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2016-06-02 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: https://www147.livemeeting.com/cc/_XML/cerner/join?id=9DMFKM&role=attend&pw=w9%7D6;Sc

Date: 2016-06-02
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
X Eric Haas Haas Consulting
X Rob Hausam Hausam Consulting LLC
X 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
Russell McDonell Telstra Health
Lloyd McKenzie Gevity (HL7 Canada)
Larry McKnight Cerner
X Michelle M Miller Cerner
Lisa Nelson Life Over Time Solutions
Viet Nguyen Lockheed Martin, 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

Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2016-05-26_Patient_Care_FHIR_Call
    • Motion: Rob/Eric Abstain - 0, Negative - 0, Approve - 3
  3. Prior Action Item Follow-up
  4. Negation Update
  5. gForge change request

Supporting Information

STU 3 Timeline

  • Wed, June 1
    • All resource and IG proposals for STU3 have been completed, reviewed by WG and submitted
    • Connectathon tracks for Sept have been proposed
    • Feedback on gForge submitted to FMG
  • Sun, July 17 - Substantive content freeze for ballot -- core resources
  • Sun, July 24 - Total content freeze, start of QA
  • Wed, Aug 10 (midnight) - All QA changes applied
  • Fri, Aug 12 - FHIR ballot opens
  • Fri, Sept 12 - FHIR ballot closes
  • Fri, Sept 16 - FHIR triage complete and ballot content loaded to gForge (or alternate)
  • Sept 17-23 - Baltimore WGM
  • Sun, Dec 11
    • Reconciliation complete/substantive changes applied
    • Just over 10 weeks
    • Will re-evaluate at Baltimore based on volume of ballot comments
  • Dec 31 - Publish

FHIR Maturity Levels

[1]

  • Level 3 requires the artifact has been verified by the work group as meeting the DSTU_2_QA_guidelines and has been subject to a round of formal balloting; has at least 10 implementer comments recorded in the tracker drawn from at least 3 organizations resulting in at least one substantive change
    • Substantive changes (element names, sort order, vocabulary bindings, etc.) need to be applied by ballot freeze (Aug 10).
    • Unapplied QA checklist changes can be logged as ballot issues to be applied Sept-Dec. Substantive changes after ballot should be driven by ballot.
    • Non-substantive changes are fine
  • Level 2 requires artifact has been tested and successfully exchanged between at least three independently developed systems leveraging at least 80% of the core data elements using semi-realistic data and scenarios based on at least one of the declared scopes of the resource (e.g. at a connectathon). These interoperability results must have been reported to and accepted by the FMG.
Resource
Current FMM Level Goal FMM Level QA Status QA Reviewer Implementation Comments
AllergyIntolerance 1 3 Rob Argonaut
Condition 2 3 PCWG Argonaut
Procedure 1 3 Argonaut
CarePlan 1 3 Argonaut
Goal 1 3
QuestionnaireResponse 2 2 Lloyd Lloyd will QA to get to level 3
Questionnaire 0 2 Lloyd Lloyd will QA to get to level 3
CareTeam 0 2 NA NA Aggressive goal (e.g. whether we'll get the implementations needed)
FamilyMemberHistory 1 2 NA NA Aggressive goal (e.g. whether we'll get the implementations needed)
ClinicalImpression 0 1 NA NA
ReferralRequest 1 1 NA NA
ProcedureRequest 1 1 NA NA
Linkage 0 1 NA NA
Flag 1 1 NA NA
Communication 1 1 NA NA
CommunicationRequest 1 1 NA NA

Note: Bold denotes top 20 resource based on survey
Note: Contraindication and Risk Assessment are owned by CDS, not Patient Care

Minutes

Prior Action Item Follow-up

Negation Update

Review Rob's proposed negation changes to AllergyIntolerance http://rhausam.no-ip.org/fhir/allergyintolerance.html

Propose renaming AllergyIntolerance.substance to AllergyIntolerance.code (it remains required, with cardinality 1..1) with revamped definition:

Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk, an allergy or intolerance condition, or a negated/excluded code (e.g., "No known allergy", "No latex allergy", etc.).

It is strongly recommended that this element be populated using a terminology, where possible. For example, some terminologies used include RxNorm, SNOMED CT, DM+D, NDFRT, ICD-9, IDC-10, UNI, ATC and CPT. Plain text should only be used if there is no appropriate terminology available. Additional details can be specified in the text

How does status and code get interpreted together?

  • Example: Reviewed https://chat.fhir.org/#narrow/stream/implementers/topic/MedicationStatement.2Estatus
  • Currently, the AllergyIntolerance spec says "If new allergy is discovered, the negated allergy record must be updated with the "refuted" status - to ensure that systems referring to this record are aware that this is no longer true."
  • This implies that we could have both:
    • status of Refuted + code of "No Latex Allergy" (user interface may hide this with an option to view it)
    • status of Confirmed + code of Latex



http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=9692 will be pre-applied, so we can all review the changes before officially voting on the resolution.

gForge Change Requests

http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10067 -- reach out to Russ about harmonization

Adjourn

Adjourned at 6:32 PM Eastern

Meeting Outcomes

Actions


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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