2016-05-11 PA WGM Minutes

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Patient Administration Work Group Minutes - May 11, 2015

Wednesday Q1

HL7 Patient Administration Meeting Minutes

Location: Salon Musset

Date: 2016-05-11
Time: Wednesday Q1
Facilitator Brian Postlethwaite Scribe Irma Jongeneel
Attendee Name Affiliation
X Irma Jongeneel HL7 Netherlands
X Alex de Leon Kaiser Permanente
X Iryna Roy Gevity, HL7 Canada
X Brian Postlethwaite HealthConnex, Australia
X Kevin Papraki Epic, USA
X Simone Heckmann HL7 Germany
X Andrew Tores Cerner, USA
X Isabelle Gibaud HL7 France
X Tim McNeil Surescripts, USA
X Dave Shaver Corepoint, USA
X Emmanuel Helm HL7 Austria
X Ron Shapiro Qvera, USA
X Michael Donnely EPIC, USA
X Toril Reite NL7 Norway
X Simon Knee NHS (MSCIC), UK
X Nat Wong HL7 Australia
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics
Welcome/introductions
FHIR discussion on Practitioner, Location and Provider directory resources
Supporting Documents

Minutes

Minutes/Conclusions Reached:
FHIR discussion on Practitioner, Location and Provider directory resources

Plan to extract the practitionerRol from Practioner into a seperate resource. Reason: easier for scheduling a service, without having to go into the practioner, especially within provider direcories. If you d want to schedule an appointment for a specialty it would have to go through specialty. What problem would be solved by splitting it up? Being able to do the association from practitioner to other things without having to access the practioner itself (??) Many other resources are referencing practitioner, would they all have to be changed to reference practitioner role? Considering other split-up option: make practitioner-role the practitioner and remove the person properties and reference a person instead. That might give a lot of pushback. If splitting up, there should be a way to have a hierarchy in roles and/or the linking to organization. Recording the person who did something Important to keep in mind that many systems that would be only referencing a practitioner with just a id, name and contact info. That should be simple to do, no matter what change we will end up doing. There is not yet consensus about a final solution, everyone is encouraged to think about it some more and do research on how it could be implemented in their systems. Action item: Brian – send out email to listserver to ask what current referencing resources to practitioner would have to be changed to link to practitioner role.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • Action:
Next Meeting/Preliminary Agenda Items
  • .

Wednesday Q2

HL7 Patient Administration Meeting Minutes

Location: Salon Musset

Date: 2016-05-11
Time: Wednesday Q2
Facilitator Brian Postlethwaite Scribe Irma Jongeneel
Attendee Name Affiliation
X Irma Jongeneel HL7 Netherlands
X Brian Postlethwaite HealthConnex, Australia
X Line Saele HL7 Norway
X Michelle Miller Cerner, USA
X Andrew Torres Cerner, USA
X Kevin Paprocki EPIC, USA
X Isabelle Gibaude HL7 France
X Tim McNeil Surescripts, USA
X Michael McDonnelly EPIC, USA
X Matt Spielman Intersystems, USA
X Brian Wright Mayo Clinic, USA
X Toril Reite HL7 Norway
X Chris Grenz AIC, USA
X Sean Moore EPIC, USA
X Cooper Thompson EPIC, USA
X Simon Knee NSCIC (NHS), UK
X Amit Popat EPIC, USA
Quorum Requirements Met (Chair +2 members): Yes

Agenda

Agenda Topics

  1. FHIR DSTU 2 PA Resources – Joint with Patient Care

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Introductions – Joint with Patient Care
Care team, Episodes of Care resources

Care team: new draft resource, separate from Episode of Care. Goal to get to FMM level 2. Interest in using the resource in the US, but it s being used as a profile on Episode of Care in DSTU2, that is making it a bit harder to get it to a level 3.
Episode of Care and Care Plan are both updated to support the new resource.
The Care team is patient centric. It has 1 subject (patient or a group). If there is to be defined a blue team and red team with practitioners, it could be defined as an organization.

Action item: Michelle. Wording will be added to make clear that the subject group is to be a group of patients.
Should cardinality of subject be 1..1? In Careplan it s optional also to support de-identified or anonymous patients for research. The subject patient should not be different from the patient that can be present in the participants.

The care team could also support roles that have the person on duty for that role, using organization to define a shift. Also as a basis for access control, but it is not access control itself.
A group cannot be a member in the care team because groups cannot be an actor. Organization can, but it s a bit vague in how those differ.

Care manager is an separate element in the episode of care from the reference to care team, since it doesn’t make sense to create a team of 1 person to support the care manager.

Encounter is not yet referring to Care team as a possible participant in an encounter. Should a reference to care team be added (0..*) or should participant structure be replaced by a reference to care team? The group leans towards keeping the participant structure, but it should be clear when to use the participant or care team. Probably a participant in a specific role for an encounter should not also be in that same role within a care team. A care team is more about coordinating and planning activities for a specific (group of) condition(s) and the participants for encounter are for defining responsibilities.

