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Difference between revisions of "2016-11-17 Patient Care FHIR Call"

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|-
 
|-
 
<!-- ********add attendee information here *********-->
 
<!-- ********add attendee information here *********-->
−
| || Elaine Ayres
+
|X || Elaine Ayres
 
|colspan="2"| NIH/Department of Clinical Research Informatics
 
|colspan="2"| NIH/Department of Clinical Research Informatics
 
|-
 
|-
−
| || Stephen Chu
+
| X || Stephen Chu
 
|colspan="2"|  
 
|colspan="2"|  
 
|-
 
|-
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|colspan="2"| Epic
 
|colspan="2"| Epic
 
|-
 
|-
−
| || Eric Haas
+
| X|| Eric Haas
 
|colspan="2"| Haas Consulting
 
|colspan="2"| Haas Consulting
 
|-
 
|-
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|colspan="2"| Allscripts
 
|colspan="2"| Allscripts
 
|-
 
|-
−
| || Russ Leftwich
+
|X || Russ Leftwich
 
|colspan="2"| InterSystems
 
|colspan="2"| InterSystems
 
|-
 
|-
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|colspan="2"| Cerner
 
|colspan="2"| Cerner
 
|-
 
|-
−
|  || Michelle M Miller  
+
|X || Michelle M Miller  
 
|colspan="2"| Cerner
 
|colspan="2"| Cerner
 
|-
 
|-
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| || Iona Thraen
 
| || Iona Thraen
 
|colspan="2"| Dept of Veterans Affairs
 
|colspan="2"| Dept of Veterans Affairs
 +
|-
 +
|X || Clem McDonald
 +
|colspan="2"| National Library of Medicine
 +
|-
 +
|X || Joe Quinn
 +
|colspan="2"| Optum
 +
|-
 +
|X || Ian Bull
 +
|colspan="2"| Optum
 
|-
 
|-
 
|colspan="4" style="background:#f0f0f0;"|
 
|colspan="4" style="background:#f0f0f0;"|
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#Agenda review
 
#Agenda review
 
#Approve previous meeting minutes [[2016-11-10_Patient_Care_FHIR_Call]]
 
#Approve previous meeting minutes [[2016-11-10_Patient_Care_FHIR_Call]]
−
#*'''Motion:''' <moved>/<seconded>
+
#*'''Motion:''' Stephen/Joe
 
# gForge change request
 
# gForge change request
 
#* Updated timelines and backlog review
 
#* Updated timelines and backlog review
−
#* Discuss/vote on pre-applied changes
+
#* Discuss/vote on pre-applied changes (including a few proposed revised resolutions)
 +
#* Discuss Clem's in person tracker items
 
#* Decide whether to spend remaining time on allergy or care plan (both will be used by IGs balloting in the January ballot, so today is the *last* day to resolve changes for the Jan ballot)
 
#* Decide whether to spend remaining time on allergy or care plan (both will be used by IGs balloting in the January ballot, so today is the *last* day to resolve changes for the Jan ballot)
  
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====In Person (Pending Schedule) ====
 
====In Person (Pending Schedule) ====
 
In Person Requests -- in the process of being scheduled
 
In Person Requests -- in the process of being scheduled
−
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11281 Overall Condition.clinicalStatus and Condition.verificationStatus Condition body site - 2016-09 core #435 - Clem McDonald - TBD
 
−
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11290 clinical impression and condition - 2016-09 core #444 - Clem McDonald - TBD
 
 
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12090 Rename goal attribute  
 
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12090 Rename goal attribute  
  
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** Our resolution conflicts with the FHIR GA guidelines 4e that say when constraining to the "code" data type, “ensure all codes are mutually exclusive or are defined in a proper hierarchy where siblings are mutually exclusive” – since the value set binding is required and cardinality is 0..*, the value set is neither mutually exclusive, nor defined in a proper hierarchy
 
