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2017-02-16 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

Date: 2017-02-16
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 Pushpalatha Bhat
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
X 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
Quorum Requirements Met: yes


Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2017-02-14_Patient_Care_FHIR_Call
    • Motion: Russ/Stephen
  3. Prior Action Item Follow-up
  4. 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


Prior Action Item Follow-up

  • GF#12810 - FamilyMemberHistory *is* an event - it's an action that has occurred. And it could, in principle, have been taken as part of a request, be taken in accordance with a particular protocol, etc. However, much of this is not in the 80%. And that's ok. The work group can decide which elements are relevant in core, which should have standard extensions and which shouldn't have mappings at all. Certainly *some* of the Event pattern elements do have mappings, so these should be tracked. The Event pattern doesn't require strict alignment, merely consideration about what might be relevant and alignment when appropriate.
  • GF#12814 - Rename Event.reasonCodeableConcept to Event.reasonCode
    • Procedure.reasonCodeableConcept
    • FamilyMemberHistory.reasonCodeableConcept
    • Communication.reasonCodeableConcept

gForge Change Requests Discussed


  • GF#12637 change usage text for Timing element to allow for event usage
  • Zulip: Use of Timing for past events
  • offline, Grahame asked "the problem is that the definition of performed is not consistent with adding Timing to the mix. I think it would be a lot more manageable to leave performed as dateTime | period, and have Timing as an extra element or extension to that so you could report the schedule you were following separately. This way, the tense of Timing can be unchanged - this is the schedule you followed, not an absolute statement about what actually did"
  • resolution documented as part of GF#10293


  • GF#12212 Include HealthcareServce in the recipient reference types -- resolved!


  • GF#12772 CareTeam.category value set updates (e.g. rename care coordination) -- resolved!
  • GF#12367 CareTeam context (e.g. add encounter) -- resolved!

gForge Change Requests Not Discussed / still in backlog



  • GF#11355 CarePlan category value set is out of date or wrong - 2016-09 core #513
  • GF#11357 Re-use the procedure value set instead of wrapping it - 2016-09 core #515
  • 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
  • GF#11359 Why only one medication in an activity? And the value set is problematic (but example) - 2016-09 core #517
  • GF#12623 valueset-care-plan-activity-status needs a code for abandoned (or quit)


  • GF#12599 Consider adding Communication.priority to match CommunicationRequest.priority

Workflow Alignment

ClinicalImpression -- as part of GF#10293 voted to scope out 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
  • 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


Adjourned at 6:35pm Eastern.

Meeting Outcomes

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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