2016-09-29 Patient Care FHIR Call

Meeting Information

Patient Care FHIR Resources Conference Call Location: Conference Call Phone Number: +1 770-657-9270 Participant Passcode: 943377 WebEx: https://cerner.webex.com/cerner/j.php?MTID=mfc8969c4f77244480beee61d31385e79		Date: 2016-09-29 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
X	Stephen Chu
X	Eric Haas	Haas Consulting
	Rob Hausam	Hausam Consulting LLC
X	Laura Heermann-Langford	Intermountain Healthcare
X	Emma Jones	Allscripts
	Russ Leftwich	InterSystems
X	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
	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 2016-09-15_Patient_Care_FHIR_Call
   • Motion: Stephen/Laura
3. Prior Action Item Follow-up
4. gForge change request

Supporting Information

STU 3 Timeline

From FHIR_Ballot_Prep

• Sun Oct. 9
  • Last date for change requests (subsequent change requests are auto-punted to release 4)
• Sun Oct. 30
  • NIBs due for any IGs balloting in the Jan. cycle
• Sun Nov. 20
  • All ballot reconciliation complete
• Sun Nov. 27
  • All substantive changes applied to Core
• Sun Dec. 4
  • Content freeze for ballot & connectathon & publication QA review
• Sun Dec. 24
  • QA review complete, Qa changes begin being applied
• Dec 29 - Jan 3ish
  • 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

Resource	Current FMM Level	Goal FMM Level	QA Status	QA Reviewer	Implementation	Comments
AllergyIntolerance	1	3		Michelle	Argonaut
Condition	2	3		Michelle	Argonaut
Procedure	1	3		Michelle	Argonaut
CarePlan	1	3		Michelle	Argonaut
Goal	1	3		Michelle
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

gForge Change Requests

Block Vote 1

Block Vote 1 is planned for October 6. Please let Michelle Miller know if you would like any items removed for further discussion.

• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10310 ClinicalImpression.investigations should be singular(Lloyd McKenzie) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10601 QA1: Update CarePlan scope and usage(Michelle Miller) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10602 QA 1d: Add entered in error to valueset-care-plan-status(Michelle Miller) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10604 QA 1d: Add entered in error to valueset-goal-status.html(Michelle Miller) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10606 QA1: Update Goal scope and usage(Michelle Miller) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10608 QA 2c: CarePlan examples with extensions should use example prefix(Michelle Miller) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10628 QA 5e & 6b: AllergyIntolerance.onset should be mapped to w5 when.init and appear before attestedDate(Michelle Miller) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10629 QA 5e & 6b: Add Procedure w5 mappings and fix order of elements(Michelle Miller) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10630 QA 5e & 6b: Add CarePlan w5 mappings and fix order of elements(Michelle Miller) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10631 QA 5e & 6b: Add Goal w5 mappings and fix order of elements(Michelle Miller) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10698 CarePlan note is no longer applicable as CareTeam is now its own resource(Michelle Miller) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11118 Goal.description should stay textual. - 2016-09 core #272 (Danielle Friend) Not Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11154 AllergyIntolerance.onset and reaction.onset are duplicates - 2016-09 core #308 (Stephen Chu) Persuasive with Mod
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11161 Include Person in the Procedure.subject reference list - 2016-09 core #315 (Stephen Chu) Not Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11172 CarePlan.status needs suspended - 2016-09 core #326 (Stephen Chu) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11174 Will accept the implementation of Goal.milestone as extension - 2016-09 core #328 (Stephen Chu) Not Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11175 Allow other resources to point to Goal - 2016-09 core #329 (Stephen Chu) Not Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11178 ReferralRequest.status missing resume - 2016-09 core #332 (Stephen Chu) Not Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11180 ProducedureRequest.status missing resume - 2016-09 core #334 (Stephen Chu) Not Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11206 entered-in-error is not "inactive" align with Condition - 2016-09 core #360 (Stephen Chu) Persuasive with Mod
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11207 entered-in-error does not implay inactive - 2016-09 core #361 (Stephen Chu) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11231 Expansion for the QuestionaireResponse.status - is there a need for entered-in-error as a status? - 2016-09 core #385 (Riki Merrick) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11333 Clarify what context means - 2016-09 core #491 (David Tao) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11336 Fix care team example - 2016-09 core #494 (David Tao) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11338 Clarify goal outcome - 2016-09 core #496 (David Tao) Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11349 Card is 1..1. (required). Suggest making 0..1 - 2016-09 core #507 (Emma Jones) Persuasive

Block Vote 2

Block Vote 2 (date TBD) due to small suggested changes to the resolution drafted as part of Block Vote 1:

• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11171 Clarify CarePlan.context and CarePlan.duration - 2016-09 core #325 (Stephen Chu) Not Persuasive with Mod
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11177 Change CareTeam definition - 2016-09 core #331 (Stephen Chu) Not Persuasive
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11337 Clarify order set - 2016-09 core #495 (David Tao) Persuasive with Mod
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11345 Add CarePlan.activity.detail.prohibited.reason - 2016-09 core #503 (Emma Jones) Not Persuasive with Mod

In Person

In Person Requests:

• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11354 Substance identified in both AllergyIntolerance.code and reaction.substance is problematic - 2016-09 core #512 - Robert McClure - Oct 20
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12136 Searching on optional attribute is dangerous (e.g., allergyintolerance.category)- Mark Kramer - TBD
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11281 Overall Condition.clinicalStatus and Condition.verificationStatus Condition body site - 2016-09 core #435 - Clem McDonald - TBD
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11290 clinical impression and condition - 2016-09 core #444 - Clem McDonald - TBD

Condition

• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10635 - QA 5a: Resource references exist in both directions for Condition and ClinicalImpression - defer until we can get Rob, Russ, Lloyd
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10662 - Clarify how medical history should be handled - resolved, but Grahame had further comment, so we need to revisit next week
• http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11089 - Inconsistencies between AllergyIntolerance and Condition - 2016-09 core #170 - started to discuss discrepancies, but no approved resolution just yet
  • http://hl7-fhir.github.io/w5 can be used to check consistency across resources

Adjourn

Adjourned at 6:45 PM Eastern

Meeting Outcomes

Actions Input from Viet, Russell, and Rob on Michelle's drafted ClinicalNote_FHIR_Resource_Proposal Daniel Lanphear (submitter of gForge 8458) to draft new resource proposal for transfusion. Rob to help fill in value sets for CareTeam status and type

Next Meeting/Preliminary Agenda Items Agenda review Approve previous meeting minutes Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#> gForge change request (including block vote)

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