** Our resolution conflicts with the FHIR GA guidelines 4e that say when constraining to the "code" data type, “ensure all codes are mutually exclusive or are defined in a proper hierarchy where siblings are mutually exclusive” – since the value set binding is required and cardinality is 0..*, the value set is neither mutually exclusive, nor defined in a proper hierarchy
  
−
==== Discuss Today ====
+
==== Discussed ====
 
Condition
 
Condition
−
* PREAPPLIED:  http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10554 - invariant updated with clarification added for abatementString
+
* PREAPPLIED (proposed revised resolution):  http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10554 - invariant updated with clarification added for abatementString - resolved
  
 
Questionnaire/QuestionnaireResponse
 
Questionnaire/QuestionnaireResponse
−
* PREAPPLIED:  http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10429 - revert back QuestionnaireResponse.questionnaire to be a reference (not uri) per https://chat.fhir.org/#narrow/stream/implementers/topic/QuestionnaireResponse
+
* PREAPPLIED (proposed revised resolution):  http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10429 - revert back QuestionnaireResponse.questionnaire to be a reference (not uri) per https://chat.fhir.org/#narrow/stream/implementers/topic/QuestionnaireResponse - resolved
−
* PREAPPLIED:  http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11003 - update resolution per Zulip chat with Brian Postlethwaite to include Questionnaire.item.initial clarification in comments:  "The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created"
+
** Per Grahame, you can put a canonical URL on a contained resource, but now you have to make it unique. And also, you can't make it contained anymore, because there's no reference to it
 +
** Per Lloyd, There's no need for URI. (URI is needed on value set because you want to be able to point to web pages for things like language codes and mime types, but it makes no sense to support that for Questionnaire.)
 +
* PREAPPLIED (proposed revised resolution):  http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11003 - update resolution per Zulip chat with Brian Postlethwaite to include Questionnaire.item.initial clarification in comments:  "The user is allowed to change the value and override the default (unless marked as read-only). If the user doesn't change the value, then this initial value will be persisted when the QuestionnaireResponse is initially created" - resolved
 +
** Per Brian, rendered to me implies view only, not storage
 +
 
 +
CarePlan
 +
* PREAPPLIED:  http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12341 Make careplan.subject 1..1 - resolved
  
−
CarePlan / Goal
+
Clem McDonald In Person
−
* PREAPPLIED:  http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12341 Make careplan.subject 1..1
+
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11281 Overall Condition.clinicalStatus and Condition.verificationStatus Condition body site - Clem McDonald - resolved
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11290 clinical impression and condition - Clem McDonald withdrew
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11288 reporting impressions as observations - Clem McDonald - PC added comments that OO/Eric will address via Observation boundaries
  
−
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12090 Rename goal-target extension to either goal-outcome or goal-targetAttainment and
+
AllergyIntolerance
−
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11116 Better define the careplan.activity.outcome field
+
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11021 Increase cardinality of substance and make certainty relation to substance not reaction - 2016-09 core #40 (Jay Lyle) -- Discussed - no resolution yet
−
** goal-target extension to be renamed goal-targetAttainment (e.g. body weight of 150 lb)
 
−
** Goal.outcome to be renamed Goal.attainment
 
−
*** Short Description = "What was end result of goal?"
 
−
*** Definition = "Identifies the change (or lack of change) at the point where the goal was deemed to be cancelled or achieved."
 
−
*** Comments = "Note that this should not duplicate the goal status"
 
−
** CarePlan.activity.outcome should be harmonized with Goal.attainment, such that it is a backbone element with a result 0..* child element with a choice of data types CodeableConcept or Reference (Observation)
 
−
*** Short Description = "Results of the activity"
 
−
*** Definition = "Results of the careplan activity."
 
−
*** Comments = "The activity outcome is independent of the goal.  For example, activities of exercise and diet may support goals to lose weight and maintain HbA1c. The outcomes of the diet and exercise activities are independent of the goals, such that the CarePlan.activity.outcome could convey calories consumed each day and calories burned each day. By contrast, the Goal.attainment.target should be used to convey the resulting body weight.  Activity outcomes (e.g. caloric intake) do not guarantee successful attainment of each related goal (e.g. lose weight, maintain HbA1c, lower blood pressure)."
 
