2016-02-29 Rx Conf Call

Attendees to be updated

• Marla Albitz (Chair, Scribe)
• John Hatem
• Daniel Zhang
• Michelle Miller
• Jose Costa Teixeira
• Scott Robertson
• Lee Surprenant

ListServ

• Link to Posting
• no new items

Pharmacy FHIR Issues

Renaming MedicationOrder to MedicationRequest Discussion

• From January 25 meeting: Lloyd shared the proposal to rename all request type resources to <resource>_Request. Seeking consistent name for all resources and term that encompasses larger swath of types of requests. An element beneath the tag instance would state the particular request, such as 'order'. This impacts the current Pharmacy Medication Order FHIR resource.

 Completed Action: Rx WG to discuss to determine if we agree or not. - agreed (with no vote) to comply with change but not needed to be made yet, per Lloyd

• Lloyd suggested that we hold off on making the change, if we decide to make the change. Wait for FHIR Infrastructure group to workout additional details before we make the changes. May have impact on how other data elements are name or included.
• Discussion: If we agree to the change, we'll need to review the description and other content for our resource to ensure that it accurately reflects the usage. This type of change will mean changes for implementers and it may not be as intuitive for implementers.
  • No decision to be made today. Will consider on a future call

 Action: to followup with Lloyd to find out status and/or next steps

FHIR Workflow Meetings Status

• For statuses - what we have so far is correct - may need to remove "superseded" as a status - need to find a different way to represent a relationship between 2 orders

Action:  Melva to add change request to GForge

John provided update to workflow meeting activities: discussions have occurred about the status types. Today, the discussions focused the relationships between a request and a task. Not quite ready to test against the Rx use cases.

 Action: (Chair for next meeting) To add agenda item to discuss Pharmacy workflow in the context internally, then take to the FHIR workflow work discussions .
 
 Action: John to reach out to Lloyd to ask for timing of Pharmacy input for the FHIR workflow discussions.

FHIR Ballot Discussion Items

• SEE SPREADSHEET OF OUTSTANDING CHANGE REQUESTS 2016-01-25 IN DROPBOX

GROUPINGS
A = Dosage Related     B = Terminology     
C = Misc               D =
E = Examples           F = Multiple indications/reason for order
G = Status             H = Medication Related
I = Mappings

 Action: Marla to commit RIM mapping changes provided by John H.

Vote on whether the following changes are "persuasive".

Regarding the Medication resource not having a status just yet (QA issue / change request 9604)…

• FHIR spec currently reads: “Medication does not have a status. If Medication was used to support a formulary use case, then an extension can be used to convey formulary statuses, such as active (e.g. the medication can be ordered) or inactive (e.g. the medication can be documented, but not ordered).”
• Lloyd’s comment was Pharmacy indicates an intention to use an extension to differentiate "active" vs. "inactive". This would have to be a modifier extension, so unless you think it's going to be exceptionally rare, it's probably better to have it as a core element….. Medication instances are a pseudo formulary anyhow unless they're "contained”

http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=5925 Persuasive: Motion Michelle, Second John 6:0:0

http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=9604 Change wording to "Medication does not have a status. Pharmacy is evaluating formulary use cases. Feedback is encouraged to the Pharmacy working group committee." Persuasive: Motion John Second Michelle 6:0:0

http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=8021 Persuasive: Motion Michelle, Second Scott 6:0:0

Catalogue PSS

• Jose to draft the start of a PSS

[Draft PSS Posting http://lists.hl7.org/read/messages?id=288115#288115]

Completed Action: Jose to send reminder to group to review PSS.

Joint Meeting with ISO/IHE Pharmacy DEFERRED

Action:  Melva to check on availability of meeting room in Montreal - in progress

Template Work DEFERRED

• Kai to let Pharmacy know when ready for review

Action:  Melva to followup with Kai to get a status

NCCN template orders - DEFERRED

• Lee Suprenant requested input on the ChemotherapyOrderTemplates work.

 Action: Lee will document the items that should be targeted for Pharmacy.

• Lee requests time in the next call for further discussion or a separate call.
• Lee completed categorization, needs next steps identified for the columns marked as "maybe".

• On 2/8 - reviewed Lee's categorizations

 Completed Action: Lee to distribute updates to the group.

• Lee plans to continue to join our calls as we work through the list.
• John recommended we would through the list before Lee takes the list to the FHIR workgroup.

Action: To add this to next week's agenda. Lee will be attending.

Next meeting

• Monday, March 7, 2016
  • NCCN template orders
  • To add agenda item to discuss Pharmacy workflow in the context internally, then take to the FHIR workflow work discussions .
  • vote on GForge #9164