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Difference between revisions of "2017-03-09 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
 
|-
 
|-
−
| || Pushpalatha Bhat
+
|X || Pushpalatha Bhat
 
|colspan="2"|
 
|colspan="2"|
 
|-
 
|-
−
| || Stephen Chu
+
| X || Stephen Chu
 
|colspan="2"| The Australian Digital Health Agency (ADHA)
 
|colspan="2"| The Australian Digital Health Agency (ADHA)
 
|-
 
|-
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|colspan="2"| EMI Advisors LLC
 
|colspan="2"| EMI Advisors LLC
 
|-
 
|-
−
| || Eric Haas
+
|X || Eric Haas
 
|colspan="2"| Haas Consulting
 
|colspan="2"| Haas Consulting
 
|-
 
|-
−
| || Rob Hausam
+
| X|| Rob Hausam
 
|colspan="2"| Hausam Consulting LLC
 
|colspan="2"| Hausam Consulting LLC
 
|-
 
|-
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|colspan="2"| Intermountain Healthcare
 
|colspan="2"| Intermountain Healthcare
 
|-
 
|-
−
| || Emma Jones
+
|X || Emma Jones
 
|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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|colspan="2"| Intermountain Healthcare
 
|colspan="2"| Intermountain Healthcare
 
|-
 
|-
−
| || Joe Quinn
+
|X || Joe Quinn
 
|colspan="2"| Optum
 
|colspan="2"| Optum
 
|-
 
|-
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| || Serafina Versaggi
 
| || Serafina Versaggi
 
|colspan="2"| Dept of Veterans Affairs
 
|colspan="2"| Dept of Veterans Affairs
 +
|-
 +
| x|| Chris Melo
 +
|colspan="2"| Philips Healthcare
 +
|-
 +
| x|| Nick Radov
 +
|colspan="2"| Optum
 
|-
 
|-
 
|colspan="4" style="background:#f0f0f0;"|
 
|colspan="4" style="background:#f0f0f0;"|
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<!-- ***** Delete instructions and fill in agenda items ON NEXT LINES  ****-->
 
<!-- ***** Delete instructions and fill in agenda items ON NEXT LINES  ****-->
 
#Agenda review
 
#Agenda review
−
#Approve previous meeting minutes  
+
#Approve previous meeting minutes [[2017-03-02_Patient_Care_FHIR_Call]]
−
#*'''Motion:''' <moved>/<seconded>
+
#*'''Motion:''' Eric/Rob
−
# STU3 Action Items 
+
# STU3 FMM Levels
−
# gForge change request
+
# STU3 QA Work (checklist, warnings, and suggested changes/clarifications)
 +
# STU3 Substantive Changes (post-freeze)
 +
# gForge Change Request
 +
# Zulip - ClinicalImpression for a cancer therapy decisions
  
 
==Supporting Information==
 
==Supporting Information==
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Target FMM levels for STU3 publication
 
Target FMM levels for STU3 publication
 
* AllergyIntolerance = 3
 
* AllergyIntolerance = 3
−
* Condition = 3
+
* Condition = 4
−
* Procedure = 3
+
* Procedure = 3  
−
* CarePlan = 1
+
* CarePlan = 2
−
* Goal = 1
+
* Goal = 2
−
* CareTeam = 1
+
* CareTeam = 2
−
* FamilyMemberHistory = 1
+
* FamilyMemberHistory = 2
 
* ReferralRequest = 1
 
* ReferralRequest = 1
 
* Flag = 1
 
* Flag = 1
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<!-- **** Delete instructions  and fill in minutes ON NEXT LINES  ******-->
 
<!-- **** Delete instructions  and fill in minutes ON NEXT LINES  ******-->
  
−
=== STU3 Outstanding Actions ===
+
=== STU3 FMM Levels ===
 +
* MOTION:  CareTeam to FMM=1;  Eric/Russ:  9-0-0
 +
* MOTION:  Condition to FMM=4;  Eric/Russ:  9-0-1 
 +
* Note:  Lloyd suggested FamilyMemberHistory move to FMM=2 due to past Clinical Genomics connectathon tracks
 +
 
 +
=== STU3 QA Work ===
 +
* New QA warnings! [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12973 GF#12973] QA Warnings for Condition.onset search parameters
 
* Update [https://docs.google.com/a/lmckenzie.com/spreadsheets/d/18HfXF7mUCUV7jACCG0oejFp6D-ibtvbmcgywNhn76lw QA checklist] for resources that we want to be FMM = 3
 
