2017-02-06 Rx Conf Call

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Attendees

  • Melva Peters (Chair)
  • Sara Cohen
  • Scott Robertson
  • John Hatem
  • Marla Albitz
  • Eric Haas
  • Michelle Miller
  • Mary V
  • Daniel Zhang

Agenda Items and notes

ListServ Discussions

Zulip

  • Long Term vs Short Term Conditions
  • Medications not to be discontinued
  • MedicationStatement
    • related to "do not do" - as in patient not to be given a certain medication
    • may come out of Negation project from Patient Care
    • a number of items included in this Zulip chat
      • patient not to be given medication
        • not likely a medicationStatement - is this a negative order?
        • has not come up for Cerner - may infer something like this from an allergy
      • doctor recommends that GP prescribes drug ABC
Action:  Melva to reach out to Philip to post tracker item

US Meds Ballot Reconciliation

  • Consolidated Ballot Spreadsheet File:Ballotcomments FHIR MEDICATION R1 D1 2017JAN.xls
  • Updated Ballot Spreadsheet File:Ballotcomments FHIR MEDICATION R1 D1 2017JAN (updated 2017-01-30).xls
  • Block Vote 1 - see spreadsheet
    • Reviewed comments from Michelle
      • Row 9 -- should be persuasive since agreeing to add content/clarification - agree - will change to Persuasive with Mod
      • Row 11 -- should be persuasive since agreeing to add content/clarification - agree - will change to Persuasive with Mod
      • Row 38 -- should be persuasive since agreeing to add content/clarification - agree - will change to Persuasive with Mod
      • Row 29 -- triage note said "At this point implementers are not supporting MedicationRequest" – just wanted to clarify the note (not necessarily change the disposition)
        • clean up the triage note to reflect that we don't have enough information about workflow patterns that will be used in order to provide guidance
        • remove the question and add a comment that "don't have enough information and will be considered for future release
        • change to persuasive with mod
        • this should not be under medicationStatement
    • Moved by John - Michelle - change disposition of line item 9, 11, 38 and 29 to persuasive with Mod and Line 29 will update triage note
      • 7/0/1 Carried
    • Motion to accept disposition of all Block Vote Items except line 46 - John - Daniel - 7/0/1 - Carried
  • Items for Discussion - 6 comments - see spreadsheet
      • Row 46 - would like to discuss (whether intended/future orders should be included)
        • Change to "discuss"
        • discussed at Connectathon - "prescribed or consumed" for all - so it would not include "entered in error" or "intended"
        • may need to re-define the med list - for medicationRequests - that are orders or proposals (not instance-orders) from "intent"
  • February 6 Update - see updated ballot reconciliation spreadsheet

File:Ballotcomments FHIR MEDICATION R1 D1 2017JAN (updated 2017-01-30).xls

FHIR Tracker Items

12751 QA Updates to Pharmacy resources

    • Medication Statement - mostly clean up
    • includes adding W5 category - which changes the order of the attributes - agreed to have this change made
      • Motion to add W5 category to all pharmacy resources - Scott/Melva - 8/0/0
    • change datatype for "taken" - to CodeableConcept rather than code - discussion to leave this as "code" - no change

12764 = Remove product backbone element on Medication

  • may help to resolve the issues with a different name for product and the confusion between product and package
  • Moved by Scott/Mary: 8-0-0 Carried

12399 - Medication reference to more abstract medication

  • Resolved in San Antonio, but submitted doesn't agree with decision

12758 Consider whether batch/lot should be on product or package

12733 Add search parameters for Encounter to MedicationStatement

12412 - Need a better name for Medication.product

12396 - Medication package and product

12395 Basis of Strength Substance

TR#12347 - Adjust Medication.package.container value set to SNOMED CT Physical object hierarchy

TR#12347

  • December 15 - IDMP - could look at using
    • Scott thinks NCPDP may have looked at using SNOMED-CT
    • could use a US centric value set if can't find anything else
    • EDQM example - container list - Jose has found and will provide to the list if there is no copyright issue
Action:  Melva to review EDQM 

12175 MedicationOrder special authorization - In Australia a Warrant number

10738 Review naming of all attributes to ensure meet QA guidelines

FHIR Workflow Meetings Status

  • no meetings held - nothing to report

FHIR Maturity

  • Current Maturity status
    • spreadsheet has been submitted - MedicationOrder, MedicationStatement and Medication - MM2
    • review of MedicationStatement Maturity
    • no further need for the resources to get them to MM2
  • Update on MedicationDispense implementations

Order Service Catalogue PSS

  • Update on project meetings
    • John has been attending the meetings - he will post more detailed updates to the pharmacy list serve

AOB

Next meeting

  • Monday, February 9, 2017 at 4pm Eastern