2016-08-25 Patient Care FHIR Call
Contents
Meeting Information
| Patient Care FHIR Resources Conference Call Location: Conference Call |
Date: 2016-08-25 Time: 5-6:30pm ET | ||
| Facilitator | Michelle M Miller | Note taker(s) | Michelle M Miller |
| Attendee | Name | Affiliation
| |
| Elaine Ayres | NIH/Department of Clinical Research Informatics | ||
| Stephen Chu | |||
| X | Eric Haas | Haas Consulting | |
| X | Rob Hausam | Hausam Consulting LLC | |
| Laura Heermann-Langford | Intermountain Healthcare | ||
| X | Emma Jones | Allscripts | |
| X | Russ Leftwich | InterSystems | |
| Tony Little | Optum 360 | ||
| Jay Lyle | Ockham Information Services LLC, VA | ||
| Sarah Maulden | VA | ||
| Hank Mayers | ReliaTech Consulting | ||
| 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 | ||
| X | 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 2016-08-18_Patient_Care_FHIR_Call
- Motion: Rob/Russ
- Prior Action Item Follow-up
- Patient Instructions - Clinicians on FHIR
- 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
- Mon, 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
Per Russ Leftwich: "I doubt if the AAAAI has agreed upon definitions for biologics or a distinction between non-tissue biologics and tissues. But I will ask. My first inclination is to keep the value set with biologics knowing that not all are "drugs". The fact is that most biologics, even if "tissues" would still fall under the category of "allergy and intolerance" in terms of adverse reactions. The only exception I can think of would be graft vs host disease."
Per Rob H., tissue is the exception. This is in context of an allergy or intolerance. We don't typically talk about allergies to tissues. Biologics that are administered are typically drugs that could cause allergies. SNOMED is aligned with the value set in that biologics is a child of substance. This means that a "below" search on medications would return all biologics.
Rob suggests cleaning up biologics definition, such that we are talking about drug biologics - not general biologics.
http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10498 was resolved to update the biologic definition
Patient Instructions - Clinicians on FHIR
Argonaut is using CarePlan (narrative only) for the Assessment and Plan of Treatment, per http://argonautwiki.hl7.org/index.php?title=Assessment_and_Plan_of_Treatment
Eric Haas is the Argonaut project team lead, for future reference or questions.
ListServ discussion: http://lists.hl7.org/read/messages?id=291376 - also implied CarePlan could be used for discharge instructions
gForge Change Requests
CarePlan
- gForge 10476: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10476 - Add search parameter for CarePlan.identifier (persuasive)
- gForge 10477: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10477 - CarePlan search parameter 'patient' seems obsolete (not persuasive per Grahame's comment on gForge 7897, the pattern should be that resources with a 'patient' element just have a 'patient' search parameter, and resources with a subject that could be a patient have both subject and patient search parameters)
- gForge 10495: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10495 - remove reference to SupplyRequest from CarePlan and ClinicalImpression (persuasive)
Goal
- gForge 10461: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10461 - Minor cleanups to goal-relationship extension (action item to follow up with FHIR-I)
Procedure
- gForge 9335: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=9335 - Orders to not do things (action item to follow up with implementer community)
Adjourn
Adjourned at 6:27 PM Eastern
Meeting Outcomes
Actions
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