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2017-01-26 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: https://cerner.webex.com/cerner/j.php?MTID=macd64a688fdc3410ab4178adab5820fb

Date: 2017-01-26
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 The Australian Digital Health Agency (ADHA)
Evelyn Gallego EMI Advisors LLC
X Eric Haas Haas Consulting
X Rob Hausam Hausam Consulting LLC
X Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
X Russ Leftwich InterSystems
Tony Little Optum 360
Jay Lyle Ockham Information Services LLC, VA
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
X Joe Quinn Optum
X Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
Serafina Versaggi Dept of Veterans Affairs
X Tracey Coleman Allscripts
X Amit Popat Epic
Quorum Requirements Met: yes

Agenda

Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2017-01-12_Patient_Care_FHIR_Call and 2017-01-25_Patient_Care_FHIR_Call
    • Motion: Russ/Emma
  3. Prior Action Item Follow-up
  4. gForge change request

Supporting Information

STU 3 Timeline

From FHIR_Ballot_Prep

  • Sun. Feb. 5 Ballot reconciliation deadline - All ballot comments must be reconciled, tracker issue report must be clean
  • Sun. Feb. 19 Publication substantive resource freeze
  • Sun. Feb 26 Publication total freeze
  • Mon. Feb 27 QA period opens
  • Tue. Feb 28 FMM QA spreadsheet updated for all WG resources
  • Sun. Mar. 13 QA period closes
  • Sun. Mar. 20 All QA applied

The "following week" STU 3 is published!

Minutes

STU3 Action Items

  • Review Tracker Issues - https://docs.google.com/a/lmckenzie.com/uc?id=0B285oCHDUr09Mzh3b09rMFhEV1E
  • Defer 12 ballot comments that won't get resolved by Feb 5 (see below for discussion today)
  • Resolve QA Warnings to have resource FMM > 0
  • Resolve QA Information messages to achieve FMM = 3
  • Update QA checklist for resources that we want to be FMM = 3
  • Review workflow gap analysis per GF#10293
  • Block Vote (see below) scheduled for next week for low hanging fruit, i.e. non-ballot comments
  • Apply changes (all "substantive" changes have been applied, except allergy, care team invariant, and workflow patterns)

Defer Ballot Comments

Motion: Russ/Rob H: 8-0-0

  • GF#7185 2015May core #244 - ClinicalImpression is poorly thought out (Clem McDonald) Waiting for Input
  • GF#10387 CommunicationRequest needs ability to describe the location that the communication is about (John Moehrke)
  • GF#10621 QA 4a: Consider whether CarePlan.activity.detail.category should be bound to an external code system (Michelle Miller)
  • GF#10622 QA 4a: Consider whether Goal.category should be bound to codes from an external code system (Michelle Miller)
  • GF#10623 QA: Goal CodeableConcept elements are missing a binding to a value set (Michelle Miller) -- QA WARNING!
  • GF#10635 QA 5a: Resource references exist in both directions for Condition and ClinicalImpression (Michelle Miller)
  • GF#11026 Relationship between Condition and Observation - 2016-09 core #45 (Jay Lyle)
  • GF#11209 Feedback on ClinicalImpression - 2016-09 core #363 (Riki Merrick)
  • GF#11355 CarePlan category value set is out of date or wrong - 2016-09 core #513 (Robert McClure)
  • GF#11357 Re-use the procedure value set instead of wrapping it - 2016-09 core #515 (Robert McClure)
  • GF#11358 Should not make a new value set ehre - use the Problem value set that also includes Events and SWEC concepts. - 2016-09 core #516 (Robert McClure)
  • GF#11359 Why only one medication in an activity? And the value set is problematic (but example) - 2016-09 core #517 (Robert McClure)

TOP Priority -- AllergyIntolerance, Condition, and Procedure -- QA Warnings/Information (desire FMM = 3)

  • AllergyIntolerance
    • Rob Hausam is helping with RIM mappings (clinicalStatus and verificationStatus)
    • Rob Hausam is using data Elaine sent to see if we can curate the SNOMED CT Clinical Findings to a smaller subset. If not, then we'll update the binding for AllergyIntolerance.reaction.manifestation to use the same valueset-clinical-findings
    • Review gForges in context of WGM discussions
      • GF#11020 Need use-case for reaction.certainty - 2016-09 core #39 (Jay Lyle) Resolved - Change required

        Will move Reaction.certainty to an extension at least for now.

      • GF#11021 Increase cardinality of substance and make certainty relation to substance not reaction - 2016-09 core #40 (Jay Lyle) DEFERRED
      • GF#11023 Why isn't AllergyIntolerance.reaction an Observation? - 2016-09 core #42 (Jay Lyle) DEFERRED
      • GF#11354 Substance identified in both AllergyIntolerance.code and reaction.substance is problematic - 2016-09 core #512 (Robert McClure) DEFERRED
  • Condition is clean on the QA report!
    • QA Checklist: GF#10635 QA 5a: Resource references exist in both directions for Condition and ClinicalImpression (Michelle Miller) -- DEFERRED
  • Procedure is clean on the QA report!

