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2016-04-14 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: 2016-04-14
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
Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
X Russ Leftwich InterSystems
X 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
X Viet Nguyen Systems Made Simple
M'Lynda Owens Cognosante
Craig Parker Intermountain Healthcare
Scott Robertson Kaiser Permanente
Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
Quorum Requirements Met: yes


Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2016-04-07_Patient_Care_FHIR_Call
    • Motion: Elaine/Emma Abstain - 0, Negative - 0, Approve - 4
  3. Prior Action Item Follow-up
  4. Work Group Meeting Agenda
  5. Negation update
  6. 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

  • Michelle updated CareTeam scope to clarify "CareTeam can be acted upon (e.g. CommunicationRequest), but the CareTeam isn't an actor".
  • AdverseEvent - RCRIM meeting coming up. Elaine has a dedicated group formed. Does Patient Care want to preview straw man resource before WGM (Tues Q3)? Elaine will check with the group and then get back to Michelle with a proposed date (if any). AdverseEvent_FHIR_Resource_Proposal exists, and she will start a wiki page under RCRIM to compile past discussions. ONC may also be working on AdverseEvent, too.

WGM Agenda

  • Emma and Stephen are compiling the agenda

Negation Update

Rob provided an update on TermInfo, which is focused on a recommendation for AllergyIntolerance. How much consistency across resources? Will aim for broad applicability, with exceptions where warranted. TermInfo discussed name of "exclusion" vs "negation". OpenEHR uses "exclusion". Next step is to seek additional input to define "negation" vs "exclusion". Regarding AllergyIntolerance:

  • one code (renamed from substance) using terminology to differentiate
  • two code elements
    • value + modifier
    • positive statement + negated statement
    • different resources

Jay leading the negation requirements call. May need to look at metrics of how often transformation is needed for each option.

Risks and safety concerns apply to all options.

Freetext is what causes the most concern about how to differentiate between affirmative statements vs negated statements.

Don't focus on user interface. FHIR can't fix existing workflows.

Wed Q4 - allergy session - sync with Elaine to see if negation is on the agenda?
Tues Q4 - general negation topic planned
Mon Q4 - TermInfo/Vocab - may also discuss

gForge Change Requests

Create examples that are principally narrative


Adjourned at 06:28 PM Eastern

Meeting Outcomes

  • Michelle to scrub gForge backlog to see if any of the items in a "Waiting For Input" status received input, if not, ping/remind the designated person that Patient Care is waiting on the input.
  • 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
Next Meeting/Preliminary Agenda Items
  1. Agenda review
  2. Approve previous meeting minutes
    • Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#>
  3. gForge change request
  4. DSTU_2_QA_guidelines

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