DoF 2016-08-03

Attendees

• Todd Cooper (BSF), Chris Courville (Epic), Bill Kleinebecker (Strategic Pathways), Parris Lucas (Ascom), Beth Pumo (KP), Brian Reinhold (LNI), John Rhoads (Philips)

Agenda/Minutes

• Introductions, Agenda Review, etc.
• Approve Minutes from previous calls:

2016.07.20 APPROVED

2016.07.27 APPROVED

• DEV WG FHIR PSS - Status Update (Cooper)

• Assigned Project #1277

> PSS is now out for a 10 day review / approval for the DESD (Domain Experts Steering Division, under the HL7 TSC (Technical Steering Committee))

• DoF Roadmapping Discussion Preview

> Todd will start drafting a 12 month DoF Roadmap based on the new PSS and scheduled meetings / events

• Resource Status: DeviceUseRequest, DeviceUseStatement

> Chris clarified that the DEV WG, which was initially assigned these two resources, indicated that they did not want to "own" them, but they also didn't "deprecate" them

> HL7 CDS determined that they needed the two resources for workflow management, events that indicate the need for device use and then subsequent documentation

> Group indicated that they would like to be in-the-loop regarding the definition and use of these two resources, possibly including a section in an IG

> ACTION(Todd) Contact the group responsible for these two resources and ensure that the DoF team is included

• Final Review of FHIR Documentation Updates (Courville)

• NOTE milestone dates

> Deferred to next meeting; Chris was not able to join the meeting until later in this agenda

• Mapping Update (Rhoads)

> John is progressing the mapping effort, but it is not yet complete; will report out next week

> General question as to the mechanics of formalizing and publishing the mappings in FHIR

- Stefan may understand this area better, but is out on vacation

- NOTE: Not all FHIR specification components have "production" mechanisms; for example, IG's

- ALSO mappings should include additional detail around Use Context, detailing WHEN a given mapping is valid

- ACTION(Todd) confer with the FHIR powers to see if they can provide clarity on these questions

• DIM to FHIR

> NOTE: This is the approach prefered by Continua, since devices communicate using 100% 11073 protocols and content

> For PoCD, today most content is sent in V2-based ORU messaging;

> A representative set of example models needs to be established to illustrate and validate the proposed mappings;

- For PHD devices, these exist in the 11073-104xx specializations

- For PoCD devices, these mostly exist in the IHE PCD TF-3 and related specification files; perhaps the ongoing infusion pump data set and modeling can be used, as well as a physiological monitor model (and OpenSDC)

• DIM to V2 to FHIR

> ACTION(Todd] Provide a more complete PoCD PCD-01 message example to the group

• PHD Mapping Example (Reinhold)

> Brian provided a tour of a detailed PHD mapping spreadsheet that he sent out to the group last week.

> Discussion included ...

- Time management challenges; time management issues have been addressed in the PCD-01 coincident time stamp. The Observation of the PHD’s current time at the PHG’s current time is a way to provide the same information in FHIR.

- ASN.1 BITS data type mapping to FHIR still an issue (entered as a tracker item); so those mappings are TBD

- observation.component leveraged heavily for many of the more complex data element mappings, including EEG or acceleration (X, Y, Z axis values)

- QUESTION: When should these be handled by a FHIR Resource extension? NOTE that FHIR with its 80/20 rule assumes that profiling with extensions will be frequenly used; however, this always comes with a cost / impact on systems that have to support recognition and processing of these "standardized" extensions. DoF will have to come to a consensus on how to strike the right balance.

- Metric source reference handle is an example of a mapping implementation challenge; there are design approaches, but they generally result in painful LoC increases and the resulting higher potential for bugs

• FHIR Connectathon Updates

• 2016 September (Baltimore WGM)

- Who will be participating - F2F / Remotely

> Brian hopes to be participating but still TBD; will bring an "uploader" and a number of PHD devices

> Stefan will participate and hopefully bring one or more real devices [he was out on vacation for this meeting]

> John Rhoads will participate as an observer

> Todd will hopefully participate, but most likely remotely; TBD if it is as an observer / facilitator or with a data source / consuming app

- Who has used a public FHIR server

> Brian has used a number of public servers including at the May Connectathon in Canada; assume Draeger has well, but not there to report out

> NOTE: Brian emphasized that the STU3 servers have considerably more conformance checking; so if an implementation passed using an STU2 implementation, it may run into problems with the STU3 implementations!

- CDS Support (specifically for devices):

> Identify device partners (Todd)

> Integrate device with HAPI FHIR Server (Claude with support from Todd)

Need to specify topic, event type, …

> Need to adapt CareWeb plugin to visualize device discrete data/waveform (Esteban)

> CDS applied to device data (tentative: for-connectathon)

- Waveform data?

• 2016 November (Amsterdam DevDays)

- Coordination with Continua & Furore (Ewout)

> ACTION(Todd) continue to reach out to Michael Kirwin regarding coordination w/ DoF on the November FHIR track supported by Continua

- ?V2 to FHIR Mapping Service?

- Use of FHIR DevDays (Furore) server?

> ACTION(Todd) get URL from Ewout for this server + timing and conditions for use

• DEV WG Baltimore (2016.09) Meetings

• Post Connectathon "Mortem" (Saturday evening or Sunday?)
• Who will be @ DEV WG meetings?

> Chris Courville (possibly), John Rhoads, Brian Reinhold (TBD)

• Topics for DEV-FHIR Joint Session?

- FMM Status Update

- FHIR Connectathon Report

- Roadmap Review: PSS, Connectathons, etc.

- General DoF Issues Review (collected between here and there)

- <Other?>

> Add: Outstanding Device-related Tracker Items

• Other Business

• Plan next meeting 2016.08.10