|
|
| Line 334: |
Line 334: |
| | <td>25</td> | | <td>25</td> |
| | <td>Care Plan -invite FHIR, Structured Docs, Pharmacy | | <td>Care Plan -invite FHIR, Structured Docs, Pharmacy |
| − | HL7 C-CDA 2.1 Care Plan Document Template - Lisa Nelson | + | * HL7 C-CDA 2.1 Care Plan Document Template - Lisa Nelson |
| − | HL7 Care Plan Domain Analysis Model/FHIR Harmonization - Laura Heermann/EMma Jones | + | * HL7 Care Plan Domain Analysis Model/FHIR Harmonization - Laura Heermann/EMma Jones |
| − | HL7 Care Coordination Services (CCS) functional model - LH/EJ | + | * HL7 Care Coordination Services (CCS) functional model - LH/EJ |
| − | HL7 CDA R2 Personal Advanced Care Plan Document - Lisa Nelson | + | * HL7 CDA R2 Personal Advanced Care Plan Document - Lisa Nelson |
| − | HL7 FHIR Care Plan Resource - LH/EJ | + | * HL7 FHIR Care Plan Resource - LH/EJ |
| − | IHE PCC Dynamic Care Planning Profile- EJ | + | * IHE PCC Dynamic Care Planning Profile- EJ |
| − | IHE QRPH Early Hearing Detection and Intervention (EHDI) Plan of Care- Lisa Nelson | + | * IHE QRPH Early Hearing Detection and Intervention (EHDI) Plan of Care- Lisa Nelson |
| − | HL7 Clinical Oncology Treatment Plan and Summary - Jeff Brown | + | * HL7 Clinical Oncology Treatment Plan and Summary - Jeff Brown |
| − | NCPDP/HL7 Pharmacist Care Plan - Shelly Spiro | + | * NCPDP/HL7 Pharmacist Care Plan - Shelly Spiro |
| − | Care team members definition update (Laura/Emma) | + | * Care team members definition update (Laura/Emma) |
| − | Child special needs | + | * Child special needs |
| − | Care Plan/Care Team Implementations | + | * Care Plan/Care Team Implementations |
| | | | |
| | Check the minutes ....</td> | | Check the minutes ....</td> |
| Line 469: |
Line 469: |
| | | | |
| | | | |
| − | == '''Madrid, Spain, WGM - May 2017. Patient Care WG Meeting Meeting Minutes''' == | + | == '''San Diego, WGM - Sept 2017. Patient Care WG Meeting Meeting Minutes''' == |
| | | | |
| − | === Sunday, May 7 === | + | === Sunday, Sept 10 === |
| | | | |
| | : International Council Meeting | | : International Council Meeting |
| Line 479: |
Line 479: |
| | <BR> | | <BR> |
| | | | |
| − | =='''Patient Care WGM, Monday, May 8, 2017'''== | + | =='''Patient Care WGM, Monday, Sept 11, 2017'''== |
| | | | |
| | * Back to [[Patient Care]] | | * Back to [[Patient Care]] |
| Line 501: |
Line 501: |
| | === Patient Care Monday Q2 === | | === Patient Care Monday Q2 === |
| | | | |
| − | '''Chair''': EHR Hosting other WG<br>
| + | General Plenary session |
| − | | + | No meeting from Patient Care |
| − | | |
| − | | |
| − | | |
| − | '''Minutes'''<br>
| |
| − | * EHR: many functional profiles, completed & in process
| |
| − | * CQI: consolidation of measure and decision support tactics
| |
| − | * PC presented [[media: Patient_Care_Mega_May_2017.pptx | slides]]
| |
| − | | |
| − | | |
| − | | |
| − | | |
| | | | |
| | <BR> | | <BR> |
| Line 519: |
Line 508: |
| | === Patient Care Monday Q3 === | | === Patient Care Monday Q3 === |
| | | | |
| − | '''Chair''': Michelle Miller <br> | + | '''Chair''': EHR <br> |
| − | '''Scribe''': Michael Tan <br> | + | '''Scribe''': <br> |
| | | | |
| | | | |
| | '''Attendees''' | | '''Attendees''' |
| − | *Ewout Kramer
| |
| − | *Marten Smits
| |
| − | *Russ Leftwich
| |
| − | *Stefan Lang
| |
| − | *Masaaki Hirai
| |
| − | *Yukimori Konishi
| |
| − | *Sadama Takaraba
| |
| − | *Jay Lyle
| |
| − | *Beau Bannerman
| |
| − | *Emma Jones
| |
| − |
| |
| − |
| |
| − |
| |
| | | | |
| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − | *Review agenda of WGM agenda
| |
| − | **Wednesday RCRIM no invitation received. Is this still on?
| |
| − | **No one from PC on Thursday Q3
| |
| − | **Wednesday Q3 is a joint with O&O. Negation will be discussed on Tuesday Q4..
