February 26, 2008

Attendees:

Name Affiliation E-mail Address Present Susan Lepping Siemens susan.lepping@siemens.com X Francine Kitchen GE Healthcare francine.kitchen@ge.com X Beat Heggli HL7 Switzerland beat.heggli@isoft.ch Mary Kay McDaniel Markam mk_mcdaniel@hotmail.com X Leslie Flaherty MN DHS leslie.welsh.flaherty@state.mn.us Joann Larson KP joann.larson@kp.org X Lisa Doyle ACS lisa.j.doyle@acs-inc.com X Jeff Strand EDS jeff.strand@eds.com X Michael Garrett GE michael.garrett@ge.com X Kathleen Connor Fox Systems, Inc kathleen.connor@foxsys.com X

CONFERENCE CALL INFORMATION TUESDAYS at 12:00 – 1:30 PM EASTERN CALL NUMBER: (702)-894-2444 PASS CODE: 4512567# I. Call to order The meeting was called to order by the co-chair, Susan Lepping, at 12:05 EDT. Kathleen wrote the minutes. II. Acceptance of agenda The agenda as sent to the e-mail list was informally approved: 1. Call to Order 2. Review agenda 3. v2.7 XPN Family Name Issue 4. v2.7 Proposal #549 to make NDC Code (FT1-29) and NDC Qty & UOM (FT1-43) repeat. 5. v2.7 Proposal to add PCP Last Seen Date to the FT1 6. v2.7 Proposal RQD Segment Fields and promotion of IS http://informatics.mayo.edu/wiki/index.php/RQD_Segment_Fields_and_Promotion_of_IS 7. v2.7 Discussion Item: Physician Administered Drugs and use of HCPCS and NDC codes http://informatics.mayo.edu/wiki/index.php/Physician_Administered_Drugs_HCPCS_% 8. Review of proposed Pricing CMET - discuss use cases, vocabulary requirements, and walk-through development 9. Approve minutes from 2/5 and 2/12 FM calls (posted on HL7 website) 10. Planning for Action Items 11. Next meeting Agenda

Informally approved agenda III. v2.7 XPN Family Name Issue Discussion continued from the February 19th call with an update by Joann Larson regarding INM decision to add MSK and NAV (not available) for the guarantor and patient 0200 name type table. Used as a means for not sending names. Other choices are alias or pseudonyms. INM decision is to go to ballot without clarification pending further discussion with INM will be scheduled in Phoenix and possibly alignment with ISO.

Further information at http://informatics.mayo.edu/wiki/index.php/Proposal_573_Update_XPN_Fields_having_Sequence-based_Meaning

Discussion Paper at discussion paper in 2/12/08 minutes at http://www.hl7.org/library/committees/fm/minutes/2008_02_12%20FM%20Conf%20Call%20Minutes.zip

Motion to replace sequence based semantics with new data types approved in San Antonio still stands.

IV. v2.7 Proposal RQD Segment Fields and promotion of IS http://informatics.mayo.edu/wiki/index.php/RQD_Segment_Fields_and_Promotion_of_IS Discussion presented by Joann Larson In the course of preparing HL7 v2 chapters 4 and 4a for the upcoming ballot, the editor, Greg Thomas, was applying proposal 522 to the fields assigned data type IS. The question arose as to whether or not it was logical to promote the following fields in the RQD Requisition Detail segment to CWE.

RQD-7 Cost Center Account Number (IS) Definition: This field contains the general ledger cost center account number associated with a department that may issue or charge for this item. Refer to HL7 Table 0319 – Department Cost Center for valid values. RQD-8 Item Natural Account Code (IS) Definition: This field contains the accounting code that identifies this item in order to charge for this item. User-Defined Table 0320 - Item Natural Account Code is used as the HL7 identifier for the user-defined table of values for this field.

Both tables have no suggested values.

I checked chapter 6 to see if there were any analogous fields there, but was unsuccessful. Many of the segment fields in chapter 6 are tied to NUBC codes which do not seem to be the case with the RQD Requisition Detail segment fields.

I am wondering if there would ever be any circumstance under which there would be more than one coding system applied to an organization's general ledger? I am thinking that perhaps a promotion to an HD data type might be more sensible. This question was discussed in InM yesterday. The conclusion was that the solution depended on whether or not these were instances or concepts. InM agreed that FM would have the expertise to determine this. Perhaps RQD-7 is an instance and RQD-8 is a concept?

