2017-05-08 PA WGM Minutes

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Patient Administration Work Group Minutes - May 08, 2017

Monday Q2

HL7 Patient Administration Meeting Minutes

Location: Marriott Madrid Auditorium, Potsdam Conference Room

Date: 2017-05-08
Time: Monday Q2
Facilitator Brian Postlethwaite Scribe Iryna Roy
Attendee Name Affiliation
X Helen Drijfhout HL7 Netherlands
X Iryna Roy Gevity Consulting Inc, Canada
X Line Saele HL7 Norway
X Brian Postlethwaite Telstra Health, Australia
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics
Welcome/introductions

  • Approve agenda
  • Review PA Mission & Charter
  • Review Decision Making Practice]
  • Review 3-Year Work Plan]
  • Review SWOT Analysis

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Introductions
WG started with the approval of the agenda.
The group discussed the attendance for the week and potentially Wednesday Q4 may be cancelled due to unavailability of resources (human resources, conflicts with other meetings). The group needs the FHIR facilitator to close tracking items. This quarter will be monitored and adjusted during the week.
Thursday Q1 and Q4 will be merged. Q1 will cover wrap up activities: Approval of the next ballot, FHIR Planning, etc. Thursday Q4 will be cancelled. Meeting Agenda is updated. Action Item: Line will notify the HL7 about the changes in the agenda.

Brian moved to approve the agenda. Second by Helen for agenda approval.
Vote (for against/abstain): 3/0/0. Motion Passes

The WG continued to review the mission and charter. TSC is requesting a charter to include what type of work the group is doing. Line asks to keep it in mind when reviewing the charter. The group reviewed the mission and charter and no changes were needed.

The WG reviewed the Decision Making Practices. No changes needed. Action: Fix link of DMP to most recent document (v3 to v4). Line (action item stays)

The WG continued reviewing the SWOT. No changes needed. A new risk noted: Brian’s company may require him to spend significant time with FM group to contribute to the development of FM resources for the national project, which may realize the human resources threat, already recorded in SWOT.
The WG continued to review the 3 year work plan. Brian suggested adding the US Provider Directory project to the plan. The project is added with the PSS Planning status. The statuses of all FHIR resources are reviewed and updated in the plan. Patient, Practitioner and Organization (and possible Location) resources are going to be normative in 2018-05.

Motion: A motion for was made by Brian to approve existing DMP, updated 3 years plan, Mission and Charter all together. Seconded by Helen.
Vote: 3/0/0
Discussion: None
Motion Passes

The group continues reviewing the Google sheet with action items. Brian will talk to Michelle to add a tracker item for 1605-6; Alex has an action item to create PSS for PA resources. Statuses for completed action items are updated to “Done”. Updated action item for #9226 to be discussed with the Patient Care during the joined meeting. A lot of action items are assigned to Alex. Line will follow up with Alex to review and update the status of action item completion.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • Action: Fix link of DMP to most recent document (v3 to v4). Line.
  • Action: Line to add the review of action items to the meeting agenda during Q4 on Tuesday


Next Meeting/Preliminary Agenda Items
  • .

Monday Q3

HL7 Patient Administration Meeting Minutes

Location: Marriott Madrid Auditorium, Potsdam Conference Room

Date: 2017-05-08
Time: Monday Q3
Facilitator Line Saele Scribe Iryna Roy
Attendee Name Affiliation
X Brian Postlethwaite Telstra Health, Australia
X Helen Drijfhout HL7 Netherlands
X Iryna Roy Gevity Consulting Inc
X Line Saele HL7 Norway
X Christian Hay GS1, Switzerland
X Craig Newman CDC, USA
X Tom de Jong HL7 Netherlands
X Lori Reed eHealth Sign, USA
X Rene Spronk Ringholm, The Netherlands
Quorum Requirements Met (Chair +2 members): Yes

Agenda

Agenda Topics
1. Update from the FHIR Connectathon 2. Update on FHIR Projects 3. Tom: Gaps for Provider Registry project 4. OHD HL7 V2

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Introductions

Connectathon Update (Brian)
Patient Track is used as educational track for “beginners”. This is one of the tracks that is chosen for testing the TestScripts by Touchstone software. It doesn’t seem to be any major issues with the Patient resource.