| |
| − | **Wednesday lunch session for Clinicians on FHIR will be in Santa Ollalla.
| |
| − | **Patient Care Tuesday Q1 will need to discuss a PSS dietary. This will be discussed during the CIMI session.
| |
| − | **No further comments on the agenda.
| |
| − | *Meeting notes of HL7 WGM January
| |
| − | **Laura moved to approve the notes WGM January 2017. Emma seconds
| |
| − | **13 in favour, 0 against, 0 abstentions.
| |
| − | *FHIR
| |
| − | **E-mail from Lloyd to all co-chairs. Which resources are candidates for the next normative publication? Deadline is April 2018. Allergies, Conditions and procedures have reached maturity level 3 and are the candidates to be promoted. The maturity level defines which resources are tested and proven that are mature enough to go to level 4. The gut feeling is that we are not ready for December.
| |
| − | **Allergy and intolerances still have issues with adverse events.
| |
| − | **The issue with Condition are about Health Concerns. Clinical Status still raises discussions on the value set. ( active, recurrence. Relapse, well controlled, poorly controlled, inactive, remission, resolved).
| |
| − | **Procedure and Procedure statements could be split, similar to medication and medication statement, for example a patient saying he has had an operation when he was a kid.
| |
| − | **Discussion arises how maturity is decided. We should have a general approach for accepting normative. For example a QA spreadsheet or looking at Zulip. Should be measurable and formalized by FMG.
| |
| − | **This concludes that we have no resources fit for promotion to normative status.
| |
| − | **Are there specific preferences for PC resources to be put on the short lists for the normative?
| |
| − | **Are there any new resources to be developed? Adverse event, procedure statements,( not PC).
| |
| − | **Maturity levels changed? Care Plan , Goal and Care team are now level 2. Family member history also 2. Has there been any experience in a Connectathon? Ewout is looking at technical connectathons. But the result is usually a self-report. It is more a sense of how stable a resource is.
| |
| − | **There is some feeling about which resources are being referenced in Zulip. Nobody has a firm finding which resources are mature.
| |
| − | **Should we make distinction between technical maturity and clinical maturity? Issue for the FMG? Laura has worries, especially if patient safety is concerned.
| |
| − | **Emma brings in the vendors point of view, that IT vendors want to roll out FHIR structures without the risk of redeveloping the software on a new release. You will also need to convince users to start using the resources.
| |
| | | | |
| | <BR> | | <BR> |
| | | | |
| − | === Patient Care Monday Q4a === | + | === Patient Care Monday Q4 === |
| | | | |
| − | '''Chair''': OO <br> | + | '''Chair''': <br> |
| − | '''Scribe''': Emma <br> | + | '''Scribe''': <br> |
| | | | |
| | | | |
| | '''Attendees''' | | '''Attendees''' |
| − | * taken by OO
| |
| − |
| |
| | | | |
| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − | * Please see [http://wiki.hl7.org/index.php?title=FHIR_Workflow_Minutes_WGM_201705 Lloyd's workflow notes]
| |
| − |
| |
| − | <BR>
| |
| − |
| |
| − | === Patient Care Monday Q4b ===
| |
| − |
| |
| − | '''Chair''': Michelle Miller<br>
| |
| − | '''Scribe''': Michael Tan
| |
| − |
| |
| − |
| |
| − | '''Attendees'''<br>
| |
| − | Michelle Miller<br>
| |
| − | Michael Tan<br>
| |
| − | Dennis Patterson<br>
| |
| − | Danielle Friend<br>
| |
| − | Marten Smits<br>
| |
| − | Ardon Toonstra<br>
| |
| − | Jay Lyle<br>
| |
| − |
| |
| − |
| |
| − |
| |
| − | '''Minutes'''<br>
| |
| − | Flag
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12798 GF#12798] Flag resource should allow for a Condition reference as subject (Ardon Toonstra) -- withdrawn
| |
| − |
| |
| − | FamilyMemberHistory
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=8782 GF#8782] NoKnown[X] for FamilyMemberHistory (Danielle Friend) -- non-substantive
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=8781 GF#8781] FamilyMemberHistory Should be Patient, not Relative Centric (Danielle Friend) -- non-substantive
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=9028 GF#9028] Use SCT values rather than V3 for family history relationship (Jay Lyle) -- Deferred
| |
| − |
| |
| − | List
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=8784 GF#8784] Proposed History Resource (Danielle Friend) -- Withdrawn
| |
| − |
| |
| − | Condition/Observation
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11026 GF#11026] Relationship between Condition and Observation - 2016-09 core #45 (Jay Lyle) -- Waiting For Input
| |
| − |
| |
| − | FHIR tracker items
| |
| − | *9028 Mapping of SNOMED codes to V3 codes for family relations. ( example binding);
| |
| − | **Found SNOMED codes for most of them, but some were not found.
