FM May 2016 Montreal WGM Minutes

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Overall Attendees

Member Name
Kathleen Connor Co-chair .
Beat Heggli Co-chair .
Paul Knapp Co-chair .
[mailto:tbd
Lorraine Constable .
Andy Stechishin .
Mark Scrimshire .
Grahame Grieve .
Corey Spears .
Mary Kay McDaniel .

May 2016 Financial Management Working Group Meeting - Montreal, Canada

Return to Financial Management Home Page

Return to FM Sept 2016 Baltimore WGM Agenda and Meeting Minutes

FM Opening Session

Monday Q1 FM Opening Session=

Monday Q1 Attendance

Member Name
Kathleen Connor Cochair x
Beat Heggli Cochair x
Mary Kay McDaniel Cognosante x
[mailto:mwilliamson@cdc.gov Michelle Williamson CDC
[mailto:hdk1@cdc.gov Hetty Khan CDC
[mailto:fboussetta@almerys.com Fahmi Boussetta Almerys x
[mailto:Guillaume Rossignel@almerys.com Guillaume Rossignel Almerys x
[mailto:benoit.schoeffler@almerys.com Benoit Schoeffier Almerys x
  • Kathleen cochaired
  • Introdutions
  • Approval of May WGM Agenda
  • Mission and Charter Review - approved to reaffirm
  • Review of FM WG Health - KC - write up 3 yr plan
  • Review of FM WG SWOT - KC to Check latest on HL7 FM
  • Discussed strategies for achieving 3 Yr Plan
    • Solicit ideas for PR and compelling FM use cases for FHIR Connectathon track in Sept - e.g., MACRA MIPS and Patient Portal for EOB and other FM transactions - e.g., sign up for enrollment, check current deductible/max OP/Lifetime limits - and benefit decrements etc
  • Agreed to plan to promote FM FHIR to Maturity = 3
  • Fix v2 Vocab
    • Discussed need to monitor v2 Database more closely for FM Action Items!!!!!
    • Prep and conduct reaffirmation of v.3 or deprecate - doc +/-
  • Discussed CDC Public Health reporting IG ballot comment re CDA Policy Activity Guarantor

What's the current value set - KC to check MDHT

    • FM confirms correctness of Epic balloter's objection to cardinality = 0..1 because guarantor is not a relationship with payer - just who the provider can bill for services not covered by payer. Not = to subscriber, but could be.

This change requires SDWG to agree to change base CCD/C-CD via Errata and/or agree to an extension for PHER IG.

Monday Q2 v2 Work Session - Vocab updates

Monday Q2 Attendance

Member Name
Kathleen Connor Cochair x
Beat Heggli Cochair x
Mary Kay McDaniel Cognosante x
[mailto:fboussetta@almerys.com Fahmi Boussetta Almerys x
[mailto:Guillaume Rossignel@almerys.com Guillaume Rossignel Almerys x
[mailto:benoit.schoeffler@almerys.com Benoit Schoeffier Almerys x
  • Kathleen cochaired
  • FM v2 Vocabulary Issues - Mary Kay to discuss spreadsheet of FM v2 vocabulary

K to Insert link to Spreadsheets and add new v.2 vocab page and page of v2 CPs from DB

Wednesday Q 1 - 4

May WGM Montreal Wednesday May 11

Q1 Attendees: Paul Knapp (Chair) Knapp Consulting Inc. pknapp@pknapp.com Benoit Schoeffler Almerys Benoit.SCHOEFFLER@almerys.com Guillaume Rossignol Almerys guillaume.rossignol@almerys.com Mary Kay McDaniel Cognosante MaryKay.McDaniel@cognosante.com

Agenda: 1) Review of recent changes to the FHIR FM resources.

Minutes: Changes to the Claim resource were reviewed.

Q2 Attendees: Paul Knapp (Chair) Knapp Consulting Inc. pknapp@pknapp.com Benoit Schoeffler Almerys Benoit.SCHOEFFLER@almerys.com Guillaume Rossignol Almerys guillaume.rossignol@almerys.com Mary Kay McDaniel Cognosante MaryKay.McDaniel@cognosante.com

Agenda: 1) Review of recent changes to the FHIR FM resources.

Minutes: Changes to the Claim resource were reviewed including collapsing the payee to a choice of resources rather than separate resource elements by resource type.

A new information structure has been created which includes category, type, reason, timing and value to replace the disparate sets of situational or explanatory information elements and types: occurrence; occurrenceSpanCode; valueCode; businessArrangement; exception; school; onset; accident; interventionException; related; employmentImpacted; hospitalization; missingteeth; material.

  Q3 Attendees: Paul Knapp (Chair) Knapp Consulting Inc. pknapp@pknapp.com Benoit Schoeffler Almerys Benoit.SCHOEFFLER@almerys.com Guillaume Rossignol Almerys guillaume.rossignol@almerys.com Mary Kay McDaniel Cognosante MaryKay.McDaniel@cognosante.com Beat Heggli (CoChair) Netcetera Beat.Heggli@netcetera.com Kathleen Connor (CoChair) Baycliffe Strategies Inc. kathleen_connor@comcast.net Corey Spears Infor corey.spears@infor.com Grahame Grieve HL7 FHIR grahameg@gmail.com

Agenda: 1) Review of recent changes to the FHIR FM resources – review with FHIR-I.

Minutes: Changes to the Claim resource were reviewed regarding the recent change to using a choice of Identifier and Reference to review to certain resources (patient, practitioner, insurer (target), enterer, etc.). FM has instituted this pattern to better accommodate situations where national identifiers exist rather than implementers having to create real or contained resources simply to wrap the identifier alone and to avoid implemented just putting the identifier in the reference as though the national resource actually existed. This had been the recent subject of vigorous and diverse debate.

Grahame reported that 5-6 core FHIR participants had spent two hours Sunday May 8th bashing this approach and were comfortable with the contained resource use but were not able to come to a consensus on the use of Identfier|Reference(). So it was felt that FHIR should not be telling domain committees what to do, but rather domain committees should carefully consider where this and other approaches made sense and to allow ballot comments to inform the discussion. Grahame also suggested that using separate elements for the Identifier and choice of resources was preferred for searching, presumably receiving servers would populate the missing elements and then just perform standard searches. This would also make it easier to profile-out elements. FM will accept this as guidance in the reviews as we approach material preparation for finalization for July 24 2016.

It was noted that a similar problems exists in EOBs where one wants to be able to identify the Claim or ClaimResponse in the EOB but may not actually give them out due to privacy reasons and therefore an resource reference is not useful.

Grahame’s use of the EOB resource and the constrained environment in which he is trying to accomplish this was discussed. If we add Author 0..1 (Identifier|Reference(Organization)) and change the cardinality of the Coverage to 0..1 then Grahame could identify the source of EOB for the benefit of the receiver, so they aren’t receiving anonymous EOBs where they can’t identify who created it.


Q4 Attendees: Paul Knapp (Chair) Knapp Consulting Inc. pknapp@pknapp.com Benoit Schoeffler Almerys Benoit.SCHOEFFLER@almerys.com Guillaume Rossignol Almerys guillaume.rossignol@almerys.com Mary Kay McDaniel Cognosante MaryKay.McDaniel@cognosante.com Beat Heggli (CoChair) Netcetera Beat.Heggli@netcetera.com

Agenda: 1) Review of recent changes to the FHIR FM resources.

Minutes: Changes to the Claim resource to replace item.provider with item.careTeam which contains a list of providers and their roles and qualifications.