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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
 
|-
 
|-
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|colspan="2"| VA
 
|colspan="2"| VA
 
|-
 
|-
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| || 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"| Health eData Inc
 
|colspan="2"| Health eData Inc
 
|-
 
|-
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| || 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
 
|-
 
|-
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|colspan="2"| InterSystems
 
|colspan="2"| InterSystems
 
|-
 
|-
−
| || Tony Little
+
| X || Tony Little
 
|colspan="2"| Optum 360
 
|colspan="2"| Optum 360
 
|-
 
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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"| Cognosante
 
|colspan="2"| Cognosante
 
|-
 
|-
−
| || Mike Padula
+
|X || Mike Padula
 
|colspan="2"|  The Children's Hospital of Philadelphia
 
|colspan="2"|  The Children's Hospital of Philadelphia
 
|-
 
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#Agenda review
 
#Agenda review
 
#Approve previous meeting minutes [[2017-10-05_Patient_Care_FHIR_Call]]
 
#Approve previous meeting minutes [[2017-10-05_Patient_Care_FHIR_Call]]
−
#*'''Motion:''' <moved>/<seconded>
+
#*'''Motion:''' Stephen/Emma
−
#Prior Action Item Follow-up 
+
# High Priority Resources
 
# gForge change request
 
# gForge change request
  
Line 174: Line 174:
  
 
AllergyIntolerance
 
AllergyIntolerance
−
* QA 4d. value set should include unknown when minOccurs=1 - AllergyIntolerance.clinicalStatus has invariant that requires it, but it doesn't have unknown -- (similar to tracker we resolved last week for AllergyIntolerance.verificationStatus [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13997 GF#13997])
+
* QA 4d. value set should include unknown when minOccurs=1 - AllergyIntolerance.clinicalStatus has invariant that requires it, but it doesn't have unknown -- (similar to tracker we resolved last week for AllergyIntolerance.verificationStatus [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13997 GF#13997]) -- keep it "as is" knowing that the data-absent-reason extension (http://build.fhir.org/extension-data-absent-reason.html) can be used if clinicalStatus is not known
−
* [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=14007 GF#14007] QA 5e. W5 mappings - AllergyIntolerance.asserter = w5 who.source whereas Condition.asserter = w5 who.author
 
−
** Similar to questions on how to map AllergyIntolerance.assertedDate = IAM-20 (Statused at Date/Time) or IAM-13 (Reported Date/Time)?
 
−
** AllergyIntolerance.assertedDate says "The date on which the existance of the AllergyIntolerance was first asserted or acknowledged" as well as "Date record was believed accurate"
 
−
** AllergyIntolerance.asserter says "The source of the information about the allergy that is recorded"
 
  
 +
Condition
 +
* [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13980 GF#13980] condition-related extension cardinality should be 0..* (pre-applied) -- resolved
 +
* QA 4a. Condition.category is CodeableConcept with FHIR-defined value set - related to past [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10091 GF#11091] -- Rob H. provided an update -- this is still an open question with next step to talk to Grahame and Ted.
 +
* revisit [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13026 GF#13026] Condition.clinicalStatus -- Rob will consult with SNOMED and Stephen's PPT is attached to the tracker
 +
* QA 4d. value set should include unknown when minOccurs=1 - Condition.clinicalStatus has invariant that requires it, but it doesn't have unknown -- keep it "as is" knowing that the data-absent-reason extension (http://build.fhir.org/extension-data-absent-reason.html) can be used if clinicalStatus is not known
  
−
Condition -- focus for next week
+
Procedure  
−
* [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13980 GF#13980] condition-related extension cardinality should be 0..* (pre-applied)
+
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13974 GF#13974] Purpose of Procedure.reasonCode vs. Procedure.reasonReference (Ioana Singureanu) -- resolved
−
* QA 4a. Condition.category is CodeableConcept with FHIR-defined value set - related to past [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10091 GF#11091]
+
Discuss Next Week:
−
* revisit [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13026 GF#13026] Condition.clinicalStatus
 
−
* QA 4d. value set should include unknown when minOccurs=1 - Condition.clinicalStatus has invariant that requires it, but it doesn't have unknown
 
−
 
 
−
Procedure -- backlog
 
−
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13974 GF#13974] Purpose of Procedure.reasonCode vs. Procedure.reasonReference (Ioana Singureanu)  
 
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13975 GF#13975] Procedure.reasonReference description is incomplete (Ioana Singureanu)  
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13975 GF#13975] Procedure.reasonReference description is incomplete (Ioana Singureanu)  
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13976 GF#13976] Procedure.focalDevice description is confusing (Ioana Singureanu)
 
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13976 GF#13976] Procedure.focalDevice description is confusing (Ioana Singureanu)
  
