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=Patient Administration Work Group Minutes - Tuesday January 15, 2013=
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=Patient Administration Work Group Minutes - Tuesday May 15, 2013=
 
* [[2013_01_PA_WGM|Return to PA January 2013 WGM]]
 
* [[2013_01_PA_WGM|Return to PA January 2013 WGM]]
 
* [[Patient_Administration|Return to PA Main Page]]
 
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| width="50%" colspan="2" align="left" style="background:#f0f0f0;"|'''Date: 2012-01-15'''<br/> '''Time: Tuesday Q1'''
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| width="50%" colspan="2" align="left" style="background:#f0f0f0;"|'''Date: 2012-05-15'''<br/> '''Time: Tuesday Q1'''
 
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| width="50%" colspan="2" align="left" style="background:#f0f0f0;"|'''HL7 Patient Administration Meeting Minutes''' <br/>
 
| width="50%" colspan="2" align="left" style="background:#f0f0f0;"|'''HL7 Patient Administration Meeting Minutes''' <br/>
 
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'''Location: Room #2761'''
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'''Location: Room #1301'''
 
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| width="50%" colspan="2" align="left" style="background:#f0f0f0;"|'''Date: 2012-05-15'''<br/> '''Time: Tuesday Q3'''
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| width="50%" colspan="2" align="left" style="background:#f0f0f0;"|'''Date: 2012-01-15'''<br/> '''Time: Tuesday Q3'''
 
|-
 
|-
 
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| width="10%" colspan="1" align="right"|'''Facilitator'''
 
| width="10%" colspan="1" align="right"|'''Facilitator'''
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| width="35%" colspan="1" align="left"|Alex de Leon
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| width="35%" colspan="1" align="left"|Line Saele
 
| width="25%" colspan="1" align="right"|'''Note taker'''
 
| width="25%" colspan="1" align="right"|'''Note taker'''
 
| width="30%" colspan="1" align="left"|Alex de Leon
 
| width="30%" colspan="1" align="left"|Alex de Leon
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|-
 
|-
−
| X || Irma Jongeneel
+
| X || Line Saele
−
|colspan="2" | HL7 Netherlands
+
|colspan="2" | HL7 Norway
 +
|-
 +
| X || Helen Drijfhout
 +
|colspan="2"| HL7 Netherlands
 +
|-
 +
| X || Nat Wong
 +
|colspan="2" | HL7 Australia
 +
|-
 +
| X || Wendy Huang
 +
|colspan="2" | HL7 Canada
 
|-
 
|-
−
| X || Iryna Roy
+
| X || Vin Sekar
−
|colspan="2"| HL7 Canada
+
|colspan="2" | Nehta
 
|-
 
|-
−
| X || Irma Jongeneel
+
| X || Toril Reite
−
|colspan="2" | HL7 Netherlands
+
|colspan="2" | HVIKT
 
|-
 
|-
 
| X || Barry Guinn
 
| X || Barry Guinn
 
|colspan="2" | EPIC
 
|colspan="2" | EPIC
 +
|-
 +
| X || Richard Kavanagh
 +
|colspan="2" | HL7 UK / NHS England
 +
|-
 +
| X || Ewout Kramer
 +
|colspan="2" | Furore
 +
|-
 +
| X || Graham Grieve
 +
|colspan="2" | Health Intersections, Australia
 +
|-
 +
| X || Rik Smithies
 +
|colspan="2" | HL7 UK
 
|-
 
|-
 
| X || Alex de Leon
 
| X || Alex de Leon
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|-
 
|-
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|colspan="4" |'''Quorum Requirements Met''' (Chair + 4 members): '''Yes'''
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|colspan="4" |'''Quorum Requirements Met''' (Chair + 2 members): '''Yes'''
 
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'''Minutes/Conclusions Reached:'''<br/>
 
'''Minutes/Conclusions Reached:'''<br/>
−
 
+
Introductions. <br/>
−
Graham presented the recent history of FHIR and how it became a part of HL7. The Patient/Person resource was developed as an example of a resource to demonstrate his idea.<br/>
+
After the introduction the WG continued with the reconciliation of the comment ballot spreadsheet with the understanding that the SubjectOfCare vs. Patient discussion which a number of comments address will be discussed later. <br/>
−
 
+
* Comment# 216 MaritalStatus – Lloyd requested in person discussion. <br/>
−
After reviewing the example for person, Irma suggested that we get a definition of what a resource is. It seems that the definition of a resource has not been clearly done.<br/>
+
* Comment # 651 – Accreditation for Organization resource. The WG decided to leave this in . <br/>
−
 
