FHIR Consent Mar 3, 2017

HL7 CBCC FHIR Consent Working Meeting

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Attendees

	Member Name		x	Member Name		x	Member Name		x	Member Name
X	David Pyke CBCC co-Chair		.	Johnathan Coleman CBCC Co-Chair		X	Suzanne Gonzales-Webb CBCC Co-Chair		.	Grahame Grieve FHIR Director
.	Alexander Mense Security Co-Chair		X	Kathleen Connor Security Co-Chair		X	John MoehrkeSecurity Co-Chair		.	Jim Kretz CBCC Co-Chair
X	Glen Marshall		.	Tarik Idris		.	Ken Salyards		X	Diana Proud-Madruga
X	Mike Davis		.	David Staggs		.	Ken Sinn		.	Beth Pumo
.	Joe Lamy, Aegis		.	Joseph Quinn		.	Wayne Kubick		.	Serafina Versaggi
.	Igor Sirkovich		.	M'Lynda Owens		.	Mohammad Jafari		.	Linda Michaelson
X	Lisa Nelson		.	Hank MayersPCWG Representative		.	Laura Heermann Langford PCWG Co-chair		.

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Agenda

• Roll-call
• Additional scope consent work status.
  • Research Consent Directive: Consent to participate in research protocol and information sharing required. --RCRIM/BRIDG meeting
  • Medical Treatment Consent Directive: Consent to undergo a specific treatment (or record of refusal to consent). -- PCWG status
  • Advance Care Directives: Consent to instructions for potentially needed medical treatment (e.g. DNR). -- PCWG status

Minutes

Discussed the Advanced Care Directive Consent possibilities

• The basic structure of the Consent resource could be modified to handle the consent to a specific order (DNR). Only one specific order would be subject to a consent resource.
• The structure could be based on the current elements as follows:
  • Actor: Health Care Practitioner impacted by the consent
  • Source: The specific signed order (DNR) based on specific instance
    • The individual orders would not likely be suitable for and Order resource and would need to be a custom rule (PolicyRule) that would have the potential for human interpretation at some point.
  • Policy: The set of "Preferences" (a.k.a. living will) that create the environment for the Source order
    • The Preferences are a larger set of "if" conditions that are created in advance, likely years in advance, that complete set of all wishes in various conditions.
  • Category: The overarching Advance Directive that is covered. This codelist already has codes for Advance Directives and could be expanded as needed.
• Some renaming of elements would be possible to allow for a more complete representation of an Advance Directive
• Lisa Nelson to send examples to the CBCC list. THis would include sample preference documents and a list of LOINC codes that represent specific orders.