Action: Next Connectathon - new track for evaluating updates and creation of encounters potentially using the Patch operations. Brian.
Projects Updates:
1) Brian: Project Statement is approved for the US Provider Registry project (centralized registry for the US, where they talk how local registries can synchronize with the central repository). Australia: Provider Directory secure messaging use. Maintenance of standard definition for the directory so GPs can be able to find the content and send a secure messaging. Connectathon at Australia May 26.
2) Tom: Netherlands have a project (Vzvz) related to the implementation of the Provider Registry using the national Infrastructure. Number of sources related to the provider, every doctor needs personalized card to access the Infrastructure to use it. The moment that happen the Organization is listed as a card issuing authority. Organization and Providers contain duplicate records (a Provider can be listed as an issuing authority for a card). The missing functionality is to identify a provider using the name known by a patient. Vzvz has a list of providers and names. The list will be combined using the common key between legal and formal name. A goal is to maintain a common list of Organizations and Providers (deduplicate?). The list will be maintained by each Organization. Centralized interface will be exposed to maintain data by external applications. COTS product is used. The product supports RESTful interface (not FHIR). The challenge is to map internal COTS Database model to the FHIR resources. The mapping is done. There is a delta in the mapping to resolve. The plan is the project will reach the Connectathon state this summer (or this year 2017).
3) Occupational Data for Health – Alex is away due to medical reasons, will further discuss when available. Feedback for the proposed structure discussed.
Mapping Gaps between FHIR resource and COTS db, discussed for Project #2:
Tom presented the Data model for the Netherlands Provider Registry and mapping delta issues. Provider Identification sharing was discussed. Tom: the issue is a limitation of only one name per Organization. Brian: Organization name is no longer the only name placeholder. An alias is introduced with the cardinality 0...* to keep other names. Tom: a type of a name would be desired to consider for future releases to distinguish a name purpose. It may be used by 80 % of systems. It can be solved as an extension for now. Tom: if we have a validity period, the Boolean may be preferred, in case of the validity date range is known. Brian: use yesterday’s day for the expiry period, when unknown. It means already expired. Tom: might add an item to a tracker for this issue. Still considering. Tom: Certificate? Brian: Australian extension for similar needs. Tom: Geolocation for an Organization. Brian: Consider using a Location resource because it is really intended for specifying a physical location. Tom: Logo for an Organization. Brian: Extension. Tom: should an interactionId be mapped to a payload type? Brian: we have a mapping to the connection type (IFE, HL73, etc) for an interactionId.”payloadType” maps to a payload identifier of a message. Check the value set, it is significantly changed in the STU3. Tom: Endpoint direction (“send” or “receive” or “both”), is not in the resource. Brian: There is no need to specify, the system would know.
Brian: Consider distribution of updates to other systems.

Occupational Health Data (PHER) HL7 V2:
Proposed structure for HL7 V2 for OHD is reviewed. Question: Move Occupation before Industry. Occupation data type should be CWE. It can be different per country. A set of elements is proposed to be attached to PD1: Usual Occupation; Usual Industry; Employment Status, Family Relationship, Usual job. Usual job may be bounded to the Occupation and Industry. Usual – the longest that was taken over period of time. Effective date is required in addition to the Recorded date. When it was known not when the system had it recorded. The PD1 segment is preferable because it is related to a patient. Item #14 does not have a data type. The whole concept of usual job may be used multiple times to identify usual job of multiple family members. A suggestion is better to create a separate segment for it. This will allow repetition and sync-up of Job information. It can be related to a patient or to someone important to a patient.
Action: Alex will review and provide updates.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • • Action: Next Connectathon new track for evaluating updates and creation of encounters potentially using the Patch operations. Brian.
  • • Action: Alex. Occupational Health Data (PHER) HL7 V2 review and update according to the feedback.
Next Meeting/Preliminary Agenda Items
  • .