+
* Comment# 652 – Image. Graham will work on creation of an image resource. <br/>
−
Graham explained that a resource is a stand alone entity, separate from a transitional state, for instance.<br/>
+
Action: There will be a reference to 0..* image resource(s). <br/>
−
 
+
* Comment # 565 – Person/Patient vs. (folded in) Patient – Graham began by going over some of the implementations have gone and how the separation of Person and Patient has been difficult for implementers since most implementations use one concept of patient. During FHIR connectathons they would have to query (for instance) using person attributes, then again patient registries. <br/>
−
The group continued to review the Person model which included relationships to qualifications, language and related person.<br/>
+
The WG continued discussion. There were use cases brought up from Norway and Canada that use the Person registries. The idea was presented to take the demographics elements currently within person convert it into a data type that could be shared by provider and patient and possibly person if/when needed.  This seems amenable to the PA work group. <br/>
−
 
+
Action: The PAWG agrees that the FHIR core team should make a person description data structure, containing all the current person attributes, which will be used instead of the current reference to person resource for patient and provider. <br/>
−
Graham continued to explain that there was a need, based on the lack of general support of V3, for a standard based on models that are easily implementable.<br/>
+
* Comment # 565 – This has to do with the Patient vs. Person issue, however, mentions animal, another potential consideration for patient. Graham suggested that we create a data structure within Patient wherein we name the elements that identify that they are used for animals (e.g. patient.animal.species , patient.animal.breed, etc.).  This prompted a discussion as to whether this is 80%. Based on some use cases from Australia and potentially the CDC, the WG decided that the attributes currently in the Animal resource will be copied in to the patient resource, with unique structures to identify their use for animal patients and designated as “must understand”. The animal resource will be removed from the specification. <br/>
−
 
+
<br/>
−
There were discussions about what FHIR is, what problems it solves, and the complexity involved in presenting an alternative in current HL7 standards.<br/>
 
−
 
 
−
Graham presented his stance on the considerations of HL7 standards use within his blog at:<br/>
 
−
 
 
−
www.heathintersection.com.au<br/>
 
−
 
 
−
Current asks for today is a project scope statement.  
 
−
 
 
−
Graham also asked that the PAWG review what has been modeled for the following resources:<br/>
 
−
* Person<br/>
 
−
* Animal<br/>
 
−
* Organization<br/>
 
−
* Agent<br/>
 
−
* Patient<br/>
 
−
 
 
−
The PAWG has agreed to review the current v3 models to try to determine the "core" elements, then compare with the current FHIR model, at which time we will ask for participation of the FHIR modelers to get a perspective as to why elements were included and why not. <br/>
 
−
 
 
−
Graham considered that there might be a few more resources that the PAWG might consider such as:
 
−
* Encounter
 
−
* Admission
 
−
 
 
 
===Meeting Outcomes===
 
===Meeting Outcomes===
 
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*.
 
*.
 
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==Tuesday Q4==
 
==Tuesday Q4==
 
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'''Location: Room# 2761'''
 
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| width="50%" colspan="2" align="left" style="background:#f0f0f0;"|'''Date: 2012-05-15'''<br/> '''Time: Tuesday Q4'''
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| width="50%" colspan="2" align="left" style="background:#f0f0f0;"|'''Date: 2013-01-15'''<br/> '''Time: Tuesday Q4'''
 
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|-
 
|-
−
| X || Line Saele
+
| X || Irma Jongeneel
−
|colspan="2" | HL7 Norway
+
|colspan="2" | HL7 Netherlands
 
|-
 
|-
−
| X || Toril Reite
+
| X || Iryna Roy
−
|colspan="2"| HL7 Norwway
+
|colspan="2"| HL7 Canada
 
|-
 
|-
−
| X || Helen Drijfhout
+
| X || Jane Daus
−
|colspan="2" | HL7 Netherlands
+
|colspan="2" | McKesson
 
|-
 
|-
 
| X || Barry Guinn
 
| X || Barry Guinn
 
|colspan="2" | EPIC
 
|colspan="2" | EPIC
 
|-
 
|-
−
| X || Wendy Huang
+
| X || Alex de Leon
 
|colspan="2"| Kaiser Permanente
 
|colspan="2"| Kaiser Permanente
 
|-
 
|-
 
| X || Nat Wong
 
| X || Nat Wong
 
|colspan="2"| HL7 Australia
 
|colspan="2"| HL7 Australia
−
|-
 
−
| X || Richard Kavanagh
 
−
|colspan="2"| HL7 UK
 
−
|-
 
−
| X || Rik Smithies
 
−
|colspan="2"| HL7 UK
 
−
|-
 
−
| X || Ewout Kramer
 
−
|colspan="2"| Furore
 
−
|-
 
−
| X || Alex de Leon
 
−
|colspan="2"| Kaiser Permanente
 
 
|-
 
|-
 
|colspan="2" |  
 
|colspan="2" |  
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−
* PA DMIM for Patient - Dutch Use Cases
+
* FHIR
  