* Update [https://docs.google.com/a/lmckenzie.com/spreadsheets/d/18HfXF7mUCUV7jACCG0oejFp6D-ibtvbmcgywNhn76lw QA checklist] for resources that we want to be FMM = 3
 
* QA Topics
 
* QA Topics
−
** [http://build.fhir.org/extension-procedure-causedby.html extension-procedure-causedby] -- beef up description
+
** [http://build.fhir.org/extension-procedure-causedby.html extension-procedure-causedby] -- review beefed up description - "This procedure is because of the related item"
−
** [http://build.fhir.org/extension-condition-criticality.html extension-condition-criticality] -- no value set binding
+
** [http://build.fhir.org/extension-condition-criticality.html extension-condition-criticality] -- no value set binding -- log tracker to address after STU3 ([http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13004 GF#13004])
 
** [http://build.fhir.org/flag.html flag] -- questionable QA feedback
 
** [http://build.fhir.org/flag.html flag] -- questionable QA feedback
−
*** As “flag” has numerous usages in FHIR, this particular use should somehow be distinguished. Might it be a “clinical flag?”   
+
*** As “flag” has numerous usages in FHIR, this particular use should somehow be distinguished. Might it be a “clinical flag?”  Reject QA feedback, some flags are non-clinical (e.g. financial)
−
*** A flag is typically presented as a label in a prominent location in "the a paper chart or visual rendering of an electronic" record to notify the clinician of the potential issues
+
*** A flag is typically presented as a label in a prominent location in "the a paper chart or visual rendering of an electronic" record to notify the clinician of the potential issues -- Reject QA feedback (too verbose)
−
*** given the volume of information frequently found in patients' records and the potentially serious consequences of losing sight of some facts, this redundancy is deemed appropriate -- Deemed by whom? HL7? We don’t make this kind of policy. Suggest “deemed important by the users of an information system.”
+
*** given the volume of information frequently found in patients' records and the potentially serious consequences of losing sight of some facts, this redundancy is deemed appropriate -- Deemed by whom? HL7? We don’t make this kind of policy. Suggest “deemed important by the users of an information system.” - Reject QA feedback (too verbose)
−
*** Patient has large dog at home -- This doesn’t seem like a credible example of the semantics for a flag, even under the “other” category.
+
*** Patient has large dog at home -- This doesn’t seem like a credible example of the semantics for a flag, even under the “other” category. -- Reject QA feedback since this is a legit flag example
−
*** The Flag resource is sometimes known as "patient notes" -- This is definitely beyond the scope of QA but there seems to be a serious conflict here between the notion of flags as a highly concise representation of information preselected for its urgency or relevance to workflow and a more general topic of patient notes, which could be wide ranging, couldn’t they?
+
*** The Flag resource is sometimes known as "patient notes" -- This is definitely beyond the scope of QA but there seems to be a serious conflict here between the notion of flags as a highly concise representation of information preselected for its urgency or relevance to workflow and a more general topic of patient notes, which could be wide ranging, couldn’t they?  
 +
**** Change The Flag resource is sometimes known as "patient notes" to be The Flag resource is sometimes used as "patient notes"
 
** [http://build.fhir.org/goal.html goal] - HgbA1c level =<5.6% -- Is this a clinically credible example?  Yes
 
** [http://build.fhir.org/goal.html goal] - HgbA1c level =<5.6% -- Is this a clinically credible example?  Yes
 +
 +
=== STU3 Substantive Changes (post-freeze) ===
 +
FMG Patch Approval
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12942 GF#12942] Change AllergyIntolerance.category data type to code -- patch sent to Grahame and Lloyd to apply
 +
 +
FMG Rejected / Deferred to R4
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12943 GF#12943] Condition.stage cardinality
 +
 +
No Approval Needed
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12973 GF#12973] QA Warnings for Condition.onset search parameters
  
 
=== gForge Change Requests ===
 
=== gForge Change Requests ===
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12988 GF#12988] Wrong mapping for Condition.clinicalStatus to HL7 V2 DG1-6 -- resolved
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12973 GF#12973] QA Warnings for Condition.onset search parameters -- resolved
 +
 +
=== Zulip ===
 +
* [https://chat.fhir.org/#narrow/stream/implementers/topic/Using.20ClinicalImpression.20for.20a.20cancer.20therapy.20decisions Using ClinicalImpression for cancer therapy decisions]
  
 
=== Adjourn ===
 
=== Adjourn ===
−
Adjourned at <hh:mm am/pm> <timezone>.
+
Adjourned at 6:32pm 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''' ''
 
   
 
