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Difference between revisions of "2016-08-25 Patient Care FHIR Call"

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|colspan="2"|  
 
|colspan="2"|  
 
|-
 
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| || Eric Haas
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|X || Eric Haas
 
|colspan="2"| Haas Consulting
 
|colspan="2"| Haas Consulting
 
|-
 
|-
| || Rob Hausam
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| X|| Rob Hausam
 
|colspan="2"| Hausam Consulting LLC
 
|colspan="2"| Hausam Consulting LLC
 
|-
 
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|colspan="2"| Allscripts
 
|colspan="2"| Allscripts
 
|-
 
|-
| || Russ Leftwich
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|X || Russ Leftwich
 
|colspan="2"| InterSystems
 
|colspan="2"| InterSystems
 
|-
 
|-
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|colspan="2"| Kaiser Permanente
 
|colspan="2"| Kaiser Permanente
 
|-
 
|-
| || Simon Sum
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| X|| Simon Sum
 
|colspan="2"| Academy of Nutrition and Dietetics
 
|colspan="2"| Academy of Nutrition and Dietetics
 
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#Agenda review
 
#Agenda review
 
#Approve previous meeting minutes [[2016-08-18_Patient_Care_FHIR_Call]]
 
#Approve previous meeting minutes [[2016-08-18_Patient_Care_FHIR_Call]]
#*'''Motion:''' <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#>
+
#*'''Motion:''' Rob/Russ
 
#Prior Action Item Follow-up   
 
#Prior Action Item Follow-up   
 +
# Patient Instructions - Clinicians on FHIR
 
# gForge change request
 
# gForge change request
  
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Per Russ Leftwich:  "I doubt if the AAAAI has agreed upon definitions for biologics or a distinction between non-tissue biologics and tissues.  But I will ask.  My first inclination is to keep the value set with biologics knowing that not all are "drugs".  The fact is that most biologics, even if "tissues" would still fall under the category of "allergy and intolerance" in terms of adverse reactions.  The only exception I can think of would be graft vs host disease."
 
Per Russ Leftwich:  "I doubt if the AAAAI has agreed upon definitions for biologics or a distinction between non-tissue biologics and tissues.  But I will ask.  My first inclination is to keep the value set with biologics knowing that not all are "drugs".  The fact is that most biologics, even if "tissues" would still fall under the category of "allergy and intolerance" in terms of adverse reactions.  The only exception I can think of would be graft vs host disease."
  
Both Rob Hausam and Russ are at the Clinical LOINC meeting today and this topic was discussed, so we will postpone further discussion until they can share those updates.
+
Per Rob H., tissue is the exception.  This is in context of an allergy or intolerance.  We don't typically talk about allergies to tissues.  Biologics that are administered are typically drugs that could cause allergies.  SNOMED is aligned with the value set in that biologics is a child of substance.  This means that a "below" search on medications would return all biologics.
 +
 
 +
Rob suggests cleaning up biologics definition, such that we are talking about drug biologics - not general biologics.
 +
 
 +
http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10498 was resolved to update the biologic definition
 +
 
 +
=== Patient Instructions - Clinicians on FHIR ===
 +
Argonaut is using CarePlan (narrative only) for the Assessment and Plan of Treatment, per http://argonautwiki.hl7.org/index.php?title=Assessment_and_Plan_of_Treatment
 +
 
 +
Eric Haas is the Argonaut project team lead, for future reference or questions.
 +
 
 +
ListServ discussion:  http://lists.hl7.org/read/messages?id=291376 - also implied CarePlan could be used for discharge instructions
  