 
'''Supporting Documents'''<br/>
 
'''Supporting Documents'''<br/>
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'''Minutes/Conclusions Reached:'''<br/>
 
'''Minutes/Conclusions Reached:'''<br/>
−
The WG proceeded with the review of the analysis done by Alexander Henket of the PA DMIM for Patient - Dutch Use Cases. The following actions were taken
+
*
−
 
+
Personnel Management – Consisted of 4 topics. Provider Registry, Organization Registry, Regulatory and Human Resources came from Canadian use cases.
−
Action Item: Replace content from patientEntityChoiceSubject with the current Activate Person R-MIM
+
Organization and Provider went normative October 2002, for release 1 and have had efforts to go to release 2.
−
* Decided to only replace the member structure in the patient activate RMIM with the member structure in the person activate.<br/>
+
Regulatory and Human Resources did not go normative. Wendy, representing Canada, asked if there were artifacts. Gregg Seppala (visiting from the areas) did remember that there were artifacts for this. In this case, Wendy asked that we put the projects on hold.  
−
 
+
Scheduling v3 will also be withdrawn.
−
Action Item: Replace PatientOfOtherProvider.A_PrincipalCareProvision with Role.CareProvision.performer.R_ResponsibleParty.
+
Action: Alex will validate that the artifacts currently in the standard will not be “lost” to the community. Gregg made clear that version 1 of the scheduling standard was not as useful as version 2 of the standard, which contains a lot of functional usage.
−
* The CMET was the newer solution, thererefor this needs to be fixed in the DMIM.
+
* Comment # 216 Marital Status – badly handled as a single code. The discussion The WG considers this to be within the 80% of usage and therefore prefers to retain this as a core element, however, to answer the balloter’s concerns we will update the definition to clarify that this is most recent marital status. Not persuasive with mod.
−
 
+
* 163 Agent (Provider) - Role repetition. This took quite a lot of discussion. Lloyd stated that this should be of cardinality of 0..1 so that it is clear that the provider is acting in a specific role, that may drive security access, system access, etc. This caused some discussions as Canada and Kaiser considers one record with multiple roles, while putting this cardinality would require one record for each role that the provider plays at a specific time (encounter related).
−
The Person topic covers non Patients as well, which means that certain attributes are specific to Patient...
+
*Comment # 166 – Organization – formal/informal – change of definition
−
* For this, the WG decided that we need more information on what the request is, with regarding to some of the listed items. Therefore the WG decided to move on to the other items.<br/>
 
−
 
 
−
Changed Personal relatiohship from E_LivingSubject to E_Person this should align with person activiate so change both or none.  
 
−
* The WG agreed that they shound align and that they should relate to E_Person in both RMIM and D-MIM.
 
−
Added Member2 and relationship to ObservationEvent to support conveying houshold
 
−
* The WG accepts this change.
 
−
Add Citizen.code
 
−
* The WG accepts this addition to patient
 
−
Added Employee.code
 
−
* The WG accepts this addition.
 
−
Added Guardian.Code
 
−
* The WG accepts this addition.
 
−
 
 
−
Patient Revise<br/>
 
−
Give this R-MIM the exact same content below the patientEntityChoiceSubject as Activate Patient
 
−
* The WG accepts this proposal.<br/>
 
−
 
 
−
Patient Demographics<br/>
 
−
Give this R-MIM the exact same content below the patientEntityChoiceSubject as Activate Patient
 
−
* The WG accetps this proposal.<br/>
 
−
 
 
−
Patient Identifiers<br/>
 
−
Replace comparable content in this R-MIM with Person Identifiers
 
−
* The WG accepts this with the clarification that the replacement content is derived from the new Demographic R-MIM with all accepted contstraints.
 
−
 
 
−
Patient Nullify<br/>
 
−
Replace comparable content in this R-MIM with the Person Nullify
 
−
* The WG did not see any difference in the models.<br/>
 
−
 
 
−
Patient Registry Query by Demogrphics
 
−
Why are most query parameters are 0...* which means AND logic? It is unlikely that someone has e.g. mulitple bith times. All value attributs are already 1..* so the OR logic is covered.
 
