2016-05-09 PA WGM Minutes

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Patient Administration Work Group Minutes - May 09, 2016

Monday Q1

HL7 Patient Administration Meeting Minutes Location: Room # Salon Musset		Date: 2016-05-09 Time: Monday Q1
Facilitator	Line Saele	Scribe	Alex de Leon
Attendee	Name	Affiliation
X	Line Saele	HL7 Norway
X	Irma Jongeneel	HL7 Netherlands
X	Alex de Leon	Kaiser Permanente
X	Brian Postlethwaite	HealthConnex, Australia
X	Cooper Thompson	EPIC
X	Toriil Reite	HVIKT/HL7 Norway
X	Christian Hay	GS1
X	Jim Whicker	Cognosante
X	Alexander Henket	Nictiz
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics
Welcome/introductions

• Approve agenda
• Review PA mission & charter
• Review PA decision making practice
• Review PA 3-year work plan
• Review SWOT

Supporting Documents

• May 2014 WGM
• PA mission & charter
• PA decision making practice
• PA 3-year work plan
• SWOT Analysis

Minutes

Minutes/Conclusions Reached:
Introductions
The WG reviewed the agenda for the week.
Irma moves to accept the agenda as reviewed. Alex seconded.
Vote (for/against/abstain): 7/0/0

The WG continued to review the Mission and Charter
First, the WG discussed the mission:

“The Patient Administration Work Group supports the HL7 mission by defining the requirements and specifications to support the interoperability among clinical and non-clinical systems regarding patient encounters, scheduling and administrative registries.”

Brian noted that there should be a comma after patient in the mission statement (“… patient encounters, scheduling and…” to “… patient, encounters, scheduling and…”. Brian made a motion to add a comma after patient. Irma seconded.

Discussion: Irma noted that patient may be included in the “administrative registries”. A discussion was held about encounters. Encounters sometimes includes provider encounters about the patient but not including the patient, so just “encounters” might work.
After discussion, the motion to add a comma is withdrawn.
The WG continued to the charter.

Brian moved to add “healthcare service” after “organizations” in the following section:
• Identifying requirements and providing specifications for exchanging:

a. Demographic and administrative data used to describe patients, persons, service delivery locations and patient encounters [scheduled and/or actual], including healthcare providers, places, organizations, and their relationships in the context of healthcare encounters.
Alex seconds.
Discussion: none
Vote: 8/0/0

Motion to approve the mission and charter by Irma. Brian seconds.
Discussion: None.
Vote: 8/0/0

The WG moved on to the decision making manual.
Irma moved to accept the DMP, Christian seconded.
Discussion: None
Vote: 7/0/0

The WG moved on to the 3 year work plan
One item was the HAVE/TEP project that shows ballot in May 2016 which would be now. We are sure that it is not being balloted now.

FHIR will be balloted in September. The work group clarified that the BillableItem is sort of the outlier of the FHIR resources. It will be a little behind of the other FHIR resources stewarded by the PAWG.

All FHIR resources have been designated as STU (new term for DSTU).

Motion made by Jim to approve the 3 year work plan. Irma seconded.
Discussion: none
Vote: 7/0/0

The WG continued with the SWOT.
In looking at the list serv. V2 questions are not being responded to in the listserv.

Brian moves to remove “Lack of interest for v2 PA implementation to migrate to PA v3 content” within the threats as FHIR is an opportunity. Irma seconded.
Discussion: None
Vote: 6/0/0

The WG continued with the action items from the last WGM minutes.
Action: Brian will follow up on the even level mapping for v2 and FHIR rather than just the element mapping.
There was an action item to contact and work with Wendy as our FHIR facilitator about covering vocabulary for FHIR. Alex noted that Wendy initially agreed but we should contact Joginder who is covering Wendy while she is out on maternity leave.
Action items about frozen resources were overlooked because the “freezing” never occurred.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)

Next Meeting/Preliminary Agenda Items .