MEDIUM Priority -- CareTeam, CarePlan, and Goal -- QA Warnings (desire FMM > 0 means we address all warnings)

  • CarePlan
    • MnM exemptions requested for element names should be singular (addresses and replaces)
  • Goal
    • MnM exemption requested for element names should be singular (addresses)
    • PCWG needs to address GF#10623
      • WARNING:Goal.target.detail[x] Need to provide a binding
      • WARNING:Goal.outcomeCodeableConcept Need to provide a binding
      • WARNING:Goal.description Need to provide a binding
      • WARNING:Goal.outcomeCodeableConcept Element has a todo associated with it (Define a proper value set for this.)
    • GF#12718 - Rename Goal.outcomeCodeableConcept to Goal.outcomeCode (Rob H) Resolved - Change Required

MEDIUM Priority -- CareTeam, CarePlan, and Goal -- QA Information (desire FMM = 3 means we address all information)

  • CareTeam
    • RIM Mapping
  • Goal
    • RIM Mapping
    • QA Checklist: GF#10622 QA 4a: Consider whether Goal.category should be bound to codes from an external code system (Michelle Miller)
  • CarePlan
    • RIM Mapping
    • Examples
      • CarePlan/activity/detail/definition Path had no found values in any example. Consider reviewing the path
      • CarePlan/activity/detail/quantity Path had no found values in any example. Consider reviewing the path
      • CarePlan/activity/detail/reasonCode Path had no found values in any example. Consider reviewing the path
      • CarePlan/activity/detail/reasonReference Path had no found values in any example. Consider reviewing the path
      • CarePlan/supportingInfo Path had no found values in any example. Consider reviewing the path
    • QA Checklist: GF#10621 QA 4a: Consider whether CarePlan.activity.detail.category should be bound to an external code system (Michelle Miller)

LOW Priority -- All other resources -- QA Warnings (desire FMM > 0 means we address all warnings)

  • ClinicalImpression
    • Stephen Chu will work on examples to cover all elements
      • ClinicalImpression.action Search Parameter 'ClinicalImpression.action' had no found values in any example. Consider reviewing the expression (ClinicalImpression.action)
      • ClinicalImpression.previous Search Parameter 'ClinicalImpression.previous' had no found values in any example. Consider reviewing the expression (ClinicalImpression.previous)
    • PCWG: ClinicalImpression.code Need to provide a binding
  • Communication & CommunicationRequest
    • PCWG: category Need to provide a binding
    • PCWG: workflow could resolve GF#10293
      • A resource must have an 'entered in error' status
      • CommunicationRequest.subject Elements with name 'subject' cannot be a reference to just a patient
  • FamilyMemberHistory
    • PCWG: FamilyMemberHistory.condition.onset[x] Element has a todo associated with it (Define/find appropriate observation code.)
  • ReferralRequest
    • PCWG: Bindings/Value Sets
      • ReferralRequest.type Need to provide a binding
      • ReferralRequest.reason Need to provide a binding
      • pc:ValueSetComparison Duplicate Valueset Names: v2-0284 (v2 Referral Category) & referralcategory (ReferralCategory) (name: [referrals, categories] / [referrals, categories]))
      • pc:ValueSetComparison Duplicate Valueset Names: v2-0283 (v2 Referral Status) & referralstatus (ReferralStatus) (name: [referrals, statuses] / [referrals, statuses]))
    • PCWG: ReferralRequest.description Element has a todo associated with it (This would be a good candidate for a 'markdown' data type.)
    • Examples
      • ReferralRequest.context Search Parameter 'ReferralRequest.context' had no found values in any example. Consider reviewing the expression (ReferralRequest.context)
      • ReferralRequest.group-identifier Search Parameter 'ReferralRequest.group-identifier' had no found values in any example. Consider reviewing the expression (ReferralRequest.groupIdentifier)
  • Linkage
    • PCWG: Linkage A resource must have an 'entered in error' status
    • PCWG: Linkage All resources should have an identifier
    • PCWG: Linkage.item Element has a todo associated with it (Make this 2..*.)

Block Vote (Thurs, Feb 2)

Non-ballot comments

  • GF#12585 Add Goal.target.measure invariant (Michelle Miller) Persuasive
  • GF#12645 CarePlan.activity.reference includes ProcessRequest (Dave Carlson) Persuasive
  • GF#12646 Add "careplan-title" extension (Dave Carlson) Persuasive with Mod
  • GF#12668 ClinFHIR: extension-condition-partof - add support for referencing Condition (Michelle Miller) Persuasive
  • GF#12669 Please add note element to careTeam (Emma Jones) Persuasive

Adjourn

Adjourned at 6:45pm Eastern.

Meeting Outcomes

Actions
  • Michelle to ask for exemptions from QA Checklist (Condition circular reference) and QA warnings (Goal bindings)
  • Michelle to schedule additional call on Monday
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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