   
−
*
+
* Nick will log tracker to add a Condition note about using the new Encounter.diagnosis structure to capture admission/primary diagnosis in context of an encounter
 +
* Russ will create a few procedure examples to cover other dimensions of scope (e.g. education, counseling, exercise)
  
 
|-
 
|-

Latest revision as of 00:01, 10 March 2017



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=macd64a688fdc3410ab4178adab5820fb

Date: 2017-03-09
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 Pushpalatha Bhat
X Stephen Chu The Australian Digital Health Agency (ADHA)
Evelyn Gallego EMI Advisors LLC
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
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
X Joe Quinn Optum
Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
Serafina Versaggi Dept of Veterans Affairs
x Chris Melo Philips Healthcare
x Nick Radov Optum
Quorum Requirements Met: yes

Agenda

Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2017-03-02_Patient_Care_FHIR_Call
    • Motion: Eric/Rob
  3. STU3 FMM Levels
  4. STU3 QA Work (checklist, warnings, and suggested changes/clarifications)
  5. STU3 Substantive Changes (post-freeze)
  6. gForge Change Request
  7. Zulip - ClinicalImpression for a cancer therapy decisions

Supporting Information

STU 3 Timeline

From FHIR_Ballot_Prep

  • 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

Maturity Levels 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

Target FMM levels for STU3 publication

  • AllergyIntolerance = 3
  • Condition = 4
  • Procedure = 3
  • CarePlan = 2
  • Goal = 2
  • CareTeam = 2
  • FamilyMemberHistory = 2
  • ReferralRequest = 1
  • Flag = 1
  • Communication = 1
  • CommunicationRequest =1
  • ClinicalImpression = 0
  • Linkage = 0

STU3 Action Items

Minutes

STU3 FMM Levels

  • MOTION: CareTeam to FMM=1; Eric/Russ: 9-0-0
  • MOTION: Condition to FMM=4; Eric/Russ: 9-0-1
  • Note: Lloyd suggested FamilyMemberHistory move to FMM=2 due to past Clinical Genomics connectathon tracks

STU3 QA Work

  • New QA warnings! GF#12973 QA Warnings for Condition.onset search parameters
  • Update QA checklist for resources that we want to be FMM = 3
  • QA Topics
    • extension-procedure-causedby -- review beefed up description - "This procedure is because of the related item"
    • extension-condition-criticality -- no value set binding -- log tracker to address after STU3 (GF#13004)
    • flag -- questionable QA feedback
      • As “flag” has numerous usages in FHIR, this particular use should somehow be distinguished. Might it be a “clinical flag?” Reject QA feedback, some flags are non-clinical (e.g. financial)
      • A flag is typically presented as a label in a prominent location in "the a paper chart or visual rendering of an electronic" record to notify the clinician of the potential issues -- Reject QA feedback (too verbose)
      • given the volume of information frequently found in patients' records and the potentially serious consequences of losing sight of some facts, this redundancy is deemed appropriate -- Deemed by whom? HL7? We don’t make this kind of policy. Suggest “deemed important by the users of an information system.” - Reject QA feedback (too verbose)
      • Patient has large dog at home -- This doesn’t seem like a credible example of the semantics for a flag, even under the “other” category. -- Reject QA feedback since this is a legit flag example
      • The Flag resource is sometimes known as "patient notes" -- This is definitely beyond the scope of QA but there seems to be a serious conflict here between the notion of flags as a highly concise representation of information preselected for its urgency or relevance to workflow and a more general topic of patient notes, which could be wide ranging, couldn’t they?
        • Change The Flag resource is sometimes known as "patient notes" to be The Flag resource is sometimes used as "patient notes"
    • goal - HgbA1c level =<5.6% -- Is this a clinically credible example? Yes

STU3 Substantive Changes (post-freeze)

FMG Patch Approval

  • GF#12942 Change AllergyIntolerance.category data type to code -- patch sent to Grahame and Lloyd to apply

FMG Rejected / Deferred to R4

No Approval Needed

  • GF#12973 QA Warnings for Condition.onset search parameters

gForge Change Requests

  • GF#12988 Wrong mapping for Condition.clinicalStatus to HL7 V2 DG1-6 -- resolved
  • GF#12973 QA Warnings for Condition.onset search parameters -- resolved

Zulip

Adjourn

Adjourned at 6:32pm Eastern.

Meeting Outcomes

Actions
  • Nick will log tracker to add a Condition note about using the new Encounter.diagnosis structure to capture admission/primary diagnosis in context of an encounter
  • Russ will create a few procedure examples to cover other dimensions of scope (e.g. education, counseling, exercise)
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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