 
=== gForge Change Requests ===
 
=== gForge Change Requests ===
 
CarePlan
 
CarePlan
* gForge 10476: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10476 - Add search parameter for CarePlan.identifier
+
* gForge 10476: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10476 - Add search parameter for CarePlan.identifier (persuasive)
* gForge 10477: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10477 - per Grahame's comment on gForge 7897,  the pattern should be that resources with a 'patient' element just have a 'patient' search parameter, and resources with a subject that could be a patient have both subject and patient search parameters  
+
* gForge 10477: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10477 - CarePlan search parameter 'patient' seems obsolete (not persuasive per Grahame's comment on gForge 7897,  the pattern should be that resources with a 'patient' element just have a 'patient' search parameter, and resources with a subject that could be a patient have both subject and patient search parameters)
* gForge 10495: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10495 - remove reference to SupplyRequest from CarePlan and ClinicalImpression
+
* gForge 10495: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10495 - remove reference to SupplyRequest from CarePlan and ClinicalImpression (persuasive)
  
 +
Goal
 +
* gForge 10461: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10461 - Minor cleanups to goal-relationship extension (action item to follow up with FHIR-I)
  
Goal
+
Procedure
* gForge 10461: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10461 - Minor cleanups to goal-relationship extension
+
* gForge 9335: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=9335 - Orders to not do things (action item to follow up with implementer community)
  
 
=== Adjourn ===
 
=== Adjourn ===
Adjourned at <hh:mm am/pm> <timezone>.
+
Adjourned at 6:27 PM Eastern
  
 
==Meeting Outcomes==
 
==Meeting Outcomes==
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| width="100%" align="left" style="background:#f0f0f0;"|'''Actions''' ''
 
| width="100%" align="left" style="background:#f0f0f0;"|'''Actions''' ''
 
   
 
   
*
+
* Michelle Miller to follow up with FHIR-I regarding data types for required bindings in an extension http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10461
 +
* Michelle Miller to follow up with implementers regarding orders to not do something http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=9335
 +
* Input from Viet, Russell, and Rob on Michelle's drafted [[ClinicalNote_FHIR_Resource_Proposal]]
 +
* Daniel Lanphear (submitter of [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=8458| gForge 8458]) to draft new resource proposal for transfusion.
 +
* Rob to help fill in value sets for CareTeam status and type
  
 
|-
 
|-

Latest revision as of 22:32, 25 August 2016



Meeting Information

Patient Care FHIR Resources Conference Call

Location: Conference Call
Phone Number: +1 770-657-9270
Participant Passcode: 943377
WebEx: https://cerner.webex.com/cerner/j.php?MTID=mb400e38da885ce6d7a79e53077c729c5

Date: 2016-08-25
Time: 5-6:30pm ET
Facilitator Michelle M Miller Note taker(s) Michelle M Miller
Attendee Name Affiliation


Elaine Ayres NIH/Department of Clinical Research Informatics
Stephen Chu
X Eric Haas Haas Consulting
X Rob Hausam Hausam Consulting LLC
Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
X Russ Leftwich InterSystems
Tony Little Optum 360
Jay Lyle Ockham Information Services LLC, VA
Sarah Maulden VA
Hank Mayers ReliaTech Consulting
Jim McClay Univ of Nebraska Medical Center
Russell McDonell Telstra Health
Lloyd McKenzie Gevity (HL7 Canada)
Larry McKnight Cerner
X Michelle M Miller Cerner
Lisa Nelson Life Over Time Solutions
Viet Nguyen Lockheed Martin, Systems Made Simple
M'Lynda Owens Cognosante
Craig Parker Intermountain Healthcare
Scott Robertson Kaiser Permanente
X Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
Quorum Requirements Met: yes

Agenda

Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2016-08-18_Patient_Care_FHIR_Call
    • Motion: Rob/Russ
  3. Prior Action Item Follow-up
  4. Patient Instructions - Clinicians on FHIR
  5. gForge change request

Supporting Information

STU 3 Timeline

  • Wed, June 1
    • All resource and IG proposals for STU3 have been completed, reviewed by WG and submitted
    • Connectathon tracks for Sept have been proposed
    • Feedback on gForge submitted to FMG
  • Sun, July 17 - Substantive content freeze for ballot -- core resources
  • Sun, July 24 - Total content freeze, start of QA
  • Wed, Aug 10 (midnight) - All QA changes applied
  • Fri, Aug 12 - FHIR ballot opens
  • Mon, Sept 12 - FHIR ballot closes
  • Fri, Sept 16 - FHIR triage complete and ballot content loaded to gForge (or alternate)
  • Sept 17-23 - Baltimore WGM
  • Sun, Dec 11
    • Reconciliation complete/substantive changes applied
    • Just over 10 weeks
    • Will re-evaluate at Baltimore based on volume of ballot comments
  • Dec 31 - Publish

