2018-03-12 Rx Conf Call

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Attendees

• Melva Peters (Chair and Scribe)
• John Hatem
• Jean Duteau
• Michelle Miller
• Tim McNeil
• Daniel Zhang
• Danielle Friend

Agenda Items and notes

FHIR

The following tracker items were resolved:

FHIR Tracker Items

• 15105 - MedicationStatement - alignment with WorkFlow
  • notTaken was removed
  • need to consider how to reflect what the prescriber thinks should be taken by the patient - is this a medStatement or is this a MedRequest?
  • Lloyd believes should be using a MedRequest with a "plan" status
  • Choices:
    • take MedStatement back to the way it was
    • US Core - embrace List
    • follow Lloyd's suggestion to use MedRequest with "Plan" status
    • use status field to identify if a prescriber believes the patient should be on this med and uses taken element to identify if the patient is following the order and taking the medication - could previous do this before we aligned MedStatement with workflow
  • March 5, 2018: - deferred until March 12, 2018
    • Ask Lloyd to join call - complete - he can't join on March 12. Need to provide an update to him
  • March 12, 2018:
    • Lloyd believes that MedStatement should only be an indicator of whether the patient/provider says they are taking the medication
    • Options:
      • revert back to having "notTaken"(pre workflow harmonization)
      • provider instructions for medication - should use MedicationRequest - with intent element
      • implement List resources to get active medication list - not preferred
      • current resource with "not taken" as a status - not preferred
    • Need to take this conversation more public -
      • Workflow group - Melva to ask Lloyd to add to Workflow agenda
      • Zulip - posting to Zulip
        • add Workflow discussion
    • Add tracker item to review and update the scope of MedicationStatement

• 15688 - MedicationRequest.category Valueset

• 14455 - Workflow report - File:Workflow pharmacy issues Jan 2018.xlsx
  • new report has been run
  • MedicationRequest
    • instantiates - currently supported but workflow has changed the pattern
      • John to talk to Lloyd about the changes needed
  • MedicationAdministration -
    • instantiates - currently supported but workflow has changed the pattern
      • John to talk to Lloyd about the changes needed
  • MedicationDispense
    • Performer - we believe we are consistent
      • Melva to reach out to Lloyd and ask if this is an error in the report - email sent to Lloyd - there is an error on the report.
        • new report to be generated
    • statusReason
      • will add to suppressed-workflow-warnings - different name
      • John to followup with workflow about the reference to DetectedIssue

• 15136 - Change Dosage to support conditional doses
  • Discussion of the requirement - this is related to conditional dose
  • Scott to pull material from NCPDP
  • John to pull V3 material
  • start to gather requirements and look at existing FHIR material including CDS

• 15589 - Pharmacy missing isModifierReason
  • MedicationRequest.substitution.allowed
    • do not believe that this should be a "isModifier"
    • will discuss on March 12 call when we have implementers on the call
  • Medication.amount
    • do not believe that this should be a "isModifier"
    • will discuss on March 12 call when we have implementers on the call

• 15509 - Create example scenarios for Pharmacy

• 12396 - Medication package and product

Action Item List

• March 5, 2018: No action this week
• March 12, 2018:

MedicationKnowledge Resource

• Melva and Jean are creating a draft resource in the build. The next step is to review the existing tracker items to see which can be done with the current draft content, which need to have data elements added, and which will remain out of scope.
• Feb 26, 2018: no discussion
• March 5, 2018: no discussion
• March 12, 2018: FMG wants to see the PSS once co-sponsors have been approved

Joint Meeting with IHE Pharmacy and ISO TC215 WG 6

• Feb 26, 2018: no discussion
• March 5, 2018: no decision
• March 12, 2018: will decline a joint meeting for Cologne
  • will commit to provide an update to IHE Pharmacy and ISO as a power point, but can not do a F2F meeting at this time.

Catalogue Project

• March 5: last weeks meeting addressed open issues related to getting the Entry Definition resource cleaned up. There were no Pharmacy specific issues.
• March 12, 2018: there was a meeting - cleaning up material to get content into the build
  • entryDefinition has a classification element

Blood Products/Transfusion/Tissue Update - Project 1370

• Feb 26, 2018: no discussion
• March 5, 2018: no updates
• March 12, 2018: no meetings have been held since New Orleans

Updates from Workflow

• March 5, 2018: no discussion - no Workflow meetings this week
• March 12, 2018: no meeting this week

AOB

• WGM Agenda

Action: start to draft an agenda for the Cologne meeting

Next meeting

• March 19, 2018 - (4pm Eastern)
  • reminder that daylight savings time goes in in North America on March 11th!