2011-12-12 Rx Conf Call

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Attendees

• Chair - Hugh; Scribe - Julie; Rob, Scott, Tom, Julie, Mike Krugman, Melva, John Hatem

List Server Items

Schizophrenia Project Scope Statement Concerns

Co-chairs checking on PSS going through DE Steering Group. Tom has picked up on a new PSS to build a DAM and business requirements for messages in the clinical area of Schizophrenia. However, once messages are developed in such a specific area, there is a big risk that existing re-useable patterns for describing diseases will get re-invented. PSS said there were no links to (work in) other groups which is a problem.

Hugh: shouldn't this be covered by design patterns? But how would these be implemented?

Tom: suggest the group add into their PSS that they search diligently for existing patterns that they can re-use.

Julie: likely to be using similar constructs to other clinical areas - e.g. assessment scales like APGAR or GCS, which are already modelled in HL7.

Rob: When feedback given to DE group, suggest that we add that our comments come from our experience with medication - multiple models of essentially the same thing, which then require a lot of harmonisation work.

John: HL7 "Glossary" for things like "this is how you represent an 'in-patient visit'" in whatever context

Stopping Medication

Disagreement on the list on how to represent the order to stop a medication originally ordered by another prescriber (or alters the dosage).

In Tom's scenario, there is no central repository, so the original prescription is not "manageable" by anyone other than the original author.

Could create a reference to the original prescription and abort it, using a control act. But would that work in a distributed environment? Can one system update the status of an object in another system?

Another use case would be an order to stop using an OTC medication.

In Canada, the scenario would be to put a (new) end date on the prescription in the central repository in a medication statement sense.

Julie: where is the stop message to go to? That helps to say what sort of message it should be. Data stays at source, to get information need to query the hub which gets information for you that you build together to give a profile.

Julie: the new "prescriber" may not have the system object, but he certainly does have conceptual control of the object. Tom's problem with this is that his implementers cannot cope with creating an abort control act against something that they don't have.

For the OTC medication, could make a medication statement acknowledging the existence of the administration, and this can then be stopped. Will need to sort this out using a whiteboard and drawings etc. - so transfer the discussion to the San Antonio meeting.

Dose Form

This was actually about "units of presentation". May be a good idea to re-name the concept domain that is tied to the attribute in the RIM to avoid confusion.

Action Items

Ballot

Progressing OK.

Agenda for San Antonio

Tom will circulate an updated Agenda after the call

OOC Meeting Minutes

John H has reviewed these and is fine with them. There are still some gaps - mark this as "information unavailable" as we need to get these out.

Melva will do this and re-post.

IHE Medication Profile White Paper

Tom is likely to meet with Jose to build use cases and to update the text

Joint Glossary

Tom has not been in touch with Marco as he has been away. How should we go about managing it as a joint exercise? Julie has looked at it, but does not have time to do any work on it before Christmas. Suggest that when we have the discussion, we should also demonstrate the tooling using the GoToMeeting. Also we need people to comment on the nature of the tool, not to just look at its content. Tom needs to take note of the calls between the Christmas/New Year period (see other item) when liaising with Marco.

Tom will ask Marco if he can join the call next week

EHR Project

This has been approved in EHR group, with our participation, pending our approval (we had not seen the document at that time);

Scott made a motion that Pharmacy WG co-sponsor with EHR - Scott will be bringing information back to Pharmacy as required.  Julie seconded.  Against: 0 Abstain: 0 For: 6

Services Project

nothing to report - no decision on the call time (folk are at OMG this week)

Clinical Statement Comparison

Hugh talked with Rik at HL7 UK meeting; Hugh didn't feel that he had done a very good job of presenting our concerns, as the response did not seem to quite capture the depth of the concerns.

Q4 on Tuesday will be a joint discussion with Clinical Statement group in San Antonio - to look in detail at some issues, to demonstrate the flavour of the concerns

Calls through the Christmas/New Year Period

17th December - will be enough folk to have a call

26th December - call has already been cancelled

2nd January will be a holiday in several realms, so will not have a call that day.

9th January - last call before the WGM.

May 2012 Ballot Preparation

Have three topics for May 2012 ballot, with closing date for content as late March

• Institutional Material
• Medication Order Release 2
• Medication Dispense and Supply Event Release 2

Hugh: trying to initiate a sense of urgency in getting ballot preparation done; John agrees.

Tom: either need to extend the WGM to include the Friday -which we had said that we wouldn't do - or an out of cycle. John, Scott and Tom could make Friday meeting; Hugh and Julie could possibly do so.

Action: Hugh to put something to the list regarding this, such that we will make a decision on the call next week.

Note: Common Product Model will be re-balloted in May 2012, which may suck some of Hugh & Julie's bandwidth