2017-05-01 Rx Conf Call

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Attendees

• John Hatem (Chair)
• Scott Robertson (Scribe)
• Marla
• Yunwei Wang
• Brett Marquard
• Kent Bui
• Steve (USP)
• Michelle Miller

Agenda Items and notes

Madrid Agenda

• Madrid Agenda
• Melva and John attending. Marla and Scott will not
• Note meeting times shifted 1 hour. for example Q1 10am to 11:30am
• Two project described - Order Service Catalogue and International Chemotherapy

Compounded meds

• Steve Emrik from USP
  • USP has monographs for compounded products/process - how to make the product
  • example Atenolol Example
  • add to future agenda for need to identify medications as compounded in FHIR Medication, necessary metadata, and possibly the directions for compounding
• April 17 Update: there is not great support in Health IT space for sending/receiving information about compounded information
  • regulations coming out in the US - California to use USP monographs when compounding
  • What types of metadata would be useful?
  • perhaps a URI to the instructions for compounding
  • receiver: anyone who needed to compound
  • sender: not sure who would send
    • will be working on a code that could be included in RxNorm - URL would be a property of the USP code or RxNorm code
    • Open Medicine - has done some work on this
    • there are pieces of metadata that could be included

Action: Add a tracker item as a placeholder for changes to medication - complete #13295

• May 1 Update.
  • California - not specifically requiring USP monographs. Sets 3 scientific prinicples that the monograph must achieve
  • what we need
    • to be able to point to the external monograph/recipe
      • this must be stated on the dispense (if applicable), may be present on the request
    • to be able to identify that the product is/will be/was compounded
      • this must be stated on the dispensed (if applicable), optional on the request

Tracker Items

FHIR Tracker

• Dosage.text vs Dosage.additionalInstruction - Tracker #13222
  • Link to tracker
  • concerns have been raised from Chemotherapy Guide project

Action:  Melva to followup with Lee
Action:  Melva to draft changes for review

• TranscribedBy
  • see Tracker #12770
  • no change - recorder attribute exists in STU3

• Special Authorization - 12175
  • many countries will need something similar but might not be standard enough
  • not likely that this is core - suggest creating an extension
  • see tracker 12175

• Tracker 13044 and 13043 - add performer role
  • discussion of change requested by Grahame

Action:  Melva to review change requested and actions needed

FHIR Maturity

• Medication, MedicationRequest and MedicationStatement = FMM 3
• MedicationDispense and MedicationAdministration - FMM 2

Order Service Catalogue Project

• To follow the Order Catalog work, use the following listserv: ordercatalog@lists.hl7.org
• 5/1 - update from last weeks meeting. The group is continuing to evaluate the use of Composition (and more recently List) resource to address the catalog requirements. There are several changes needed to Composition to meet the requirements.
• Update planned on Catalog work in Madrid WGM Tuesday Q2 at O&O

International Chemotherapy Implementation FHIR IG

• Chemotherapy IG Wiki Page
• 5/1 - IG work is continuing. There are a few questions regarding Medication Request and Medication Administration and few new tracker items that have come out of these discussions.
• Planned update on the work at Madrid WGM Wednesday Q2 in CDS

AOB

• none

Next meeting

• Monday, May 15, 2017 at 4pm Eastern - NOTE, please confirm time since this will be the first meeting post the Madrid WGM