−
* The cardinality (0..*) on the query parameter is to support RIM query infrastructure.
 
−
 
 
−
Patient Registry Query by Identifier
 
−
Why are most query parameters are 0...* which means AND logic? It is unlikely that someone has e.g. mulitple bith times. Use logic
 
−
* The cardinality (0..*) on the query parameter is to support RIM query infrastructure.  
 
−
 
 
−
Patient Registry Find Candidates Reponses
 
−
* The WG accepts this proposals
 
−
 
 
−
A motion was made by Alex to accept the changes outlined above
 
−
Seconded by Jane
 
−
 
 
−
Vote: 5/0/0
 
−
 
 
 
===Meeting Outcomes===
 
===Meeting Outcomes===
 
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{|border="1" cellpadding="2" cellspacing="0"  

Revision as of 15:35, 16 January 2013

Patient Administration Work Group Minutes - Tuesday May 15, 2013

Tuesday Q1

HL7 Patient Administration Meeting Minutes

Location: Guest Room 1301

Date: 2012-05-15
Time: Tuesday Q1
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Line Saele HL7 Norway
X Toril Rite HL7 Norway.
X Alex de Leon Kaiser Permanente
X Helen Drijfhout HL7 Netherlands
X Nat Wong HL7 Canada
X Barry Guinn EPIC
Quorum Requirements Met (Chair + 4 members): Y

Agenda

Agenda Topics

  • V3 FHIR Comment Ballot Reconciliation

Supporting Documents

Minutes

Minutes/Conclusions Reached:

  • Comment # 149 DOB Already changed. Persuasive
  • Comment# 165 Persuasive
  • Comment# 167 Persuasive
  • Comment# 170 Persuasive
  • Comment# 171 ContactPerson relationship within the Organization resource could be an organization. Suggest rename to contact. The WG agrees with the comment but “Contact” is ambiguous with the contact data type. Persuasive with mod. The WG will discuss the name change and the impact to the constraint.

Action: Discuss name with possible alternatives of “ContactParty” and “ContactEntity”.

  • Comment# 173 Organization Resource – Person is not within the 80%. The attribute will be removed.

Action: Remove Person attribute in ContactPerson (will be renamed from item #171)

  • Comment# 174 Move type to be above address and telecom. WG agrees to move this after name, above address. Persuasive.

Action: Move “type” attribute within the Organization resource below name but above address.

  • Comment# 175 The term "issuer" is clearer. Not all issuers of accreditations will be "institutions" . Persuasive.

Action: Change “institution” in accreditation association to “issuer”.

  • Comment# 179 A portion of name using some kind of phonetic matching algorithm. Referred and tracked.

Action: Refer to Modeling and Methodology.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
Next Meeting/Preliminary Agenda Items
  • .

Tuesday Q2

HL7 Patient Administration Meeting Minutes

Location: Room #1301

Date: 2012-01-15
Time: Tuesday Q2
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Line Saele HL7 Norway
X Toril Reite HL7 Norway
X Helen Drifjhout HL7 Netherlands
X Barry Guinn EPIC
X Alex de Leon Kaiser Permanente
X Nat Wong HL7 Australia
X Christian Hay HL7 GS1
X Lloyd McKenzy HL7 Canada
X Rik Smithies HL7 UK
X Virinder Batra HL7 GS1
X Terje Halvorsen HL7 Norway
X Alexander Henket HL7 Netherlands
X Richard Kavanagh HL7 UK
X Corey Spears Aetna
Quorum Requirements Met (Chair + 2 members): Y

Agenda

Agenda Topics

  • V3 FHIR Comment Ballot Reconciliation

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Lloyd began with a list of items to be discussed that came out of ballots for PA and others.
First, the naming of FHIR items resources, methods, attributes, etc. General naming rules.
Second, boundaries between resources e.g., Patient, Person, Agent
Lloyd proceeded to present draft methodology having to do with naming conventions which outlines guidelines. This will be “test driven” here so that we can measure the usability of it.
This methodology, while being summarized here, is being maintained on the wiki. The MnM WG as part of the FHIR governance is taking the stance that methodology will be defined as there are needs to be met (rather than define all possible scenarios).
The joint WG moved into addressing the list of items against the draft methodology. During discussion, it was clarified that aliases do not have to conform to these rules. Within the spreadsheets, this is a new column called “Aliases”.

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
Next Meeting/Preliminary Agenda Items
  • .

