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2016-07-07 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
WEBEX: Meeting number: 198 139 396

Date: 2016-07-07
Time: 5-6:30pm ET
Facilitator Elaine Ayres Note taker(s) Elaine Ayres
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
Jay Lyle Ockham Information Services LLC, VA
Sarah Maulden VA
Jim McClay Univ of Nebraska Medical Center
Russell McDonell Telstra Health
X Lloyd McKenzie Gevity (HL7 Canada)
Larry McKnight Cerner
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
X 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 2016-06-30_Patient_Care_FHIR_Call
    • Motion: Stephen/Rob H.
  3. Prior Action Item Follow-up
  4. Address workflow changes proposed for "request" and "event" resources
  5. Rob H - re allergy and intolerance negation proposal
  6. gForge change request for questionnaire

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.
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


Prior Action Item Follow-up

Did not tackle prior action item list except for Rob H negation work for allergy and intolerance.

Rob displayed is his proposed changes to the allergy and intolerance resource. The proposal is to add a repeating group that includes a + and a - statement such as reacts to or does not react to. The group reviewed the possible approaches to handling negation - e.g. take no action and use current code such as "no known allergies", or adopt the repeating group approach or add the repeating group as an extension.

The group agreed that Rob should go ahead and add his proposed repeating group approach to the core resource prior to the deadline. This will allow comment during the ballot cycle as well as allow implementers to test.

Work Flow discussion for Event and Request

The group reviewed the proposal to add consistent data elements to resources which are used to capture requests (orders) and events (responses to requests). Patient Care has the following resources that were considered as a part of this proposal:

  • ClinicalImpression -- Event
  • Communication -- Event
  • Procedure -- Event
  • Condition -- Event
  • FamilyMemberHistory -- Event
  • QuestionnaireResponse -- Event
  • CarePlan -- Request
  • CommunicationRequest -- Request
  • ProcedureRequest -- Request
  • ReferralRequest -- Request

The group considered the proposal for the change to include standard data elements to these resources as per the suggestions of the Work Flow group. The outcome of this discussion is captured in this GFORGE item:

gForge Change Requests

The group addressed one change request related to the questionnaire resource to support the work of the ONC SDC initiative:

GFORGE 10289:

Lloyd announced that he had reviewed remaining change requests and will have a block vote for some of the outstanding items during the call on 7/14/16.


Adjourned at 6:40 PM ET

Meeting Outcomes

  • Review GFORGE items for block vote on 7/14/16
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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