| |
| − | **VA desires to use SNOMED, but it is not a hard requirement. Michelle remarks that it is an example binding and if the VA wants to use the SNOMED, then they could use it. SNOMED could add the V3 values to SNOMED. Clinical genomics require certain values on the relationships such as natural father of fetus.
| |
| − | **Motion to defer the request until SNOMED has harmonized their value set. Request at SNOMED will be placed by Jay.
| |
| − | **Move Jay second Danielle: Vote 6 in favor, 0 abstentions, 0 against
| |
| − | *8782 Danielle ( EPIC) Often “no known history” of patients. How do I express this?
| |
| − | **This is resolved when the value set was updated with an extra SNOMED code: “no current problems or disability”. Similarity with conditions. Have to add a note on the conditions, because the value set is shared.
| |
| − | **Move Danielle, second Marten: Vote 6 in favor, 0 abstentions, 0 against
| |
| − | *8781 “no known problems” On the patient level.
| |
| − | **Lloyd suggests to use list. List empty reason
| |
| − | **Move Danielle, second Marten: Vote 6 in favor, 0 abstentions, 0 against
| |
| − | *10508 Gap in the entry . It mentions events and conditions, but it does not cover this topic anymore and only mentions conditions. Comment is deferred.
| |
| − | *8784 Requirement to have a broader usage of family history.
| |
| − | **Discussion postponed.
| |
| − | *12798 flag resource should allow a Condition reference as subject on a non-patient condition. It is related to the “Alerts” in NL. But the issue is withdrawn because the use case is not completely clear.
| |
| − | *13201 Discussion on outcome of clinical status ( inactive, resolved or remission. ) and Abated. Why do we need abatement? This discussion is postponed until we have clinicians to explain the use case of abatement.
| |
| − | *11026. Distinction between conditions and observations. The boundary is rather subjective, but there is explanation in the wiki. These resources will not be merged. They should however be of similar construction. This is a broad topic and Jay should provide more explanation. Waiting for input from Jay.
| |
| − |
| |
| − |
| |
| − |
| |
| − | <BR>
| |
| − |
| |
| − | === Patient Care Monday Q4c ===
| |
| − |
| |
| − | '''Chair''': <br>
| |
| − | '''Scribe''': <br>
| |
| − |
| |
| − |
| |
| − | '''Attendees'''
| |
| − |
| |
| − |
| |
| − |
| |
| − |
| |
| − | '''Minutes'''<br>
| |
| − |
| |
| − |
| |
| | | | |
| | | | |
| Line 665: |
Line 543: |
| | <BR> | | <BR> |
| | | | |
| − | =='''Patient Care WGM, Tuesday, May 9, 2017'''== | + | =='''Patient Care WGM, Tuesday, Sept 12, 2017'''== |
| | | | |
| | * Back to [[Patient Care]] | | * Back to [[Patient Care]] |
| Line 677: |
Line 555: |
| | === Patient Care Tuesday Q1 === | | === Patient Care Tuesday Q1 === |
| | | | |
| − | '''Chair''': Laura Heerman-Langford <br> | + | '''Chair''': <br> |
| − | '''Scribe''': Emma Jones <br> | + | '''Scribe''': <br> |
| | | | |
| | | | |
| | '''Attendees''' | | '''Attendees''' |
| − | * See [https://docs.google.com/spreadsheets/d/1NoT7dU0sO0VLmtPn2o5bz45sUdkvng8T7gYPiBHFuhk/edit#gid=0 Attendee list]
| + | |
| − | '''Agenda'''
| |
| − | * Podiatry EHR SFM PSS
| |
| − | * Skin model update
| |
| − | * CLIM project
| |
| | | | |
| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − | * Podiatry EHR SFM PSS
| |
| − | ** Brought forward by practicing podiatrist - American Podiatry Association and Vendors in the podiatry space. Many of the people new to the standards development process
| |
| − | ** Gaps have been identified in EHR functional model as it relates to this domain. For example, physician dispense samples - no good workflow to handle this; no tool in the EHR for devices implanted
| |
| − | or wound treatment
| |
| − | **Best route when CIMI is co-sponsoring a model - the requesting group will be the owner
| |
| − | Not just patient care
| |
| − | ** PC will consider offline
| |
| − | **CIMI is documenting the process
| |
| − | ***Patient is a strong advocate of CIMI. Need for CIMI to teach us how we can get other groups engaged
| |
| − | ** Resulting discussion of SFM/DAM/DCM process. Draft:
| |
| − | *** 1. Clinical use cases
| |
| − | *** 2. DAM
| |
| − | *** 3. EHR System Functional Model profiling (decomposition/elaboration of DAM cases)
| |
| − | *** 4. DCM
| |
| − | *** 5. implementable specification
| |
| − | ** Further discussion in CIMI/CIC meeting Wednesday
| |
| − |
| |
| − | * Skin model
| |
| − | ** SOLOR modeling of skin assessment concepts
| |
| − | *** Further discussions on CIMI Skin project, probably Friday mornings ET.
