2018-01-22 Rx Conf Call

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  • Scott Robertson (Chair)
  • Melva Peters (Scribe)
  • Stephen Chu
  • John Hatem
  • Dion McMurtie
  • Jean Duteau


  • round table introductions

Agenda Items and notes

  • New business

WGM Agenda

  • Review updated Agenda - most recent updates were completed week ending Jan 12, 2018
  • Discuss if any new updates are needed
  • John will attend Workflow meeting - Monday Q4
    • Melva to move forward planning discussion
    • Scott will only be in attendance Monday and Tuesday
    • find time to discuss status issues when Michelle can attend

Pharmacy List


FHIR Tracker Items

FHIR Tracker

Workflow Changes (Group = Workflow)

  • Workflow harmonization changes have been made - should be reviewed

Medication Related (Group = A)

  • Medication resources
    • started with Medication resources that was used within other resources
      • lots of GForge items to add additional attributes - didn't seem to fit within a medication that would be put in an order, dispenses
      • continuum of medication resources
      • Medication - for administering, ordering, dispensing, stating medications taken
        • doesn't include definitional attributes
      • MedicationKnowledge - represent of a medication - used in a drug knowledge base formulary
        • classes, interactions
      • Submission of to a Medicine Agency - close tied to IDMP - owned by BR&R WG
        • marketing authorization, ingredients, etc
    • want all 3 of the future resources to be consistent
    • Australia requirements
    • generated medication resources - 1 for every concept in AMT - experimental
    • started to develop and have stood up National Clinical Terminology Services - used to distribute terminology and provide terminology services
    • FHIR Terminology server
    • discovered that medicines is a bit special - AMT used in different way
      • search for medications (AMT codes) using a bunch of properties
      • search by medication code (AMT) and find out details about the medication
      • using HAPI server to expose medication resources
      • Could merge content from other sources - Pharmaceutical Benefits Scheme and PGA (regulator)
      • functionality allows searching by codes
      • want to bring in more content particularly from regulator
      • has created a number of extensions - to represent what can't be currently represented
        • isBrand flag
        • subsidy information/ benefit resource - has been packaged using extensions
        • regulatory resource
        • Experimental Online Search [1]

Dosage Related (Group = B)

Action:  Melva to create 2 examples for discussion next week

Status (Group I)

  • Status
    • GF #14364
      • clean up definitions for our attributes to be sure that they are clear
      • possibly of invariants or comments on when the status/reason would be used
Action:  pull out all definitions for status and statusReason - and propose updates to wording
    • GF #14340
Action:  followup with Marten in New Orleans
    • GF #13878 Clarify definition for reasonNotTaken on MedicationStatement
      • Dec 4 discussion
        • see tracker item comments for a suggested approach on how to update the documentation. This info came in very late during today's meeting and we were not able to vote on the suggestion. We will address this in an upcoming conference call
      • January 15 - same issue as in GF#14364 - discuss at the same time
        • discussion of the level of granularity of "in progress" - do we need to have additional codes to differentiate "being prepared by the pharmacy" vs "not picked up". Added note to tracker item.
    • GF #13881 Definitions for MedDispense

Misc (Group = none)

Action:  Melva to reach out to submitter to request more information so we can understand the use case as well as how he distinguishes original-order and order
    • GF #14431 - Fix all examples in resources to include all attributes

Order Service Catalogue FHIR Project

  • To follow the Order Catalog work, use the following listserv: ordercatalog@lists.hl7.org
  • Background
    • under Orders WG.
    • Catalogue vs Formulary. Catalog is a superset of Formulary, includes orderable items beyond medications.
    • expect one or two new resources
    • Jose and John involved
  • Updates
    • New Lab resource was created. John Hatem will continue to monitor and attend meetings.
    • August 14: last meeting was specific to lab specimen
      • content of the resource is generic
    • August 28: no update. There will be a meeting this week
      • specimen resource - believed to be a definitional resource
    • September 25: not started up
    • October 2: actively being discussed - John attending calls
    • October 9: no update
    • November 13: discussions over the past few weeks have been on prep for Connectathon and cleaning up new resource for Catalog Entry, Observation Definition. Per latest discussions there will be no formal pharmacy workflow specific connectathon activity in New Orleans WGM.
    • November 20: No updates from this week
    • November 27: No updates - lab folks will be testing at Connectathon
    • Dec 4: No updates this week
    • Dec 11: No updates this week
    • Dec 18: No updates this week
    • 2018-01-08: Planning for connectathon - lab catalogue will be tested
      • resource has been refined - now called EntryDefinition
    • 2018-01-15: No meetings schedule - preparing for Connectathon

