2017-02-06 Rx Conf Call

Related Links Pharmacy Home Page Conference call minutes

Attendees

• Melva Peters (Chair)
• Sara Cohen
• Scott Robertson
• John Hatem
• Marla Albitz
• Eric Haas
• Michelle Miller
• Mary V
• Daniel Zhang

Agenda Items and notes

ListServ Discussions

• List Serve Postings

Zulip

• Long Term vs Short Term Conditions
  • [Link to Zulip Chat]
  • Melva and Lloyd have responded - suggested adding a TR item.
• Medications not to be discontinued
  • Medications not to be discontinued
  • Melva and Lloyd have responded
• MedicationStatement
  • related to "do not do" - as in patient not to be given a certain medication
  • may come out of Negation project from Patient Care
  • a number of items included in this Zulip chat
    • patient not to be given medication
      • not likely a medicationStatement - is this a negative order?
      • has not come up for Cerner - may infer something like this from an allergy
    • doctor recommends that GP prescribes drug ABC

Action:  Melva to reach out to Philip to post tracker item

US Meds Ballot Reconciliation

• Consolidated Ballot Spreadsheet File:Ballotcomments FHIR MEDICATION R1 D1 2017JAN.xls
• Updated Ballot Spreadsheet File:Ballotcomments FHIR MEDICATION R1 D1 2017JAN (updated 2017-01-30).xls
• Block Vote 1 - see spreadsheet
  • Reviewed comments from Michelle
    • Row 9 -- should be persuasive since agreeing to add content/clarification - agree - will change to Persuasive with Mod
    • Row 11 -- should be persuasive since agreeing to add content/clarification - agree - will change to Persuasive with Mod
    • Row 38 -- should be persuasive since agreeing to add content/clarification - agree - will change to Persuasive with Mod
    • Row 29 -- triage note said "At this point implementers are not supporting MedicationRequest" – just wanted to clarify the note (not necessarily change the disposition)
      • clean up the triage note to reflect that we don't have enough information about workflow patterns that will be used in order to provide guidance
      • remove the question and add a comment that "don't have enough information and will be considered for future release
      • change to persuasive with mod
      • this should not be under medicationStatement
  • Moved by John - Michelle - change disposition of line item 9, 11, 38 and 29 to persuasive with Mod and Line 29 will update triage note
    • 7/0/1 Carried
  • Motion to accept disposition of all Block Vote Items except line 46 - John - Daniel - 7/0/1 - Carried
• Items for Discussion - 6 comments - see spreadsheet
  • • Row 46 - would like to discuss (whether intended/future orders should be included)
      • Change to "discuss"
      • discussed at Connectathon - "prescribed or consumed" for all - so it would not include "entered in error" or "intended"
      • may need to re-define the med list - for medicationRequests - that are orders or proposals (not instance-orders) from "intent"
• February 6 Update - see updated ballot reconciliation spreadsheet

File:Ballotcomments FHIR MEDICATION R1 D1 2017JAN (updated 2017-01-30).xls

FHIR Tracker Items

12751 QA Updates to Pharmacy resources

• • Medication Statement - mostly clean up
  • includes adding W5 category - which changes the order of the attributes - agreed to have this change made
    • Motion to add W5 category to all pharmacy resources - Scott/Melva - 8/0/0
  • change datatype for "taken" - to CodeableConcept rather than code - discussion to leave this as "code" - no change

12764 = Remove product backbone element on Medication

• may help to resolve the issues with a different name for product and the confusion between product and package
• Moved by Scott/Mary: 8-0-0 Carried

12399 - Medication reference to more abstract medication

• Resolved in San Antonio, but submitted doesn't agree with decision

TR#12347 - Adjust Medication.package.container value set to SNOMED CT Physical object hierarchy

TR#12347

• December 15 - IDMP - could look at using
  • Scott thinks NCPDP may have looked at using SNOMED-CT
  • could use a US centric value set if can't find anything else
  • EDQM example - container list - Jose has found and will provide to the list if there is no copyright issue

Action:  Melva to review EDQM 

FHIR Workflow Meetings Status

• no meetings held - nothing to report

FHIR Maturity

• Current Maturity status
  • spreadsheet has been submitted - MedicationOrder, MedicationStatement and Medication - MM2
  • review of MedicationStatement Maturity
  • no further need for the resources to get them to MM2
• Update on MedicationDispense implementations

Order Service Catalogue PSS

• Update on project meetings
  • John has been attending the meetings - he will post more detailed updates to the pharmacy list serve

Next meeting

• Monday, February 9, 2017 at 4pm Eastern