| |
| − | ** Semantics of CIMI assertion & evaluation patterns (a.k.a. Condition & Observation)
| |
| − | *** To the extent this discussion informs FHIR, it goes through PC (and loop in OO)
| |
| − | ** Fall ballot:Vitals & labs
| |
| − | ** Project ownership; transition to CIMI
| |
| − | *** To do: confirm current PSS closure criteria. Close and re-start to address broader scope, possible change of sponsor.
| |
| − | *Stefan Hufnagle project CLIM making progress
| |
| | | | |
| | <br> | | <br> |
| | | | |
| − | === Patient Care Tuesday Q2a === | + | === Patient Care Tuesday Q2 === |
| − | | |
| − | '''Chair''': Michelle Miller <br>
| |
| − | '''Scribe''': Michael Tan <br>
| |
| − | | |
| − | | |
| − | '''Attendees'''
| |
| − | | |
| − | [http://bit.ly/HL7PC_May17_Attendees]
| |
| − | | |
| − | | |
| − | '''Minutes'''<br>
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11021 GF#11021] Increase cardinality of substance and make certainty relation to substance not reaction - 2016-09 core #40 (Jay Lyle) - need to discuss jointly with BR&R (formally known as RCRIM)
| |
| − | * GF11021 Allergy : Certainty can change overtime. The substance is preferably stored in code, because this is where Clinical Decision Support would be looking at. Resolution to remove reaction and instead replace with a reference to adverse reaction. Options^:
| |
| − | **Keep reaction embedded in Allergy
| |
| − | **Slim down the reaction ( move substance out of the resource).
| |
| − | **Reference to observation
| |
| − | **Make adverse reaction a separate resource
| |
| − | **Make adverse event a separate resource.
| |
| − | *Difference between adverse reaction and event is that an adverse reaction is strongly related to the patient ( disposition for a medicine). An event is more related to a context, such as falling out of bed. Possibly an event is an overarching event, where adverse reaction to a drug is a component of the adverse event. The event is also meant for reporting purposes. The event is the action of giving medication to a patient, while a reaction is the outcome.
| |
| − | *Consider that when the event occurs you might not know whether it really is an allergy. You may suspect that it is an allergy, but it could be caused by other reasons such as empty stomach.
| |
| − | *Jay withdraws his request to refer to observation. (gf 11023).
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11023 GF#11023] Why isn't AllergyIntolerance.reaction an Observation? - 2016-09 core #42 (Jay Lyle) - withdrew
| |
| − | *Can you have reference to a backbone element? And query it?
| |
| − | *Current EHR systems usually record the adverse events in a separate system.
| |
| − | *For creating a new resource ( adverse reaction) you have to prove why adverse event is inadequate. Adverse event is owned by BRR ( formerly RCRIM).
| |
| − | *Need to test this out in Clinicians for FHIR.
| |
| − | *Allergy & Intolerance is usually used for patient safety reasons. In that case you should keep the resource simple.
| |
| − | *GF 12623 care plan activity status.
| |
| − | **Value set: not started, scheduled, in progress, on hold…..
| |
| − | **Missing abandoned. There is cancelled. What are the characteristics? Who abandoned, after start of before start? There is an element called statusreason where you can express a reason why it is cancelled. Do we need a hierarchy ( ended, with abandoned and cancelled. Discussion will be continued.
| |
| − | | |
| − | === Patient Care Tuesday Q2b ===
| |
| − | | |
| − | '''Chair''': SOA <br>
| |
| − | '''Scribe''': Emma Jones <br>
| |
| − | | |
| − | | |
| − | '''Attendees'''
| |
| − | Attendance taken by SOA
| |
| − | | |
| − | | |
| − | | |
| − | '''Minutes'''<br>
| |
| − | | |
| − | *Ken Rubin not present.
| |
| − | *Update given that CCS has been published on HL7 products page.
