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2017-02-02 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: 2017-02-02
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 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
X Jay Lyle Ockham Information Services LLC, VA
Russell McDonell Telstra Health
Lloyd McKenzie Gevity (HL7 Canada)
Larry McKnight Cerner
X Michelle M Miller Cerner
X Lisa Nelson Life Over Time Solutions
Viet Nguyen Lockheed Martin, Systems Made Simple
M'Lynda Owens Cognosante
Craig Parker Intermountain Healthcare
Joe Quinn Optum
Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
Serafina Versaggi Dept of Veterans Affairs
X Tracey Coleman Allscripts
X Hank Mayers
X Pushpalatha Bhat
Quorum Requirements Met: yes

Agenda

Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2017-01-31_Patient_Care_FHIR_Call
    • Motion: Laura/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

Block Vote (Thurs, Feb 2)

Non-ballot comments (all have been pre-applied) Motion: Stephen/Russ: 9-0-0

  • 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

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

  • AllergyIntolerance
    • RIM mappings (clinicalStatus and verificationStatus) -- use the same RIM mappings as Condition statuses
      • The ACT.statusCode is a workflow status element and cannot be used to represent clinical status. This will have to be mapped to an Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code=""clinicalStatus"", moodCode=EVN].value
      • The ACT.statusCode is a generic workflow status element and may not be adequate for representing clinical verification status. This will have to be mapped to an Observation ACT .inboundRelationship[typeCode=COMP].source[classCode=OBS, code=""verificationStatus"", moodCode=EVN].value
    • GF#12768 Motion: Rob/Eric: 12-0-0 -- Bind AllergyIntolerance.reaction.manifestation to http://build.fhir.org/valueset-clinical-findings.html (to remove the duplicate value sets)
      • Duplicate Valueset Names: manifestation-codes (SNOMED CT Clinical Findings) & clinical-findings (SNOMED CT Clinical Findings)
      • AllergyIntolerance.reaction.manifestation -- http://build.fhir.org/valueset-manifestation-codes.html
      • DiagnosticReport.codedDiagnosis (and profiles) -- http://build.fhir.org/valueset-clinical-findings.html
      • pc:ValueSetComparison Duplicate Valueset Names: manifestation-codes (SNOMED CT Clinical Findings) & adverse-event-type (SNOMED CT Clinical Findings) (name: [cts, findings, snomeds, clinicals] / [cts, findings, snomeds, clinicals]))
      • pc:ValueSetComparison Duplicate Valueset descriptions: manifestation-codes (SNOMED CT Clinical Findings) & adverse-event-type (SNOMED CT Clinical Findings) (description: [cts, findings, snomeds, alls, clinicals] / [cts, findings, snomeds, alls, clinicals]))
  • Condition is clean on the QA report!
  • Procedure is clean on the QA report!

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

  • CareTeam - no QA warnings!
  • CarePlan - no QA warnings!
    • MnM approved exemptions requested for element names should be singular (addresses and replaces)
  • Goal
    • MnM approved exemption requested for element names should be singular (addresses)
    • GF#10623
      • MnM approved exemption requested for Goal.target.detail because target detail is a choice of data types (i.e. Quantity and CodeableConcept could have different value sets) - Observation.value[x] does not show this same QA warning.
      • Update Goal.description's definition to read: Human-readable and/or coded description of a specific desired objective of care, such as "control blood pressure" or "negotiate an obstacle course" or "dance with child at wedding"
      • Bind Goal.description to http://build.fhir.org/valueset-clinical-findings.html

MEDIUM Priority -- All other resources (except Linkage and ClinicalImpression) -- QA Warnings (desire FMM > 0 means we address all warnings)

  • Flag -- no QA warnings!
  • FamilyMemberHistory -- no QA warnings!
    • Stephen Chu's recommendation is to use LOINC 75272-5 Age at onset for the FamilyMemberHistory.condition.onset
    • Motion: Stephen/Elaine: 11-0-1
  • Communication & CommunicationRequest
    • Examples
      • Communication.definition Search Parameter 'Communication.definition' had no found values in any example. Consider reviewing the expression (Communication.definition) -- hyperkalemia protocol
      • Communication.part-of Search Parameter 'Communication.part-of' had no found values in any example. Consider reviewing the expression (Communication.partOf) -- part of observation measuring serum potassium
    • Bindings
      • Communication.notDoneReason An element of type CodeableConcept or Coding must have a binding GF#12766
      • Category Need to provide a binding - GF#8564 - Create FHIR value set with: alert, notification, reminder, instruction
  • ReferralRequest
    • Bindings/Value Sets
      • pc:ValueSetComparison Duplicate Valueset Names: v2-0284 (v2 Referral Category) & referralcategory (ReferralCategory) (name: [referrals, categories] / [referrals, categories])) -- align with workflow, rename element to intent and use http://build.fhir.org/valueset-request-intent.html
      • pc:ValueSetComparison Duplicate Valueset Names: v2-0283 (v2 Referral Status) & referralstatus (ReferralStatus) (name: [referrals, statuses] / [referrals, statuses])) -- rename value set to Referral Request Status
    • ReferralRequest.description Element has a todo associated with it (This would be a good candidate for a 'markdown' data type.) -- delete TO DO

LOW Priority -- CareTeam, CarePlan, and Goal -- QA Information

  • CareTeam
    • RIM Mapping
    • Example: CareTeam/note Path had no found values in any example. Consider reviewing the path
  • 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/title Path had no found values in any example. Consider reviewing the path
      • 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)

Draft Resources with FMM = 0 -- ClinicalImpression and Linkage

  • ClinicalImpression -- keep as FMM = 0
    • 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
  • Linkage -- keep as FMM = 0
    • 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..*.)


Adjourn

Adjourned at 6:45pm Eastern.

Meeting Outcomes

Actions
  • Michelle to email out workflow gap analysis
Next Meeting/Preliminary Agenda Items
  1. Agenda review
  2. Approve previous meeting minutes
    • Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#>
  3. Workflow patterns
  4. gForge change request

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