can be acted upon (e.g. CommunicationRequest), but it isn't an actor.
Next Meeting/Preliminary Agenda Items
  1. Agenda review
  2. Approve previous meeting minutes
    • Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#>
  3. gForge change request

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