| |
| − | *No new information on OMG use of care plan
| |
| − | *SOA has a report out on Mondays - would prefer to have this meeting then instead of on Tuesday - next WGM
| |
| − | | |
| − | === Patient Care Tuesday Q3a ===
| |
| | | | |
| − | '''Chair''': Michelle Miller <br> | + | '''Chair''': <br> |
| − | '''Scribe''': <br> | + | '''Scribe''': <br> |
| | | | |
| | | | |
| | '''Attendees''' | | '''Attendees''' |
| − |
| |
| − | [http://bit.ly/HL7PC_May17_Attendees]
| |
| | | | |
| | | | |
| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − | CarePlan/Goal
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11359 GF#11359] Why only one medication in an activity? And the value set is problematic (but example) - 2016-09 core #517 (Robert McClure) -- Not Persuasive / No Change
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11355 GF#11355] CarePlan category value set is out of date or wrong - 2016-09 core #513 (Robert McClure) -- Not Persuasive / No Change
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10622 GF#10622] QA 4a: Consider whether Goal.category should be bound to codes from an external code system (Michelle Miller) -- Not Persuasive / No Change, but need to revisit
| |
| | | | |
| − | Communication
| + | === Patient Care Tuesday Q3 === |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13306 GF#13306] Communication Extension: reasonNotPerformed is redundant (Eric Haas) -- Persuasive
| |
| | | | |
| − | === Patient Care Tuesday Q3b ===
| + | '''Chair''': <br> |
| − | | |
| − | '''Chair''': <br> | |
| | '''Scribe''': <br> | | '''Scribe''': <br> |
| | | | |
| | | | |
| | '''Attendees''' | | '''Attendees''' |
| − |
| |
| − |
| |
| | | | |
| | | | |
| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − |
| |
| − |
| |
| − |
| |
| − |
| |
| − | <br>
| |
| | | | |
| | === Patient Care Tuesday Q4 === | | === Patient Care Tuesday Q4 === |
| | | | |
| − | '''Chair''': Jay Lyle <br> | + | '''Chair''': <br> |
| − | '''Scribe''': Michael Tan <br> | + | '''Scribe''': <br> |
| | | | |
| | | | |
| | '''Attendees''' | | '''Attendees''' |
| − | [http://bit.ly/HL7PC_May17_Attendees]
| |
| | | | |
| | '''Agenda''' | | '''Agenda''' |
| − | * Negation ballot comments
| |
| − | * Negation analysis; possible tactics for policy
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12633 GF#12633] Split Procedure into Procedure and ProcedureStatement (Lloyd McKenzie) -- agreement for PC to do the analysis
| |
| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13201 GF#13201] Condition Xpath constraint con-4 is not correct (Ardon Toonstra) -- Persuasive with Mod
| |
| − |
| |
| − |
| |
| | | | |
| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − |
| |
| − | *Nr, ? Comment ballot: Should use CDA examples. Disposition: Persuasive.
| |
| − | **Richard Move; Rob Second. Vote : 21 in favor, 1 abstain, 0 against
| |
| − | *Organize better table or remove it. Disposition to include definitions of columns in the text and explain and in the key.
| |
| − | **Richard Move; Rob Second. Vote : 22 in favor, 1 abstain, 0 against
| |
| − | *Commenter does not know what the table means
| |
| − | **Susan Move; Rob Second. Vote : 21 in favor, 1 abstain, 0 against
| |
| − | *Nr. 26, 27, 69 numbers and headings
| |
| − | **Susan Move; Rob Second. Vote : 23 in favor, 1 abstain, 0 against
| |
| − | *Nr 30, and 70 definitions all seem persuasive. Motion to make the definition:
| |
| − | **Galen move Second Susan: Vote : 23 in favor, 1 abstain, 0 against
| |
| − | *Nr. 36 will provide explanation:
| |
| − | **Galen move Second Claude: Vote : 24 in favor, 0 abstain, 0 against
| |
| − | *Nr. 32, 33 and 37 and 39 will be rewritten:
| |
| − | **Additional editors volunteering to provide text.
| |
| − | *Galen move Second Susan: Vote : 25 in favor, 0 abstain, 0 against
| |
| − | **Nr.46 there are no standard formats: will be refrased. There are formats, but none are standard.
| |
| − | **Galen move Second Claude: Vote : 25 in favor, 0 abstain, 0 against
| |
| − | *Nr. 47 question answered. Need to talk to Lisa.
| |
| − | *Nr. 51 the classes in the appendices will be aligned. Persuasive
| |
| − | **Rob move Second Galen: Vote : 25 in favor, 0 abstain, 0 against
| |
| − | *Nr. 60 the document is not a DAM. No requirements: There are requirements; Not persuasive. It does contain requirements.
| |
| − | **Galen move Second Claude: Vote : 25 in favor, 0 abstain, 0 against
| |
| − | *Nr. 63 needs an better example. The given example is also not valid. Susan provides a better example.
| |
| − | **Richard move, second Susan; Vote : 21 in favor, 0 abstain, 0 against
| |
| − | *Nr. 71 will include principles:
| |
| − | **Galen move, second Susan; Vote : 21 in favor, 0 abstain, 0 against
| |
| − | *Nr. 83 Prohibition: Don’t do something: Not persuasive but will add more clarification.
| |
| − | **Galen move, second Richard; Vote : 20 in favor, 1 abstain, 0 against
| |
| − | FHIR Procedure resource
| |
| − | *Up till now procedure capture procedures information as history, but there is also a need to capture data for management purposes. These are 2 different needs and scenario;s.
| |
| − | **Options:
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| − | ***2 different resources
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| − | ***1 resource with an extra flag.
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| − | **These would be similar to medication administration and medication statement. I.e. procedure versus procedure statement.
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| − | **The should be alignment with other resources. PC would apply the same policy towards procedure and procedure statements.
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| − | **Also need to analyse how the different resources would look like before a decision is made. Need to look which attributes goes into which resource.
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| − | **Also need to look into GF issues that have comments related to the split.