 +
=== gForge Change Requests (Backlog) ===
 +
 +
Communication/CommunicationRequest
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13936 GF#13936] CommunicationRequest - intent value set (Ravi Kuchi)
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13979 GF#13979] QA 4a:  Communication.topic needs binding to a value set (Michelle Miller)
 +
 +
CarePlan/Goal backlog 
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13903 GF#13903] CarePlan should allow tracking of past activities (i.e. past interventions) (Rick Geimer)
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13904 GF#13904] Consider renaming CarePlan.activity.outcomeCodeableConcept and CarePlan.activity.outcomeReference (Rick Geimer)
 +
 +
BR&R:
 +
* [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13302 GF#13302] Vocabulary issues with AdverseEvent
 +
* [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13698 GF#13698] AdverseEvent.suspectedEntity.instance should allow CodeableConcept
 +
* [https://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11021 GF#11021] Increase cardinality of substance and make certainty relation to substance, not reaction - 2016-09 core #40
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13892 GF#13892] Need guidance on overlap of AdverseEvent.event.text and AdverseEvent.description (Lloyd McKenzie)
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13893 GF#13893] Correction to AdverseEvent.subject definition (Lloyd McKenzie)
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13894 GF#13894] AdverseEvent.eventParticipant needs work (Lloyd McKenzie)
 +
 +
 +
LHS:
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12509 GF#12509] CareTeam participant (Michelle Miller)
 +
 +
OO:
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12673 GF#12673] How to handle HCT/TP
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12993 GF#12993] Please Create a NonMedicationAdministration object or an Administration object
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13047 GF#13047] Add DosageInstructions to Procedure
 +
 +
SD:
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12676 GF#12676] Guidance request for GP SOAP in FHIR (Alexander Henket) -
 +
** https://chat.fhir.org/#narrow/stream/implementers/topic/ClinicalImpression
  
−
=== gForge Change Requests ===
+
<br>
 +
Medium Backlog
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12633 GF#12633] Split Procedure into Procedure and ProcedureStatement (Lloyd McKenzie)
 +
** Zulip chat asking for implementer feedback:  https://chat.fhir.org/#narrow/stream/implementers/topic/Procedure.20vs.20ProcedureStatement
 +
** Dave commented that there is relevance for ProcedureStatement in context of CarePlan activities (Activity Statements where the activity is a procedure)
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10028 GF#10028] Careplan: Provide ability to specify patient and/or provider preferences (Emma Jones)
 +
** meet need with a profile for preference on the observation resource.  Requirements are a preference category (nutrition, medication, care), the preference priority (high/medium/delayed from C-CDA) and with elements of expressor and recorder. 
 +
** This profile would not be developed for this release cycle
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13140 GF#13140] logical definition of care-plan-category value set may require realignment with SCT changes (Matthew Cordell)
 +
** pending SNOMED proposal: https://confluence.ihtsdotools.org/display/cmag/Care+plans
 +
** Rob said he would follow up on the status of the SNOMED proposal
 +
<br>
 +
Low Backlog
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10635 GF#10635] QA 5a: Resource references exist in both directions for Condition and ClinicalImpression (Michelle Miller)
 +
** ClinicalImpression is not mature enough to resolve this issue.  Ask MnM for an exemption on the QA checklist (re: Condition having a circular reference with ClinicalImpression)
 +
** Add note: "A known issue exists with circular references between Condition and ClinicalImpression, which is due to the low maturity level of ClinicalImpression. The Patient Care work group intends to address this issue when ClinicalImpression is considered substantially complete and ready for implementation"
 +
* [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11173 GF#11173] CarePlan needs support for reviews - 2016-09 core #327 (Stephen Chu)
 +
** Tracking of reviews and plans for reviews is something that applies to many resources, not just CarePlan (e.g. protocols, standing orders, long term care admissions, etc.).  This is something probably best handled by "Task" but will require a fair bit of analysis and discussion with other work groups to agree on approach.  Defer to R4. Consider transfer to OO who owns Task
  
 
=== Adjourn ===
 
=== Adjourn ===
−
Adjourned at <hh:mm am/pm> <timezone>.
+
Adjourned at 6:32pm Eastern.
  
