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2017-02-23 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: 2017-02-23
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
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
Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
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
Quorum Requirements Met: yes


Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2017-02-16_Patient_Care_FHIR_Call
    • Motion: Emma/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


gForge Change Requests

  • GF#12868 Linkage QA issues that Lloyd pre-applied

STU3 Publication TO DOs

  • Replacing the workflow "planned change" text with "This resource is an event resource from a FHIR workflow perspective - see Workflow" -- is there a preference about making this the first or last sentence in the Scope and Usage sections? Motion Eric/Joe: Add sentence at the beginning of "Scope and Usage" 5-1-0
  • Does Patient Care want Linkage to be FMM=0 or FMM=1? Keep as FMM=0
  • Linkage/Person boundaries need to be updated -- add Boundaries to say "The Person resource should be used to represent a person independent of a specific health-related context. Linkage can be used for all other use cases.
  • More examples needed for resolved trackers:
    • GF#8604 FamilyMemberHistory needs explanation of how to record Patient's own history (Russell McDonell) Applied note, but not example

      Will add a section to FamilyMemberHistory noting that a List representing a patient's "family history" can include Conditions and Observations that capture "family-history" relevant assertions about the patient themselves that would typically be captured as part of a family history. Â Will ensure at least one family history example instance includes such content.

      add reference to

    • GF#9795 Create examples that are principally narrative (Lloyd McKenzie) Resolved - Change required

      Add examples for CarePlan and Procedure that are primarily narrative with minimal if any discrete data.

      Profiles can further communicate when and if it is appropriate or encouraged to use discrete data.

  • Remaining gForges that need more attention
    • GF#5546 Clarify Timing - Condition vs. Concern (Lawrence McKnight) We haven't done the Motion 1 analysis; Motion 2 has been addressed as part of GF#10090.

      Motion 1: Need an analysis of the distinction of data attributes in condition vs. concern to determine if new concern resource is needed. 

      Motion 2:  Clarify in the FHIR specification that this resource is to be used as a point in time observation of a condition (event). Larry/David  11-8-3

    • GF#7057 2015May core #123 - Update RIM and CDA mappings (Brett Marquard) - We only prioritized RIM mappings for FMM = 3 resources

      Will update RIM mappings for all PC resources.  C-CDA mappings will be done if time allows - they really belong in the C-CDA on FHIR profile.

    • GF#10662 Clarify how medical history should be handled (Grahame Grieve) Grahame didn't think our resolution addressed everything....

      The List resource already includes guidance on medical history as follows:

      "The List resource is a flat possibly ordered collection of records. List resources are used in many places including allergies medications alerts family history medical history etc. List resources can be used to support patient-specific clinical lists as well as lists that manage workflows such as tracking patients managing teaching cases etc. Resources supported by the List resource can be homogenous consisting of only one type of resource (e.g. allergy list); as well as heterogeneous containing a variety of resources (e.g. a problem list including Conditions, AllergyIntolerances, Procedures etc.)."

      List will have more examples included per <a href=""></a>

      Within the scope of Condition expand usage section to include example of condition as a result of a procedure:

      Amputee-BKA could be a condition following a surgical procedure of amputation

  • QA Volunteers [1] -- Elaine, Emma (+ Michelle and Rob H)


Adjourned at 6:30pm 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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