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| − | **Vendors ( Cerner, EPIC) need to check
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| − | **Lloyd: Motion PC need to make a initiative to make an analysis to make 2 separate resources, Michelle Second: Vote 20 in favor, 0 abstain, 0 against.
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| − | *GF 13201: Condition : status: should we have a rule that abatement ( Boolean= false) and status not contradicting the Boolean. What is the use case for abatement? This can be reflected by status. Motion to remove the Boolean. But the remaining fields of abatement are still there. They should be in line with status. Stan Huff has not seen any system capturing abatement. Michelle moves a motion, second Galen.
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| − | **Vote 20 in favor, 0 abstain, 0 against
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| | <BR> | | <BR> |
| | | | |
| − | =='''Patient Care WGM, Wednesday, May 10, 2017'''== | + | =='''Patient Care WGM, Wednesday, Sept 13, 2017'''== |
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| | * Back to [[Patient Care]] | | * Back to [[Patient Care]] |
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| | === Patient Care Wednesday Q1 === | | === Patient Care Wednesday Q1 === |
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| − | '''Chair''': Michelle Miller <br> | + | '''Chair''': <br> |
| − | '''Scribe''': Emma Jones <br> | + | '''Scribe''': <br> |
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| | '''Attendees''' | | '''Attendees''' |
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| − | * See [https://docs.google.com/spreadsheets/d/1NoT7dU0sO0VLmtPn2o5bz45sUdkvng8T7gYPiBHFuhk/edit#gid=0 Attendee list]
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| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − |
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| − | CarePlan
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11332 GF#11332] Acknowledge Advance Directives as type of Care Plan - 2016-09 core #490 (David Tao) -- need representation from Community Based Collaborative Care (CBCC), who is working on Consent -- Resolved
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| − |
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| − | CareTeam
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13233 GF#13233] add careteam to endpoint (Eric Haas) -- Resolved
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13293 GF#13293] XPath in CareTeam invariant is too restrictive (James Agnew) -- Resolved
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13338 GF#13338] careteam into and scope to be clearer about group (Brian Postlethwaite) -- Resolved
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| | <BR> | | <BR> |
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| − | === Patient Care Wednesday Q2a === | + | === Patient Care Wednesday Q2 === |
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| | '''Chair''': Brian P. (Patient Admin hosted quarter) | | '''Chair''': Brian P. (Patient Admin hosted quarter) |
| − | '''Scribe''': Michelle Miller <br> | + | '''Scribe''': <br> |
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| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − | PC/LHS gave PA a brief update on CareTeam related work
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12509 GF#12509] CareTeam participant
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13338 GF#13338] careteam into and scope to be clearer about group (Brian Postlethwaite)
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| − |
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| − | Resolved PA tracker:
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13146 GF#13146] Separate .relation and .role on RelatedPerson -- agreed that CareTeam.participant can be used for Power of Attorney (i.e. don't add role to RelatedPerson), but it is ok to support multiple RelatedPerson.relationship to meet requirements around grandmother AND legal guardian
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| − |
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| − | CareTeam DAM update given by Russ Leftwich
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| − |
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| − | === Patient Care Wednesday Q2b ===
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| | | | |
| − | Meeting combined with Q2a
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| − | | + | === Patient Care Wednesday Q3 === |
| − | <BR>
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| − | | |
| − | === Patient Care Wednesday Q3a === | |
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| | '''Chair''': <br> | | '''Chair''': <br> |
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| − |
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| − | '''Minutes'''<br>a
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| − |
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| − | === Patient Care Wednesday Q3b ===
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| − |
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| − | '''Chair''': Michelle Miller <br>
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| − | '''Scribe''': Riki Merrick <br>
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| − |
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| − |
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| − | '''Attendees'''
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| − |
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| − | [http://bit.ly/HL7PC_May17_Attendees]
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| | | | |
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| | '''Minutes'''<br> | | '''Minutes'''<br> |
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13196 GF#13196] Clarify the boundary between ProcedureRequest and ReferralRequest or merge them (Eric Haas) -- Resolved (OO will own)
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13047 GF#13047] Add DosageInstructions to Procedure (Jamie Hignite) - [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12966 GF#12966] ProcedureRequest - add DosageInstructions or Quantity -- Joint with OO/PC/Pharmacy
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10028 GF#10028] Careplan: Provide ability to specify patient and/or provider preferences (Emma Jones)
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| − | * [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12633 GF#12633] Split Procedure into Procedure and ProcedureStatement (Lloyd McKenzie) -- agreement for PC to do the analysis
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| − |
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| − | Podiatry Functional Model PSS<br>
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| − | * Implantations of artificial joints – writing conformance criteria for capturing device IDs<br>