  
 
==== Backlog - Ready to Discuss in Subsequent Calls ====
 
==== Backlog - Ready to Discuss in Subsequent Calls ====
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=== Adjourn ===
 
=== Adjourn ===
−
Adjourned at <hh:mm am/pm> <timezone>.
+
Adjourned at 6:45pm Eastern.
  
 
==Meeting Outcomes==
 
==Meeting Outcomes==

Latest revision as of 23:54, 17 November 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=mfc8969c4f77244480beee61d31385e79

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


X Elaine Ayres NIH/Department of Clinical Research Informatics
X Stephen Chu
Danielle Friend Epic
X Eric Haas Haas Consulting
Rob Hausam Hausam Consulting LLC
Laura Heermann-Langford Intermountain Healthcare
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
Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
X Clem McDonald National Library of Medicine
X Joe Quinn Optum
X Ian Bull Optum
Quorum Requirements Met: yes

Agenda

Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2016-11-10_Patient_Care_FHIR_Call
    • Motion: Stephen/Joe
  3. gForge change request
    • Updated timelines and backlog review
    • Discuss/vote on pre-applied changes (including a few proposed revised resolutions)
    • Discuss Clem's in person tracker items
    • Decide whether to spend remaining time on allergy or care plan (both will be used by IGs balloting in the January ballot, so today is the *last* day to resolve changes for the Jan ballot)

Supporting Information

STU 3 Timeline

From FHIR_Ballot_Prep

  • Sun. Nov. 27 Ballot substantive resource freeze (prioritize resources that IGs will be based on)
  • Sun. Dec. 4 Ballot total freeze
  • Sun. Dec. 9 (or a day or two earlier) Freeze released - all changes allowed
  • Sun. Feb. 5 Ballot reconciliation deadline - All ballot comments must be reconciled, tracker issue report must be clean
  • Sun. Feb. 19 Publication substantive resource freeze
  • Sun. Feb 26 Publication total freeze
  • Mon. Feb 27 QA period opens
  • Tue. Feb 28 FMM QA spreadsheet updated for all WG resources
  • Sun. Mar. 13 QA period closes
  • Sun. Mar. 20 All QA applied

The "following week" STU 3 is published!

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

Resource
Current FMM Level Goal FMM Level QA Status QA Reviewer Implementation Comments
AllergyIntolerance 1 3 Michelle Argonaut
Condition 2 3 Michelle Argonaut
Procedure 1 3 Michelle Argonaut
CarePlan 1 3 Michelle Argonaut
Goal 1 3 Michelle
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 Michelle 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

gForge Change Requests

FHIR Publication / Backlog Status

  • 44 unresolved tracker items (39 ballot + 5 high maturity resource non-ballot comments)
    • 18 requested input from vocab (value set related ballot comments)
    • 7 waiting for input
    • 5 waiting to be scheduled (joint with OO or in person requests)
    • 14 ready for discussion during our weekly conference call
  • 24 Resolved - Change Request tracker items
    • 20 ballot or high maturity resource (+ 4 non-ballot, non-priority resource)
    • 9 are substantive (+ 15 are non-substantive)
      • 5 related to new extensions/profiles
      • 2 workflow patterns
      • 1 is pre-applied pending revised resolution
      • 1 populate structure

In Person (Pending Schedule)

In Person Requests -- in the process of being scheduled

Joint with OO -- in the process of being scheduled

Feedback on prior resolutions - may need to revisit when Rob McClure can attend.

Discussed

Condition

Questionnaire/QuestionnaireResponse

CarePlan

Clem McDonald In Person

AllergyIntolerance

Backlog - Ready to Discuss in Subsequent Calls

Resources with higher maturity - target FMM Level 3

AllergyIntolerance

CarePlan / Goal

Condition

Procedure

Questionnaire / QuestionnaireResponse

Care Team

ProcedureRequest

FamilyMemberHistory List

Adjourn

Adjourned at 6:45pm 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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