Monday Q2

HL7 Patient Administration Meeting Minutes Location: Salon Musset		Date: 2016-05-24 Time: Monday Q2
Facilitator	Line Saele	Scribe	Alex de Leon
Attendee	Name	Affiliation
X	Line Saele	HL7 Norway
X	Irma Jongeneel	HL7 Netherlands
X	Alex de Leon	Kaiser Permanente, USA
X	Brian Postlethwaite	HealthConnex, Australia
X	Cooper Thompson	EPIC, USA
X	Andrew Torres	Cerner
X	Toril Reite	HL7 Norway
X	Christian Hay	GS1
X	Micheal Donnely	EPIC, USA
X	Tim McNeil	SureScripts, USA
X	Alexander Henket	Nictiz
X	Amit Popat	EPIC, USA
Quorum Requirements Met (Chair +2 members): Yes

Agenda

Agenda Topics

• Open Session for new proposals
• Feedback from Connectathon
• Other projects
• v3 RTLT Ballot reconciliation

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Introductions
Open Session for new proposals
FHIR
Alex noted that there may be a pss for occupational health Irma noted that there might be work toward using FHIR in their healthcare interoperability infrastructure. Brian noted that there is an endpoint resource that is being developed. The WG continued to review the “endpoint” resource at https://hl7-fhir.github.io/endpoint.html Although this seems like an infrastructure resource, we have a large stake in its development due to our registries work. This should be something included in the 3 year work plan. Action: Include the Endpoint resource work (resource proposal, etc.), within the 3 year work plan. Connectathon feedback from Brian No interest in the scheduling side. Provider directory had EPIC and Surescripts interests using the Argonaut profile but more work needs to be done. Micheal from EPIC was involved in that and asked that Kevin (EPIC) be around for the details. Wed Q1 will be the discussion for details about this. Reaffirmation of the Real Time Location tracking. It passed the ballot but had comments on the ballot. Action: O&O to be contacted per this comment to suggest to them that they include in their PSS the research and communication of the impact of identifier requirements (UDI) work of their finished work across the v3 models. Alexander Henket to introduce in facilitator roundtable. The WG continued with the ballot reconciliation. The ballot reconciliation was completed. Action: Line will submit the ballot reconciliations online for all ballot submitters. Since all were affirmative with comments, we can move forward with affirmation.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)

Next Meeting/Preliminary Agenda Items •

Monday Q3

HL7 Patient Administration Meeting Minutes Location: Salon Musset		Date: 2016-05-09 Time: Monday Q3
Facilitator	Irma Jongeneel	Scribe	Alex de Leon
Attendee	Name	Affiliation
X	Irma Jongeneel	HL7 Netherlands
X	Line Saele	HL7 Norway
X	Brian Postlethwaite	Telstra Health, Australia
X	Alex de Leon	Kaiser Permanente
X	Christian Hay	GS1
X	Kevin Paprouki	EPIC, USA
X	Toril Reite	HL7 Norway
X	Micheal Donnelly	EPIC, USA
X	Simone Heckmann	HL7 Germany
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

1. Ballot reconciliation FHIR

Supporting Documents

Minutes

Minutes/Conclusions Reached:
The WG continued with the FHIR ballot reconciliation (FHIR Tracking Gforge.

1. 7963 Summary: 2015May core #1283 - Type careProvider to account for roles.
   

Care provider is a more complex concept than the current definition. This could represent a patient's PCP, preferred pharmacist, etc. At very least, the careProvider needs a "type" value to account for provider roles within a care team.
This tracker comments refers to 8135
The WG continued to discuss the roles and types.
Much discussion was around the primary care provider and specialty care providers.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)

Next Meeting/Preliminary Agenda Items .

Monday Q4

HL7 Patient Administration Meeting Minutes Location: Room # 1367		Date: 2016-01-11 Time: Monday Q4
Facilitator	Brian Postlethwaite	Scribe	Alex de Leon
Attendee	Name	Affiliation
X	Brian Postlethwaite	Telstra Health, Australia
X	Irma Jongeneel	HL7 Netherlands
X	Line Saele	HL7 Norway
X	Alex de Leon	Kaiser Permanente, USA
X	Kevin Paprocki	EPIC, USA
X	Michael Donnelly	EPIC, USA
X	Toril Reite	HL7 Norway
X	Simone Heckmann	HL7 Germany
X	Richard Kavanagh	HSCIC, UK
X	Alexander Henket	Nictiz
X	Jenni Syed	Cerner, USA
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

1. Approve Atlanta Minutes
2. Plan next meeting Draft Agenda
3. Harmonization proposals
4. v2 work

Supporting Documents

Minutes

Minutes/Conclusions Reached:

1. 7963 Summary: 2015May core #1283 - Type careProvider to account for roles. Cont.ALex
   

I think the submitter is indicating that they believe most systems to track “type” information and that this would be necessary for most systems to process careProvider. Example “types” = Primary Care Provider, Dentist, OB/GYN (if different form PCP), etc. In HL7v2, this would correspond to ROL-3 which uses table 0443 = Provider Role. I think there’s a case to be made for careProvider to have a similar structure as participant has within Encounter.