Here is the context for the fields: RQD - Requisition Detail Segment : contains the detail for each requisitioned item. The segment appears in the following messages: OMS - stock requisition order message (event O05) and its Ack (event O06) OMN - non-stock requisition order message and its Ack (event O08) HL7 Attribute Table – RQD – Requisition Detail SEQ LEN DT OPT RP/# TBL# ITEM # ELEMENT NAME 1 4 SI O 00275 Requisition Line Number 2 250 CWE C 9999 00276 Item Code - Internal 3 250 CWE C 9999 00277 Item Code - External 4 250 CWE C 9999 00278 Hospital Item Code 5 6 NM O 00279 Requisition Quantity 6 250 CWE O 9999 00280 Requisition Unit of Measure 7 30 IS O 0319 00281 Cost Center Account Number 8 30 IS O 0320 00282 Item Natural Account Code 9 250 CWE O 9999 00283 Deliver To ID 10 8 DT O 00284 Date Needed

Hans Buitendijk favors HD for RQD-7 Cost Center Account Number, and CWE for RQD-8 Item Natural Account Number.

Questions were raised about whether the CWE 22 components could be constrained to support the HD data type components of local value and OID or GUID. Further investigation of how these are used by provider systems is needed. Kathleen to follow up with Dan Russler for the cost accounting perspective; Joann, Francine, and Susan to follow up on how their systems handle this.

Vote: Table until further discussion with OO TC in Phoenix. Kathleen moved to approve this proposal; Joann seconded the motion. The motion passed 8-0-0. V. v2.7 Discussion Item: Physician Administered Drugs and use of HCPCS and NDC codes http://informatics.mayo.edu/wiki/index.php/Physician_Administered_Drugs_HCPCS_% Email discussion is at wiki. During this call, this topic was combined with discussion of the Proposal 587 “NDC Should Repeat” topic below. VI. v2.7 Proposal #549 to make NDC Code (FT1-29) and NDC Qty & UOM (FT1-43) repeat Francine presented Proposal 587 “NDC Should Repeat”.

Discussion:

There was some concern that different systems doing business in different ways may be incompatible.

System A: Clinical/Rx  <charge: HCPCS, NDC >  billing system  <claim: HCPCS, NDC >  payer System A needs to end multiple NDCs per charge.

System B: Clinical/Rx  <charge: NDC >  billing system  <claim: HCPCS, NDC >  payer System B does not support multiple NDCs per charge and is neutral to the support of multiple NDCs. If a billing system, which does not support receiveing multiple NDCs, is sent a charge with multiple NDCs, then important data may be lost. One version of this proposal suggested putting the repeating NDCs in OBX segments. But in light of the different business rules discussion, FT1-29 should not be made “for backwards compatibility only”. Given this, it was pointed out that we shouldn’t have NDC codes in both FT1 and OBX. So the final adopted proposal is to make two fields in FT1 repeat: FT1-29 and FT1-43.

Kathleen chaired so that Susan could participate in the vote. Francine moved to approve the proposal; Joann seconded the motion. The motion passed 3-1-1.

The approved revised proposal can be reviewed at http://informatics.mayo.edu/wiki/index.php/Proposal_587:_NDC_Should_Repeat

VII. v2.7 Proposal to add PCP Last Seen Date to the FT1 Deferred due to time constraints VIII. v.3 Review of A_Pricing CMET Kathleen discussed briefly: Tooling issues with RMIM Designer are interfering with meeting ballot submission timelines. Additionally, there is input from SPL that need to be discussed further. As a result, this CMET may not make the ballot until May. IX. Action Items • Kathleen will post minutes and links for past minutes needing approval. • Mary Kay will submit NDC and drug rebate mapping information developed with Pam Morgan and Francine will incorporate into the FM Mapping material • Beat will continue v.2 edits • Susan, Mary Kay, Beat, Francine, and Leslie may contribute business requirements and use cases for the A_Pricing CMET development • Francine will develop Requirements capture template X. Next Meeting Agenda 1. Call to Order (Chair Beat Heggli or Kathleen Connor; Scribe: Susan Lepping 2. Review agenda 3. Approve Minutes from 2/5, 2/12, 2/19 and 2/26 http://informatics.mayo.edu/wiki/index.php/Financial_Management_Committee 4. v2.7 Proposal to add PCP Last Seen Date to the FT1 5. v2.7 Discussion Item: Physician Administered Drugs and use of HCPCS and NDC codes http://informatics.mayo.edu/wiki/index.php/Physician_Administered_Drugs_HCPCS_% 6. v2.7 HL7-defined tables for NUBC codes (UVC Data Type Issues) Outstanding Issues at: http://informatics.mayo.edu/wiki/index.php/V2.7_HL7-defined_tables_for_NUBC_Codes_% 7. Review of proposed Pricing CMET - discuss use cases, vocabulary requirements, and walk-through development 8. Planning for Action Items 9. Next meeting Agenda XI. Adjournment

Informal decision for adjournment at 1:00PM EDT Upload minutes at http://hl7.org/special/Committees/