 
==Meeting Outcomes==
 
==Meeting Outcomes==

Latest revision as of 22:52, 12 October 2017



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: 2017-10-12
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
Dave Carlson VA
X Stephen Chu The Australian Digital Health Agency (ADHA)
Evelyn Gallego EMI Advisors LLC
Eric Haas Health eData Inc
X Rob Hausam Hausam Consulting LLC
Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
Russ Leftwich InterSystems
X 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
X Mike Padula The Children's Hospital of Philadelphia
Craig Parker Intermountain Healthcare
Joe Quinn Optum
Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
Serafina Versaggi Dept of Veterans Affairs
Quorum Requirements Met: yes

Agenda

Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2017-10-05_Patient_Care_FHIR_Call
    • Motion: Stephen/Emma
  3. High Priority Resources
  4. gForge change request

Supporting Information

Minutes

High Priority Resources (AlleryIntolerance, Condition, Procedure)

AllergyIntolerance

  • QA 4d. value set should include unknown when minOccurs=1 - AllergyIntolerance.clinicalStatus has invariant that requires it, but it doesn't have unknown -- (similar to tracker we resolved last week for AllergyIntolerance.verificationStatus GF#13997) -- keep it "as is" knowing that the data-absent-reason extension (http://build.fhir.org/extension-data-absent-reason.html) can be used if clinicalStatus is not known

Condition

  • GF#13980 condition-related extension cardinality should be 0..* (pre-applied) -- resolved
  • QA 4a. Condition.category is CodeableConcept with FHIR-defined value set - related to past GF#11091 -- Rob H. provided an update -- this is still an open question with next step to talk to Grahame and Ted.
  • revisit GF#13026 Condition.clinicalStatus -- Rob will consult with SNOMED and Stephen's PPT is attached to the tracker
  • QA 4d. value set should include unknown when minOccurs=1 - Condition.clinicalStatus has invariant that requires it, but it doesn't have unknown -- keep it "as is" knowing that the data-absent-reason extension (http://build.fhir.org/extension-data-absent-reason.html) can be used if clinicalStatus is not known

Procedure

  • GF#13974 Purpose of Procedure.reasonCode vs. Procedure.reasonReference (Ioana Singureanu) -- resolved

Discuss Next Week:

  • GF#13975 Procedure.reasonReference description is incomplete (Ioana Singureanu)
  • GF#13976 Procedure.focalDevice description is confusing (Ioana Singureanu)

gForge Change Requests (Backlog)

Communication/CommunicationRequest

  • GF#13936 CommunicationRequest - intent value set (Ravi Kuchi)
  • GF#13979 QA 4a: Communication.topic needs binding to a value set (Michelle Miller)

CarePlan/Goal backlog

  • GF#13903 CarePlan should allow tracking of past activities (i.e. past interventions) (Rick Geimer)
  • GF#13904 Consider renaming CarePlan.activity.outcomeCodeableConcept and CarePlan.activity.outcomeReference (Rick Geimer)

BR&R:

  • GF#13302 Vocabulary issues with AdverseEvent
  • GF#13698 AdverseEvent.suspectedEntity.instance should allow CodeableConcept
  • GF#11021 Increase cardinality of substance and make certainty relation to substance, not reaction - 2016-09 core #40
  • GF#13892 Need guidance on overlap of AdverseEvent.event.text and AdverseEvent.description (Lloyd McKenzie)
  • GF#13893 Correction to AdverseEvent.subject definition (Lloyd McKenzie)
  • GF#13894 AdverseEvent.eventParticipant needs work (Lloyd McKenzie)


LHS:

  • GF#12509 CareTeam participant (Michelle Miller)

OO:

  • GF#12673 How to handle HCT/TP
  • GF#12993 Please Create a NonMedicationAdministration object or an Administration object
  • GF#13047 Add DosageInstructions to Procedure

SD:


Medium Backlog

  • GF#12633 Split Procedure into Procedure and ProcedureStatement (Lloyd McKenzie)
  • GF#10028 Careplan: Provide ability to specify patient and/or provider preferences (Emma Jones)
    • meet need with a profile for preference on the observation resource. Requirements are a preference category (nutrition, medication, care), the preference priority (high/medium/delayed from C-CDA) and with elements of expressor and recorder.
    • This profile would not be developed for this release cycle
  • GF#13140 logical definition of care-plan-category value set may require realignment with SCT changes (Matthew Cordell)


Low Backlog

  • GF#10635 QA 5a: Resource references exist in both directions for Condition and ClinicalImpression (Michelle Miller)
    • ClinicalImpression is not mature enough to resolve this issue. Ask MnM for an exemption on the QA checklist (re: Condition having a circular reference with ClinicalImpression)
    • Add note: "A known issue exists with circular references between Condition and ClinicalImpression, which is due to the low maturity level of ClinicalImpression. The Patient Care work group intends to address this issue when ClinicalImpression is considered substantially complete and ready for implementation"
  • GF#11173 CarePlan needs support for reviews - 2016-09 core #327 (Stephen Chu)
    • Tracking of reviews and plans for reviews is something that applies to many resources, not just CarePlan (e.g. protocols, standing orders, long term care admissions, etc.). This is something probably best handled by "Task" but will require a fair bit of analysis and discussion with other work groups to agree on approach. Defer to R4. Consider transfer to OO who owns Task

Adjourn

Adjourned at 6:32pm 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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