2017-04-13 Patient Care FHIR Call

Meeting Information

Patient Care FHIR Resources Conference Call Location: Conference Call Phone Number: +1 770-657-9270 Participant Passcode: 943377 WebEx: https://cernermeeting.webex.com/join/michelle.m.miller		Date: 2017-04-13 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
	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
X	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	Bob Milius	NMDP
X	Kirt Schaper	CIBMTR
	Mike Padula	CHOP
X	Matt Prestegaard
Quorum Requirements Met: yes

Agenda

Agenda Topics

1. Agenda review
2. Approve previous meeting minutes 2017-04-06_Patient_Care_FHIR_Call
   • Motion: Stephen/Russ
3. Transplant Material
4. gForge change request

Supporting Information

• Tracker Issues - https://docs.google.com/a/lmckenzie.com/uc?id=0B285oCHDUr09Mzh3b09rMFhEV1E
• Resolve QA Warnings to have resource FMM > 0
• Resolve QA Information messages to achieve FMM = 3
• Maintain QA checklist

Minutes

Zulip

• Blood, Tissue, Organ Donation
  • NMDP (National Marrow Donor Program) and CIBTMR (Center for International Blood and Marrow Transplant Research) would like to participate in helping develop a new resource for transplant material
  • It would include things like bone marrow, cord blood, peripheral blood stem cells - and any new resource could also address solid organs and blood transfusion although not part of the initial use case
  • Align with scope of ISBT128, the purpose of which is: to provide standards and guidance for the coding and labeling of medical products of human origin (MPHO): blood, cellular therapy, tissues, regenerated tissue, milk, fecal microbiota, topical products of human origin, in vivo diagnostic MPHO, and organs for transplant, as well as those plasma derivatives for which ABO is relevant. (we may want to extend the scope to “biological origin” rather than limiting to “human origin”)
  • Previously, Patient Care had voted to create a new resource, per GF#8458
  • Transplant material resource would have relationship to two things -- who gave it and who received it
  • Also includes examples that might originate from a human, but then manipulated
  • Map process/forms to existing resources; profile for transplantation; categorize patients as donor vs recipient/patient
  • Specimen is only for diagnostic purposes; Device was considered/debated;
    • Per OO ListServ, proposed boundaries included
      • Device: a manufactured item that is used in the provision of healthcare without being substantially changed through that activity. The device may be a medical or non-medical device
      • Substance: A homogeneous material with a definite composition
      • BiologicallyDerivedProduct: material extracted from a living mammalian organism or that is still living
  • PC recommends creating a logical/domain model - Kirt has started this work via ClinFHIR via Model Selector > Graft > Mapping tab
  • Desire to have transfusions (blood transfusion) included in scope -- start more broadly with BiologicallyDerivedProduct
  • Motion to support creation of a new "biologically derived product" resource proposal (which will be approved by PC once written): Eric/Stephen: 10-0-0

TermInfo Feedback

• TermInfo project to be able to reason with data in FHIR and SNOMED - reasoning across both models combined (using OWL) to be able to classify independently of model (pre vs post coordination) - need to understand meaning and possibly update/clarify definitions
• Condition.verificationStatus (condition-ver-status)
  • How do we map provisional (= This is a tentative diagnosis - still a candidate that is under consideration) to SNOMED concept model?
    • Probably present (qualifier value)
    • Suspected (qualifier value)
    • Known possible (qualifier value)
  • Same question for differential (= One of a set of potential (and typically mutually exclusive) diagnoses asserted to further guide the diagnostic process and preliminary treatment)
• TermInfo will propose mappings for Patient Care to review
• Review current definitions
  • Provisional - The diagnosis that is most likely based on the currently available data.
  • Differential - One of a set of potential (and typically mutually exclusive) diagnoses asserted to further guide the diagnostic process and preliminary treatment. Potential diagnoses in the list may not have equal probability.
    • Note: map to "known possible" despite some being more likely than others
  • Confirmed (no change) -- There is sufficient diagnostic and/or clinical evidence to treat this as a confirmed condition.
    • Note: mapping to "known present" -- does this make sense for amputee or no family history of cancer

Adjourn

Adjourned at 6:31PM Eastern

Meeting Outcomes

Actions Michelle will email Bob, Kirt, and Matt the New Resource Proposal Template

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

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