Motion Kevin Paprocki/second Michelle Miller to include initial reference to care team (0..*) and clarify the wording of the participants backbone element and how the 2 relate.

Discussion: what is this reference suppose to be used for? The care team within the context of encounter exist to facilitate the planning of ongoing care provision to the patient. Who do we need to call if there is an issue? Care team will contain the organization that is responsible for clipping toenails, however the participant will be the actual practitioner that did the clipping.

It seems there is not yet clear vision on how to use this.

Action item: Brian to create a proposal to be discussed in a joint conference call.

There will be another joint meeting at the next WGM.

There was discussion about the encounter.participant.period: what does ‘present’ mean in the definition? How about like lab technicians, that might not be present at the encounter itself.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • Action:
Next Meeting/Preliminary Agenda Items
  • .

Wednesday Q3

HL7 Patient Administration Meeting Minutes

Location: Salon Musset

Date: 2016-05-11
Time: Wednesday Q3
Facilitator Line Saele Scribe Irma Jongeneel
Attendee Name Affiliation
X Irma Jongeneel HL7 Netherlands
X Line Saele HL7 Norway
X Brian Postlethwaite HealthConnex, Australia
X Dennis Patterson Cerner, USA
X Jenni Syed Cerner, USA
X Kevin Paprocki EPIC, USA
X Cooper Thompson EPIC, USA
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  1. FHIR DSTU2 Ballot Reconciliation

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Introductions

8801: duplicate with 9539.

3408: change binding to V2 contact type (table 0103) for the patient’s contact.
Motion - Brian moves/Jenni seconds: 6/0/0

9824: Add additional guidance.
Motion - Brian moves/Jenni seconds: 6/0/0

9627: new resource Endpoint is being constructed

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • Action: .
Next Meeting/Preliminary Agenda Items
  • .

Wednesday Q4

HL7 Patient Administration Meeting Minutes

Location: Salon Mussett

Date: 2016-05-11
Time: Wednesday Q4
Facilitator Brian Postlethwaite Scribe Alex de Leon
Attendee Name Affiliation
X Irma Jongeneel HL7 Netherlands
X Line Saele HL7 Norway
X Brian Postlethwaite HealthConnex, Australia
X Alexander de Leon Kaiser Permanente, USA
X Simone Heckmann HL7 Germany
X Kevin Paprocki EPIC, USA
X Iryna Roy Gevity/HL7 Canada
X Cooper Thompson EPIC, USA
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  1. FHIR Account Resource Review/Preparation

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Introductions

  1. 8760 - Summary: The ServiceDeliveryLocation value set appears incomplete There's a great deal of overlap between this value set and http://www.cdc.gov/nhsn/PDFs/pscManual/15LocationsDescriptions_current.pdf, but some key terms are missing (e.g., Long Term Acute Care, which is a distinct classification in the US similar to Skilled Nursing Facility [which is present]).. While this value set is extensible, and some of the terms in the NHSN value set are probably not part of core, others should be in core. I have a partial mapping of these two value sets.

The suggested value set are US specific while the current value set is not realm specific and is extensible. Therefore the WG will suggest to the submitter to use a DAF for this.

Irma moved to Alex seconded.

The WG discussed the link/unlink and merge/unmerge tracker items and decided to forgo this as this subject has been an issue for the previous standards. We considered it best to allow for usage of the FHIR resources as they are now and find what might be requested, if anything, from that usage.
Having tabled that item, the WG continued with the consideration of FMM levels and what we might be able to shoot for. Brian reviewed the FMM level criteria, along with the FHIR QA criteria. Brian reviewed a spreadsheet that collects the Resource, average requested FMM, current FMM, Desired FMM, V3 Map, QA and Examples.
PA Resources FMM Status Spreadsheet.PNG
The WG continued with the FHIR tracker items

  1. 9624 Summary: No place to store alternate name, alias or historic name

There's no place to store additional names on the location resource. These include, but are not limited to, an alias, alternate name, or historic name.
The primary use case of this information is searching. When a user is searching for a location by name (which is the most common use case), they may only know the location by a historic name. Facilities often change names, or have a colloquial name.
We propose to increase the cardinality of the name element to be 0..n. Without this change, the location resource would need to be repeated, one for each name.

This is specifically for location, but it also applies to Organization.

Kevin Papracki Made a motion to add a property to the Location and Organization resource called “alias” which will be a string and cardinality of 0..* with the description to “A list of alternate names that the location is is known as, or was known as in the past”.Also include thi “alias property in the name search field.
Also include this “alias property in the name search field”. Included will be a name type extension. Irma seconds This resolution was the same for tracker item # 9625

Discussion: None
Vote: 7/0/0

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • Action Item:

.

Next Meeting/Preliminary Agenda Items
  • .

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