Tuesday Q3

HL7 Patient Administration Meeting Minutes

Location: Room #1301

Date: 2012-01-15
Time: Tuesday Q3
Facilitator Line Saele Note taker Alex de Leon
Attendee Name Affiliation
X Line Saele HL7 Norway
X Helen Drijfhout HL7 Netherlands
X Nat Wong HL7 Australia
X Wendy Huang HL7 Canada
X Vin Sekar Nehta
X Toril Reite HVIKT
X Barry Guinn EPIC
X Richard Kavanagh HL7 UK / NHS England
X Ewout Kramer Furore
X Graham Grieve Health Intersections, Australia
X Rik Smithies HL7 UK
X Alex de Leon Kaiser Permanente
X Oyvind Aassve HL7 Norway
X Graham Grieve
X Ewout Kramer Furore
X Norman Doust Doust & Associates
X Nat Wong HL7 Australia
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  • FHIR Discussion - Next Steps

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Introductions.
After the introduction the WG continued with the reconciliation of the comment ballot spreadsheet with the understanding that the SubjectOfCare vs. Patient discussion which a number of comments address will be discussed later.

  • Comment# 216 MaritalStatus – Lloyd requested in person discussion.
  • Comment # 651 – Accreditation for Organization resource. The WG decided to leave this in .
  • Comment# 652 – Image. Graham will work on creation of an image resource.

Action: There will be a reference to 0..* image resource(s).

  • Comment # 565 – Person/Patient vs. (folded in) Patient – Graham began by going over some of the implementations have gone and how the separation of Person and Patient has been difficult for implementers since most implementations use one concept of patient. During FHIR connectathons they would have to query (for instance) using person attributes, then again patient registries.

The WG continued discussion. There were use cases brought up from Norway and Canada that use the Person registries. The idea was presented to take the demographics elements currently within person convert it into a data type that could be shared by provider and patient and possibly person if/when needed. This seems amenable to the PA work group.
Action: The PAWG agrees that the FHIR core team should make a person description data structure, containing all the current person attributes, which will be used instead of the current reference to person resource for patient and provider.

  • Comment # 565 – This has to do with the Patient vs. Person issue, however, mentions animal, another potential consideration for patient. Graham suggested that we create a data structure within Patient wherein we name the elements that identify that they are used for animals (e.g. patient.animal.species , patient.animal.breed, etc.). This prompted a discussion as to whether this is 80%. Based on some use cases from Australia and potentially the CDC, the WG decided that the attributes currently in the Animal resource will be copied in to the patient resource, with unique structures to identify their use for animal patients and designated as “must understand”. The animal resource will be removed from the specification.


Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • .
Next Meeting/Preliminary Agenda Items
  • .

Tuesday Q4

HL7 Patient Administration Meeting Minutes

Location: Room# 2761

Date: 2013-01-15
Time: Tuesday Q4
Facilitator Irma Jongeneel Note taker Alex de Leon
Attendee Name Affiliation
X Irma Jongeneel HL7 Netherlands
X Iryna Roy HL7 Canada
X Jane Daus McKesson
X Barry Guinn EPIC
X Alex de Leon Kaiser Permanente
X Nat Wong HL7 Australia
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  • FHIR

Supporting Documents

Minutes

Minutes/Conclusions Reached:

Personnel Management – Consisted of 4 topics. Provider Registry, Organization Registry, Regulatory and Human Resources came from Canadian use cases. Organization and Provider went normative October 2002, for release 1 and have had efforts to go to release 2. Regulatory and Human Resources did not go normative. Wendy, representing Canada, asked if there were artifacts. Gregg Seppala (visiting from the areas) did remember that there were artifacts for this. In this case, Wendy asked that we put the projects on hold. Scheduling v3 will also be withdrawn. Action: Alex will validate that the artifacts currently in the standard will not be “lost” to the community. Gregg made clear that version 1 of the scheduling standard was not as useful as version 2 of the standard, which contains a lot of functional usage.

  • Comment # 216 Marital Status – badly handled as a single code. The discussion The WG considers this to be within the 80% of usage and therefore prefers to retain this as a core element, however, to answer the balloter’s concerns we will update the definition to clarify that this is most recent marital status. Not persuasive with mod.
  • 163 Agent (Provider) - Role repetition. This took quite a lot of discussion. Lloyd stated that this should be of cardinality of 0..1 so that it is clear that the provider is acting in a specific role, that may drive security access, system access, etc. This caused some discussions as Canada and Kaiser considers one record with multiple roles, while putting this cardinality would require one record for each role that the provider plays at a specific time (encounter related).
  • Comment # 166 – Organization – formal/informal – change of definition

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • .
Next Meeting/Preliminary Agenda Items
  • .

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