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2016-06-09 Patient Care FHIR Call
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Contents
Meeting Information
| Patient Care FHIR Resources Conference Call Location: Conference Call |
Date: 2016-06-09 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 | |
| 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
- Agenda review
- Approve previous meeting minutes 2016-06-02_Patient_Care_FHIR_Call
- Motion: Elaine/Stephen Abstain - 0, Negative - 0, Approve - 3
- Negation Update
- Prior Action Item Follow-up
- 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
- 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
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10067 -- Russ' comments about harmonization are denoted in the gForge, but he will be in Amsterdam on 6/9, so let's wait to resume discussion until 6/16 when he can attend.
- Will defer the discussion until next week, but Rob thinks there may still be some changes needed (possibly a hierarchy where active includes both confirmed and unconfirmed) to differentiate between record status (entered in error) and clinical status (confirmed, unconfirmed).
- Elaine suggested that we consider whether each status is "actionable" or not.
- Michelle suggested that we consider how systems have it implemented; allergies don't always get confirmed whereas conditions more often go through a verification/confirmation lifecycle.
gForge Change Requests
FamilyMemberHistory: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10008
Goal: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10023
CarePlan: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10026
Negation Update
- Zulip chat: https://chat.fhir.org/#narrow/stream/implementers/topic/negation.2Fexclusion.20in.20AllergyIntolerance.20resource
- via Zulip, Erich suggested code (allergen/substance/category) + relationship (refuted/no known/confirmed)
- relationship mixes assertions (no known) and verification status (refuted)
- via Zulip, Grahame suggested seeking "a solution that enables what should be but allows a graceful path forward for those constrained by what already is in place"
- Would like to see how current use cases would be handled:
- No Known Allergies
- No Known Drug Allergies (category)
- No Known Latex Allergy (substance)
- Latex Allergy (confirmed)
- Latex Allergy (refuted)
- Terminology relies on information model to provide context, i.e. SNOMED would consider AllergyIntolerance.code = substance a causative agent.
- Do we need to declare context model for each type of SNOMED concept?
Adjourn
Adjourned at 06:34PM Eastern.
Meeting Outcomes
Actions
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Next Meeting/Preliminary Agenda Items
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