Care Provider/ Care Team discussion
Simone said that there was a similar discussion held regarding condition. For this, that work group decided upon, instead of a reference, then a flat structure that contains all the information for that element. In this case for condition.

The WG continued with the discussion on the need for a general practitioner.

Alex made a motion to change the element name in the Patient resource from “careProvider” to “generalPractitioner” and leaving the cardinality from “0…*” and put “gatekeeper” wording in the description to clarify the use. If there is a need for other care providers, include a suggestion to look at the standard extensions (e.g. preferredDentist, preferredPharmacist, etc.) or careTeam resource where encounter or episode of care references are needed along with time bound references. Irma seconds.

Discussion: the wg discussed the backwards compatability of this. Since it is at FMM3, the wg can make the change but has also decided to inform the implementer community. Alexander asked if this also includes how to model the standard extensions? These are all that have use cases at this time.
Vote: 10/0/1

1. 7853 Encounter Coverage
   

EpisodeOfCare – mapping to v2.
Summary: 2015May core #1173 - EpisodeOfCare mapping to HL7v2

After discussion the WG determined that the v2 mapping is impractical as the segments and elements do not define an episode of care. Additionally, the elements in the resource would map differently for v2 outpatient elements versus v2 inpatient elements.
Irma moved to close this issue. Simone seconded.
Vote: 09/0/2

1. 9539 - Summary: Make patient-mpi-match StructureDefinition more generic/available for multiple resources
   

The OpenHIE community is contemplating a use-case that supports a health worker in the field, who needs to add a new health care facility to a master facility list. In that scenario, we'd like to have the submitter's result checked against the master list in the same basic way that a patient demographic query might return statistical results. I could imagine that this statistical matching function could additionally be relevant to a number of resources, including health workers, clinical concepts, etc. I propose that you make the existing patient-mpi-match StructureDefinition more generic. Perhaps consider something like algorithmic-match or statistical-match instead, and broaden the resources that can be bundled into this definition to include potentially all resources.

The WG discussed the MPI searches and the confidence with the returned results with MPI searches. Different examples of algorithms of MPI searches for MPI searches.
The discussion centered around whether MPI searches could be generalized so that it could be used in a greater source.

PA 9 May 2016 Montreal WGM:
POST http://[base]/Patient/$search (and send the complete - or what you have - patient resource) and the results would be the same as a search bundle, and may include the confidence scores.
This is a potential replacement for the mpi match parameters, and couple be generic accross all resource types. Will take this approach to FHIR-I for consideration.
This would be so that we reduce the number of options for "searching" that clients/servers need to implement/negotiate.
This gives servers the freedom to implement the searching as they desire, without needing to update clients with more parameters as needed.
If a server performs a "fuzzy" match algorithm, then a weighting MUST be included?
Consideration also if there should be a parameter for determining if the system must give only accurate results, or the user will be able to select from multiple.
Consideration if this should be $match and $search could be considered.

Tomorrow in Q1 we are in Salon 3

Meeting Outcomes

Actions (Include Owner, Action Item, and due date) Alex Action Item - PA decision: No suggested values and remove the values in 2.9. Include following URLs for example values as part of implementation notes: Action: Communicate to the v2 project to remove the above. Alex Action Item: (Alex/Wendy) Contact CGIT co-chairs, and Brian Pech from publishing and Tony Julian from INM to see if this is possible to update this table 452 as noted above. Same for tables 453, 454. Also contact Heather Grain on the HTA. If approved, then the PAWG would like to change the table to user-defined, remove suggested values and reference the appropriate level of the ANSI ASC X12 Health Care Provider by table. Action item: Follow up with Wendy on action items. Followed up with Ted

Next Meeting/Preliminary Agenda Items .

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