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2017-02-09 Patient Care FHIR Call
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Contents
Meeting Information
| Patient Care FHIR Resources Conference Call Location: Conference Call |
Date: 2017-02-09 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 | ||
| 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 | ||
| 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 | |
| Simon Sum | Academy of Nutrition and Dietetics | ||
| Iona Thraen | Dept of Veterans Affairs | ||
| Serafina Versaggi | Dept of Veterans Affairs | ||
| X | Pushpalatha Bhat | ||
| Quorum Requirements Met: yes | |||
Agenda
Agenda Topics
- Agenda review
- Approve previous meeting minutes 2017-02-02_Patient_Care_FHIR_Call
- Motion: Russ/Stephen
- Prior Action Item Follow-up
- gForge change request
Supporting Information
STU 3 Timeline
From FHIR_Ballot_Prep
- 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!
FHIR Maturity Levels
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
Target FMM levels for STU3 publication
- AllergyIntolerance = 3
- Condition = 3
- Procedure = 3
- CarePlan = 1
- Goal = 1
- CareTeam = 1
- FamilyMemberHistory = 1
- ReferralRequest = 1
- Flag = 1
- Communication = 1
- CommunicationRequest =1
- ClinicalImpression = 0
- Linkage = 0
STU3 Action Items
- Review Tracker Issues - https://docs.google.com/a/lmckenzie.com/uc?id=0B285oCHDUr09Mzh3b09rMFhEV1E
- 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
- Apply changes (all "substantive" changes have been applied, except care team invariant and workflow patterns)
Minutes
gForge Change Requests
GF12776 Goal.subject should be 1..1 -- Deferred
Event Workflow Pattern
Review workflow patterns GF#10293
FamilyMemberHistory - Ask FHIR-I to exempt FMH from workflow
- make identifier a summary element
- add definition element Reference(Questionnaire | PlanDefinition) -- search parameter / example
- don't add basedOn element
- don't add partOf element
- don't bind status to http://hl7.org/fhir/ValueSet/event-status
- add notDone element
- add notDoneReason element (example binding; similar to FHIR value set to http://build.fhir.org/valueset-list-empty-reason.html)
- Patient does not know subject
- Patient refused to provide information about subject
- Unable to obtain
- Deferred (e.g. don't know why family member died)
- don't add code element
- don't rename patient element to subject -- keep the Reference(Patient)
- don't add context element -- Reference(Encounter|EpisodeOfCare)
- exempt from occurrence pattern (i.e. don't rename date, keep dateTime data type)
- don't add performer structure (i.e. role, actor, onBehalfOf)
- add reasonCodeableConcept (example value set binding to http://build.fhir.org/valueset-clinical-findings.html)
- add reasonReference element Reference (Condition | Observation | AllergyIntolerance |QuestionnaireResponse)
Communication
- exempt from occurrence pattern (i.e. keep sent/received dateTime)
- exempt performer structure (i.e. role, actor, onBehalfOf) and keep sender/recipient elements as is
- add reasonCodeableConcept (example value set binding to http://build.fhir.org/valueset-clinical-findings.html)
- add reasonReference element Reference(Observation | Condition)
Request Workflow Pattern
CommunicationRequest
- add supportingInfo as extension (GF#10293)
- add relevantHistory as extension (GF#10293)
- add definition as extension Reference(ActivityDefinition|PlanDefinition)
- add basedOn element -- Reference(CommunicationRequest + all other request)
- add replaces element -- Reference(CommunicationRequest)
- add groupIdentifier element -- search parameter / example
- don't add intent element (order doesn't apply)
- change priority from CodeableConcept to code (and add w5 mapping to grade)
- exempt from having code element added
- exempt from making subject 1..1 -- keep 0..1
- rename scheduled element to occurrence and don't add choice of Timing
- rename requestedOn element to authoredOn, add w5 mapping to when.recorded, add aliases (createdOn, signedOn) -- update search param
- align requester element with the agent and onBehalfOf elements (allowing agent to also be Organization|Device)
- exempt from performerType/performer pattern; prefer to keep sender/recipient instead
- rename reason element to be reasonCode
- add reasonReference element - Reference(Condition | Observation)
- add note element
Next Week
ReferralRequest
- add definition element -- search parameter / example
- add replaces element -- search parameter / example
- add aliases (grouperId and requisition) to groupIdentifier element
- bind status element to http://hl7.org/fhir/ValueSet/request-status (effectively adding suspended and unknown)
- rename category element to intent and bind to http://hl7.org/fhir/ValueSet/request-intent (pre-applied)
- change priority from CodeableConcept to code
- exempt from having code element added OR rename serviceRequested element to code? (request pattern has 0..1 cardinality, but keep 0..*)
- rename patient element to be subject Reference(Patient|Group) and change to be required 1..1
- rename fulfillmentTime element to be occurrence with choice of dateTime|Period|Timing?
- align requester element with the agent and onBehalfOf elements (allowing agent to also be RelatedPerson|Device)
- exempt from performerType/performer pattern; prefer to keep recipient 0..* instead
- rename reason element to be reasonCode, and increase cardinality 0..*
- add reasonReference element
- add relevantHistory element
ClinicalImpression
- add definition element -- search parameter / example
- add basedOn as extension (GF#10293) -- search parameter? / example
- add partOf as extension (GF#10293) -- search parameter? / example
- bind status to http://hl7.org/fhir/ValueSet/event-status
- add notDone element
- add notDoneReason element (need to determine value set binding)
- add alias (of patient) to subject element
- exempt from occurrence pattern (i.e. don't rename effective, don't add Timing)
- align assessor with the performer structure (i.e. role, actor, onBehalfOf) - can actor Reference(Practitioner|Organization|Patient|Device|RelatedPerson)? or just Practitioner?
- add reasonCodeableConcept (need to determine value set binding)
- add reasonReference element
Resource QA Summary
TOP Priority
- AllergyIntolerance is clean on the QA report!
- Condition is clean on the QA report!
- Procedure is clean on the QA report!
HIGH Priority
- CareTeam - no QA warnings!
- CarePlan - no QA warnings!
- MnM approved exemptions requested for element names should be singular (addresses and replaces)
- Goal - no QA warnings!
- MnM approved exemption requested for element names should be singular (addresses)
- 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.
MEDIUM Priority
- 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 -- no QA warnings!
- CommunicationRequest -- no QA warnings!
- ReferralRequest -- no QA warnings!
LOW Priority
- 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
- Stephen Chu will work on examples to cover all elements
- 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 6:36pm Eastern.
Meeting Outcomes
Actions
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Next Meeting/Preliminary Agenda Items
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