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| − | * OO owns UDI project – ties nicely in there, simple motion for OO to support Hans, Lorraine, no further discussion, abstain: 2, against: 0, in favor: 32<br>
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| − | <br>
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| − | [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13196 GF#13196]: procedureRequest vs referralRequest – boundaries or merge <br>
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| − | * The outcome is what is different, but the boundary is fluid depending on the organizational relationships<br>
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| − | * procedureRequest is NOT always precise as to what exact procedure is going to be done – so is that using procedureRequest or referralRequest<br>
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| − | * when you merge and you cannot establish how much care was transferred vs just for the specific procedure<br>
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| − | * if we can describe that using this kind of resource, when care is being handed off, vs when you are just asking for a specific procedure <br>
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| − | * perhaps merge and add element (who decides it is a transfer of care – initiator and receiver) to indicate if transfer of care (Boolean / more vocab needed as may be, for sure etc)<br>
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| − | * how would we track who is owner of care provision – choice is patient vs sender vs receiver – put this somewhere else not in this resources<br>
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| − | * Epic stores referrals separately from orders, but from a data model no difference – if merge – what name?<br>
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| − | * Difference is not in data elements, but in business flow / trigger events<br>
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| − | * Collaborate on the problem rather than transfer care – depends on the individual situation<br>
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| − | * Referral: take over care for a problem / consultation = just input on specific issue<br>
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| − | * Since we are STU add comment to implementers to submit comments on issue and if we get no answer there is no problem = merge both resources and add the extra element (NOT Boolean) – this would require more analysis of the two reources<br>
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| − | * Capture the intent of care transfer rather than the actual act of transfer of care
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| − | * procedureRequest (FMM3) does has more elements than referralRequest (FMM1) – what happens to those elements, when you want a referral?
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| − | * If there are differences, then do we need a main resource that each of these would be profiles? – If that is the case, keep them separate.
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| − | * Currently only have leaf resources besides the requestPattern
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| − | * Motion to merge and request implementer feedback (merge ok, how dealing with care transferring) category element and how transfer of care is managed), do the analysis and name change if needed and add the additional element about intent of transfer of care and evaluate the FMM level, have OO be the sponsoring WG of that merged – similar to merge of diagnosticRequest with ProcedureRequest Eric Haas, Floyd Eisenberg, further discussion: first do the analysis before the make decision about merge; note of FMM level – and will merging change the FMM? – after merge will have to re-analyse FMM level; what do we do with the elements that don’t stay in the final resource – where do they go? – that is part of the analysis; abstain: 8, against: 2, in favor: 21
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| − | <br>
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| − | [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=13047 GF#13047] Add DosageInstructions to Procedure (Jamie Hignite) - [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12966 GF#12966] ProcedureRequest - add DosageInstructions or Quantity -- Joint with OO/PC/Pharmacy
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| − | * also has been discussion about how to handle blood products / biological derived project – to create a resource proposal for that – do we need more instructions in general procedures / procedureRequests in
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| − | * Should we not have a resource or pattern that abstract class for products – for biological product vs medication vs vaccine vs supply that can have the same approach for all “things” – table that discussion
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| − | * What does dosage mean here- that is for medication vs how fast to give the blood product? What are chemotherapy – procedure or medication? Need to talk to Rx
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| − | * The problem here is managing the transfusion process – so we need Rx in the room
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| − | * Need Rx, OO, PC for the next discussion – also may be use v2 Chapter 4 on Blood product handling – add note to both trackers
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| − | <br>
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| − | [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10028 GF#10028] Careplan: Provide ability to specify patient and/or provider preferences (Emma Jones)
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| − | * How to represent patient preferences: PC suggest to do a profile on observation – example prefer apple juice – could this also apply to procedure kind that drives care / decision support, so that is sometimes the reason we did something
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| − | * How do vendors represent these preferences in current systems? Isn’t this just a note on the procedure or order etc
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| − | * Would like it to be reusable and easy to find for the patient – as new improvement to systems
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| − | * Proposed as profile, not base
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| − | * Experience: in imaging system has notes that relate to the patient – similar stuff here; but not experience with exchange of that data
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| − | * In NL have patient portal that collects patient preferences on specific things, like diet, birth type etc.
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| − | * Need to ay be differentiate between observation and statement?
