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Clinicians on FHIR - Jan 2018, New Orleans. LA

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Introduction

The January 2018 Clinician-on-FHIR event will be hosted on Friday February 2, 2018.


Conference calls


Weekly preparatory conference calls are being hosted on Tuesdays at 5:00 - 6:00 pm US Eastern.


Conference call details: please see HL7 email broadcast Phone Number: +1 770-657-9270 Participant Passcode: 943377

https://intermountainmeetings.webex.com/intermountainmeetings/j.php?MTID=m285042c1dfaad164ef45fcf2b7aa8619


Planning

Planning Calendar and Meeting Minutes


Goal = create at least one (or more if possible) meaningful example(s) (actual JSON resource instance) for each FHIR resource otherwise the limitation of the FHIR resource is identified.


Resources

Demo Videos

- Useful demo video
- ClinFHIR Demo 2017-09-05 for San Diego CoF
- Useful information on document building capabilities
- David Hay Update demo Browser Setting Instructions - if needed



Powerpoint Slides


Tooling and Supporting Information

  • Tool
- Participants registered for the Clinician-on-FHIR event are strongly recommended to familiarise themselves with the clinFHIR tool
- A new user interface has been created to support creation of clinical story built from a set of FHIR resources based on the clinical scenario described in the Tracks section below
- Logon to the clinFHIR site:
- [clinFHIR.com/]
- Connect to the FHIR servers by selecting the appropriate Data Server (e.g. Public HAPI DSTU3), Conformance Server and Terminology Server
- click on the "Tool" icon on the top right hand corner of the clinFHIR page and select "simple builder" option
(Note - "simple builder" will soon be changed to "scenario builder")


  • Supporting Information



Clinician-on-FHIR Tracks


Track 1

Chronic Care (Care Planning)

  • Track co-lead: Emma Jones/Jeff Danford/Dave Carlson
  • Preparations: - Will use the spreadsheet prepared.


Track 2

Acute Care

  • Track co-lead: Rob Hausem/Stephen Chu
  • Details - will focus on the inpatient section at this time.
  • Preparations: - Scope = Resources that are related to the hospital component and exclude Care Plan from the scope. Will investigate the use of care team without the use of care plan.


Track 3

Perinatology - Cancelled

  • Track co-lead: Laura
  • Details - Look at focus on discharge from hospital.
  • Preparations: -


Track 4

Newborn

  • Track co-lead: Mike Padula and Viet Nguyen
  • Details - 2 day-old male infant that needs follow-up for serum bilirubin level following discharge from birth hospital to home.
    • Unique features include:
      • modeling maternal data in infant's chart (related person; observation-focal-subject)
      • examples of demographic and lab data that may be used for calculating risk of hyperbilirubinemia and potential need for intervention (phototherapy)
  • Findings/ feedback:
    • Unable to add the birthTime as an extension to birthDate (as recommended) using the ClinFHIR tool
    • Using multiple users at the same time was troublesome
      • will need to redo with a single person entering the information
    • Learned that related person is not sufficient for maternal information
      • Need observations with a modified extension of observation-focal-subject
      • Need to establish analogous functionality for condition
      • Also need to determine how to document maternal medication exposure as relevant to fetus/infan


Track 5

Emergency Care (NLM L Forms)

  • Track co-lead: Clem McDonald and Jim McClay
  • Details - focusing on the screening aspect of ED visit
  • Preparations: -

The login credentials for the form builder is lforms/demo

Use case spreadsheet

Use case notes

  1. The conduct of the lab request task is an implementation decision; the use case can support any number of approaches.
  2. The registration needs to be cleared up in the clinical process. The patient is triaged, given a room, and then registered. It’s unclear
  3. Is the referral simply a phone number, or does the ED send a referral? Do they also send a CCD or some other report? How does the gastro report back?
  4. Most of the focus for this group was on the L-Forms demonstration. NLM L-forms may be a nice way to make creating resources easier.

The url of the form builder is https://lhc-formbuilder.lhc.nlm.nih.gov


Track 6

Medications

  • Track co-lead: Melva Peters / John Hatem
  • Typically this track has reviewed the existing Pharmacy resources by testing any of the existing examples found in the Resource documentation.
  • The current resources are:
    • Medication Request - use for orders, prescriptions
    • Medication Dispense - use the pharmacy dispense event as a response to a medication order
    • Medication Administration - use to document the administration of a medication
    • Medication Statement - used to capture medication history re: statements of medication use; also used to represent 'derived' medication statements from medication orders
    • Medication - used to capture the details associated with a specific medication, including compounded medications
      • Medications are referenced by the Request, Dispense, Administration and Statement resources
  • Discussions
    • Review of resources
    • Identification of gap in dosage - can not currently support complex dosing with conditions such as sliding scale for insulin or give medication when BP is "x"
    • Review of Observation to confirm if recording of input/output is supported based on MedAdmin
    • Review what is expected for example scenarios - potential scope of scenario


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