Monday Q4

HL7 Patient Administration Meeting Minutes

Location: Marriott Madrid Auditorium, Potsdam Conference Room

Date: 2017-05-08
Time: Monday Q4
Facilitator Brian Postlethwaite Scribe Iryna Roy
Attendee Name Affiliation
X Helen Drijfhout HL7 Netherlands
X Line Saele HL7 Norway
X Brian Postlethwaite Telstra Health, Australia
X Iryna Roy Gevity Consulting Inc.
X Rene Spronk Ringholm
X Juha Mykkanen HL7 Finland
X Michael Donnelly EPIC, USA
X Attila Farkas Canada Health Infoway
X Christian Knaap Furore
X Richard Kavanagh NHS Digital
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  1. FHIR Scheduling

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Introductions
There is a project on Scheduling and PA resources are contributing to this project.
1. 8774 – Preferred bundle examples –
Needs to be done. No issues. Examples will be added. Already voted.
2. 12603 Define an operation to find a potential slot.
Locating slots that are appropriate for an appointment involves several steps. Proposed operations is Appointment.$find that will do it. The draft is published by Epic system. Discussion: “resume-key” is not needed in the proposed structure, because the “bundle” resource returned in a response contains the “next” link reference. Instead of start-time/end-time, introduce a repeatable “period” structure with start-time and end-time elements optional to be able to specify multiple time slots for searching in one operation. A “period” is optional as well (0..*). The operation Outcome may contain an indication what period was searched. Additional guidance needed around the visit-type element (Michael to take back to Cooper); “appointment-provider is an actor? OperationOutcome should have clear indication on what was searched. Reasons: optimal search for a user and a system (to minimize the number of searches). Should a search for a patient include the same extensions as a patient search? Potentially to add a flag to indicate a perfect match vs. a match for less than all search criteria. Patient (resource): patient is suggested to be a reference or resource data type. Reasoning: a patient may not be found in the system. A patient does not need to be created as part of the find operation. Only when appointment is decided to be created. “specialty” – suggested to use and add serviceCategory and serviceType (same as healthcare service). This may result in no longer needing the visit-type element. “indication” – review property if this should match an appointment resource (reference Condition | Procedure).
Output should be either bundle or single operation outcome. The bundle may contain operation outcome with information or warning messages regarding the results processed (e.g. what period was searched, what provider etc.) Question (Helen): if there are multiple actors in a search requested, should the result include the response for each? Answer: the behavior of a scheduling system isn’t prescribed. Discussion about possible outcomes of a search. The possible match or match score requires the follow up. The item is still open. Participant type should be considered. Preferred search elements may be specified.
Multiple appointments search considerations.
Additional details are in the tracker.
Action: Cooper to review the feedback and address. cooper@epic.com
3. 6262 – Recurring appointment pattern.
Discussion: Epic system does not indicate recurring appointments but all appointments may be linked to one episode of care. Australian system: service on wheels – may be recurring appointment use case. Community services are a use case for recurring appointment. The group still does not have enough requirements.
Status: Deferred.
Moved by Michael Donnely/Second Line Saele
Discussion: None
Voting: 8/0/1
4. 9452 - Add/document a standard extension to Appointment which references the Encounter act. In cases where an encounter contains/groups/is comprised of/fulfills multiple appointments. That's a fairly typical use case if the encounter is e.g. an outpatient encounter with a hospital.
Discussion: Rene: to solve the problem by the standard extension that allows association of multiple appointments to the same encounter.
Status: Persuasive.
Moved by Rene Spronk / Seconded by Michael Donnelly
Discussion: None
Voting: 6/0/2
5. 13195 (related to 13196) – Add a reference to an order (Procedure Request) as a new property.
Discussion: Rene requests an element to indicate a ProcedureRequest for an appointment. at the moment. Other requests may be added in the future. Brian: proposed to defer the discussion to the joined session with the Patient Care group. Michael: suggested to add now and PC may add other references in the future. Property name is suggested BasedOn.
Additional details are in the tracker.
Moved by Rene Spronk / Seconded by Michael Donnelly
Discussion: None
Vote: 7/0/1

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • None
Next Meeting/Preliminary Agenda Items
  • .


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