2017-07-27 Patient Care FHIR Call

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: 2017-07-27 Time: 5-6:30pm ET
Facilitator	Michelle M Miller	Note taker(s)	Michelle M Miller
Attendee	Name	Affiliation
	Elaine Ayres	NIH/Department of Clinical Research Informatics
	Dave Carlson	VA
	Stephen Chu	The Australian Digital Health Agency (ADHA)
	Evelyn Gallego	EMI Advisors LLC
	Eric Haas	Haas Consulting
	Rob Hausam	Hausam Consulting LLC
	Laura Heermann-Langford	Intermountain Healthcare
	Emma Jones	Allscripts
	Russ Leftwich	InterSystems
	Tony Little	Optum 360
	Jay Lyle	Ockham Information Services LLC, VA
	Russell McDonell	Telstra Health
	Lloyd McKenzie	Gevity (HL7 Canada)
	Larry McKnight	Cerner
	Michelle M Miller	Cerner
	Lisa Nelson	Life Over Time Solutions
	Viet Nguyen	Lockheed Martin, Systems Made Simple
	M'Lynda Owens	Cognosante
	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 2017-07-20_Patient_Care_FHIR_Call
   • Motion: <moved>/<seconded>
3. Prior Action Item Follow-up
4. gForge change request

Supporting Information

• Tracker Issues - https://docs.google.com/a/lmckenzie.com/uc?id=0B285oCHDUr09Mzh3b09rMFhEV1E
• Resolve QA Warnings to have resource FMM > 0
• Resolve QA Information messages to achieve FMM = 3
• Maintain QA checklist

Minutes

Prior Action Item Follow-up

• Aug 3 - Mary Ann will join our PC FHIR call to discuss the transition of AdverseEvent resource

gForge Change Requests

Prioritization of backlog was discussed on July 20, 2017

Backlog Ready for Discussion

• GF#10621 QA 4a: Consider whether CarePlan.activity.detail.category should be bound to an external code system (ballot)
• GF#10352 Change Encounter or annd element to remove referencial limitation to on Encounters (Paul Knapp)
• GF#12163 Update payload URL to lead to a real file (Guillaume Rossignol)

Medium Backlog

• GF#12509 CareTeam participant (Michelle Miller)
  • Feedback from LHS, and LHS continues to meet and discuss
  • CareTeam.participant.role (existing) 0..* - need to update definition of role (since it mentions responsibility) Example: PCP - close to finalizing the value set
  • CareTeam.participant.function 0..* (new) - Example: PT, Wound Care - close to finalizing the value set
  • CareTeam.participant.specialty is no longer needed -- instead, get from Practitioner
• 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)
• 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)
  • pending SNOMED proposal: https://confluence.ihtsdotools.org/display/cmag/Care+plans
  • Rob said he would follow up on the status of the SNOMED proposal

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

Aug 3: Joint discussion with BRR (AdverseEvent)

• GF#11021 Increase cardinality of substance and make certainty relation to substance not reaction - 2016-09 core #40 (Jay Lyle)
• GF#13698 AdverseEvent.suspectedEntity.instance should allow CodeableConcept

Aug 10 + WGM: Joint discussion with Pharmacy, 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
• GF#12676 Guidance request for GP SOAP in FHIR (Alexander Henket) -
  • https://chat.fhir.org/#narrow/stream/implementers/topic/ClinicalImpression
  • PC, SD - possibly Thurs Q2

Patient Care WGM agenda: PC_Sept_2017_WGM

Adjourn

Adjourned at <hh:mm am/pm> <timezone>.

Meeting Outcomes

Actions Aug 10 - transfusion joint call with OO/Pharm/PC

Next Meeting/Preliminary Agenda Items Agenda review Approve previous meeting minutes Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#> AdverseEvent gForge change request

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