Blood Products/Transfusion/Tissue Update

  • Background:
    • based in Patient Care. also includes Orders
    • Blood Products/etc moving into FHIR. Want to maintain alignment with Orders and Pharmacy resources
  • Eric H has sent out a Doodle poll to determine a meeting time for OO, PC and Pharmacy to discuss.
    • Meeting is currently scheduled for Aug 10, 2017
  • Updates
    • August 14, 2017
      • Minutes
      • meeting was held on August 10
      • scoped to Blood Transfusion for now - profiles on Pharmacy resources may work for the requirements
      • will continue to investigate requirements in preparation for the WGM Quarter
      • Michelle will post to Zulip inviting participation at WGM - complete
    • October 9: no update
    • November 13: no update
    • November 20: no update
    • November 27: no update
    • December 4: no issues to discuss. Expect to see this issues discussed at next WG meeting in Jan/Feb 2018
    • 2018-01-08 - Wednesday Q3 - meeting with O&O
Action:  Melva to confirm with HQ about cancellation of Pharmacy Wed Q3

CIMI Pharmacy Model Update

  • Update from John Hatem
    • July 17, 2017 - Claude Nanjo provided an overview of the CIMI logical model that incorporates the Pharmacy FHIR resource work. This work will be balloted as Informative in the HL7 September 2017 ballot.
    • July 31, 2017 - concerns raised about how Pharmacy will be involved and be expected to manage the content
      • will be balloted as informative
    • August 7, 2017 - John Hatem is following up with Claude N. on what type of commitment is expected from Pharmacy going forward.
    • August 14, 2017 - John has reached out to Claude. He has a general slide deck but will have to re-create a pharmacy specific version.
    • August 28, 2017 - ballot is open. It is not easy to read the ballot content without using the mapping spreadsheet and even then it isn't clear
  • September 25 update: Claude believes more information needs to be provided to navigate through the material
    • he is willing to come to Pharmacy WG
  • October 2 update: CIMI was pulled from the ballot
    • October 9: no update
    • November 13: Claude has reached out to discuss updates and follow up presentation to pharmacy - no time for this discussion has been set.
    • November 20: no update
    • November 27: no update
    • December 4: Claude responded that he is willing to attend the Dec 11 meeting to discuss CIMI model pharmacy related content. Will add to Dec 11 agenda.
    • December 11: Claude confirmed he will attend Dec 11 meeting to discuss CIMI model pharmacy related content.
      • Claude provided an overview including a walkthrough of an updated spreadsheet with mappings from the Pharmacy FHIR resources to the CIMI Reference model
        • CIMI is comprised of a Reference model and archetypes. The work that Pharmacy is reviewing is the Pharmacy related content in the CIMI reference model
        • The upcoming ballot in January 2018 will be a Comment only ballot on the CIMI Reference model. It will NOT cover the archetypes.
      • This meeting was recorded and saved in FreeConferenceCall
      • A link to the Google Doc spreadsheet can be found at: https://docs.google.com/spreadsheets/d/1XZUZg1-bKbumS8vcoRc4Vy8JR7NwFCooBm4zLeOTNe0/edit#gid=708341114
        • Items in the spreadsheet highlighted in yellow have not been modeled in CIMI (yet).

Action Item List

  • December 18: no updates
  • January 15, 2018: no updates

Ballot Reconciliation - Templates

MedicationKnowledge Resource

  • January 15, 2018
    • there will meetings and discussion in New Orleans
  • November 13, 2017
    • was approved by TSC today
    • can consider aligning with definitional concepts - Specimen Definition, etc
  • Should be approved by the TSC by next Monday
  • Discussion of how we want to work on this project
Action:  Determine if we will schedule a separate call


Next meeting

  • Monday, Q1 - New Orleans WGM