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| − |
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| − | <br>
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| − | [http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12633 GF#12633] Split Procedure into Procedure and ProcedureStatement (Lloyd McKenzie) -- agreement for PC to do the analysis
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| − | * proposal voted on by PC – involves procedure is written that you can document history about procedures in the past and actual procedures executed during encounter (more detail); analysis what elements needed for procedure statement (history) vs procedure instance in the record – so level of detail as part of who the informant is here rather than it is statement overall (may be evaluate what is relevant over time vs the current active handling of the procedure)
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| − |
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| − | <BR>
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| | | | |
| | === Patient Care Wednesday Q4 === | | === Patient Care Wednesday Q4 === |
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| − | '''Chair''': Jay Lyle <br> | + | '''Chair''': <br> |
| − | '''Scribe''': Michael Tan <br> | + | '''Scribe''': <br> |
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| | | | |
| | '''Attendees''' | | '''Attendees''' |
| − | * See [https://docs.google.com/spreadsheets/d/1NoT7dU0sO0VLmtPn2o5bz45sUdkvng8T7gYPiBHFuhk/edit#gid=0 Attendee list]
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| | | | |
| | '''Agenda''' | | '''Agenda''' |
| − | # Drug substance list
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| − | ## approach
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| − | ## preliminary results
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| − | ## Key issues
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| − | ### Defining cross-reactive classes
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| − | ### Routes, salts, and other details; e.g., salycilates
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| − | ### Vaccines & biologics
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| − | ### Identifier selection
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| − | # IDMP: model & possible impact on identifier selection
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| − |
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| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − |
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| − | PC wants to create a concise list of substances as value set of allergies and intolerances. The presentation from Jay is available on the wiki. There is a top 20 registered allergies. Currently this is a US realm project ( RXNorm, UNII are US realm specific). You need a license for SNOMED.
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| − | IDMP.
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| − | #Are salts relevant? Salts are relevant for intolerances. You would put retromycin on the list of substances.
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| − | #what to do about classes that have been attributed to the wrong product. Does not really fall into classes.
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| − | #Cross reactivity in modern penicillin’s is rather small. The technical components should support the need for the doctors to register their allergies. IT cannot decide for the doctors what they are allowed to register. This project is on the border of domain knowledge. The concern is valid.
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| − |
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| − | '''IDMP'''<br>
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| − | Presentation of IDMP by Christian Hay and Panagiotis Telonis. See the presentation ( with the wedding cake) . IDMP is a joint project from HL7 and ISO TC215. Without substance ID you don’t have IDMP. ISO 14872 is the implementation guide for the governance of IDMP.
| |
| − | Substances are complex, but the substances implementation guide is in the third iteration and is being reviewed. The substances are registered in GSRS.
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| − | The GSRS is free available and contains all information required for the registration of Allergies and Intolerances. It describes all types of medication ranging from herbal products, bloodproducts chemical products.
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| − | What is the impact of IDMP on the value set of allergies and intolerances? The allergies team needs to get familiar with IDMP. We should make GSRS work for this purpose. Christian suggests a tutorial of 90 minutes to understand IDMP.
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| − | Questions from Rob McLure:
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| − | *What domains have been researched.
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| − | *How to deal with cross reactivity.
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| − |
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| | <BR> | | <BR> |
| | | | |
| − | =='''Patient Care WGM, Thursday, May 11, 2017'''== | + | =='''Patient Care WGM, Thursday, Sept 14, 2017'''== |
| | | | |
| | * Back to [[Patient Care]] | | * Back to [[Patient Care]] |
| Line 1,049: |
Line 671: |
| | <BR> | | <BR> |
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| − | === Patient Care Thursday Q1a === | + | === Patient Care Thursday Q1 === |
| − | | |
| − | '''Chair''': <br>
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| − | '''Scribe''': <br>
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| − | | |
| − | | |
| − | '''Attendees'''
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| − | | |
| − | | |
| − | | |
| − | | |
| − | '''Minutes'''<br>
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| − | | |
| − | === Patient Care Thursday Q1b ===
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| | '''Chair''': <br> | | '''Chair''': <br> |
| Line 1,074: |
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| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − |
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| − |
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| − | <BR>
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| − |
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| − |
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| | | | |
| | === Patient Care Thursday Q2 === | | === Patient Care Thursday Q2 === |
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| − | Joint with SDWG and Template WG
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| | '''Chair''': <br> | | '''Chair''': <br> |
| Line 1,120: |
Line 723: |
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| − | === Patient Care Thursday Q3a === | + | === Patient Care Thursday Q3 === |
| − | | |
| − | '''Chair''': <br>
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| − | '''Scribe''': <br>
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| − | | |
| − | | |
| − | '''Attendees'''
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| − | | |
| − | | |
| − | | |
| − | | |
| − | '''Minutes'''<br>
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| − | | |
| − | === Patient Care Thursday Q3b ===
| |
| − | | |
| − | '''Chair''': <br>
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| − | '''Scribe''': <br>
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| − | | |
| − | | |
| − | '''Attendees'''
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| − | | |
| − | | |
| − | | |
| − | | |
| − | '''Minutes'''<br>
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| − | | |
| − | === Patient Care Thursday Q3c ===
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| | '''Chair''': <br> | | '''Chair''': <br> |
| Line 1,158: |
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| | '''Minutes'''<br> | | '''Minutes'''<br> |
| − |
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| − |
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| − |
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| − | <BR>
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| − |
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| Line 1,185: |
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| | <BR> | | <BR> |
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| − | =='''Patient Care WGM, Friday, May 12, 2017'''== | + | =='''Patient Care WGM, Friday, Sept 15, 2017'''== |
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| | '''Clinician-on-FHIR''' | | '''Clinician-on-FHIR''' |