FHIR Maturity Levels

[1]

  • Level 3 requires the artifact has been verified by the work group as meeting the DSTU_2_QA_guidelines and has been subject to a round of formal balloting; has at least 10 implementer comments recorded in the tracker drawn from at least 3 organizations resulting in at least one substantive change
    • Substantive changes (element names, sort order, vocabulary bindings, etc.) need to be applied by ballot freeze (Aug 10).
    • Unapplied QA checklist changes can be logged as ballot issues to be applied Sept-Dec. Substantive changes after ballot should be driven by ballot.
    • Non-substantive changes are fine
  • Level 2 requires artifact has been tested and successfully exchanged between at least three independently developed systems leveraging at least 80% of the core data elements using semi-realistic data and scenarios based on at least one of the declared scopes of the resource (e.g. at a connectathon). These interoperability results must have been reported to and accepted by the FMG.
Resource
Current FMM Level Goal FMM Level QA Status QA Reviewer Implementation Comments
AllergyIntolerance 1 3 Rob Argonaut
Condition 2 3 PCWG Argonaut
Procedure 1 3 Argonaut
CarePlan 1 3 Argonaut
Goal 1 3
QuestionnaireResponse 2 2 Lloyd Lloyd will QA to get to level 3
Questionnaire 0 2 Lloyd Lloyd will QA to get to level 3
CareTeam 0 2 NA NA Aggressive goal (e.g. whether we'll get the implementations needed)
FamilyMemberHistory 1 2 NA NA Aggressive goal (e.g. whether we'll get the implementations needed)
ClinicalImpression 0 1 NA NA
ReferralRequest 1 1 NA NA
ProcedureRequest 1 1 NA NA
Linkage 0 1 NA NA
Flag 1 1 NA NA
Communication 1 1 NA NA
CommunicationRequest 1 1 NA NA

Note: Bold denotes top 20 resource based on survey
Note: Contraindication and Risk Assessment are owned by CDS, not Patient Care

Minutes

Prior Action Item Follow-up

Per Russ Leftwich: "I doubt if the AAAAI has agreed upon definitions for biologics or a distinction between non-tissue biologics and tissues. But I will ask. My first inclination is to keep the value set with biologics knowing that not all are "drugs". The fact is that most biologics, even if "tissues" would still fall under the category of "allergy and intolerance" in terms of adverse reactions. The only exception I can think of would be graft vs host disease."

Per Rob H., tissue is the exception. This is in context of an allergy or intolerance. We don't typically talk about allergies to tissues. Biologics that are administered are typically drugs that could cause allergies. SNOMED is aligned with the value set in that biologics is a child of substance. This means that a "below" search on medications would return all biologics.

Rob suggests cleaning up biologics definition, such that we are talking about drug biologics - not general biologics.

http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10498 was resolved to update the biologic definition

Patient Instructions - Clinicians on FHIR

Argonaut is using CarePlan (narrative only) for the Assessment and Plan of Treatment, per http://argonautwiki.hl7.org/index.php?title=Assessment_and_Plan_of_Treatment

Eric Haas is the Argonaut project team lead, for future reference or questions.

ListServ discussion: http://lists.hl7.org/read/messages?id=291376 - also implied CarePlan could be used for discharge instructions

gForge Change Requests

CarePlan

Goal

Procedure

Adjourn

Adjourned at 6:27 PM Eastern

Meeting Outcomes

Actions
Next Meeting/Preliminary Agenda Items
  1. Agenda review
  2. Approve previous meeting minutes
    • Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#>
  3. gForge change request

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