2013-03-25 PA Call Minutes

Patient Administration Call

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Meeting Information

PA Work Group Meeting Minutes Phone Number: +1 770-657-9270 Participant Passcode: 986210 Go to [1] Meeting Password: Host Key:		Date: Monday March 25, 2013 Time: 01:00 PM (US Pacific Time, GMT -7)
Facilitator	Alex de Leon	Note taker	Alex de Leon
Attendee	Name	Affiliation
X	Brad Fonseca	Canada Health Infoway, Canada
X	Helen Drijfhout	HL7 Netherlands
X	Alexander Henket	HL7 Netherlands
X	Irma Jongeneel	Nictiz, Netherlands
X	Alex de Leon	Kaiser Permanente, USA

Agenda

Agenda Topics

1. Scope of visit (entire episode of care vs. individual care provider encounter)
   
2. Separate or single Appointment and Visit resources
   

Supporting Documents

• FHIR Encounter Resource
  

Minutes

Minutes/Conclusions Reached:
There were far too many email replies to follow. The work group was hoping to have better attendance at this meeting to be able to actively discuss the various opinions regarding these two items. So, the WG tried as best the members could to cover the various proposals.
Visit
The WG considered the feedback and concluded that we would treat the Visit resource as an atomic, single visit. Build the resource based on this, then consider how the visit is associated or aggregated with other visits as an episode of care. Later constructs might be considered as extensions. Appointment
Outpatient visits seem to have the difference between intention to visit (appointment) from the actual visit/encounter. There are a whole lot of attributes in a visit that would not necessarily appy to an appointment.
The scheduled Inpatient visit has a planned date which gets fulfilled once the patient arrives, meaning there is less of a distinction. Usually they are not different objects. Essentially they are the same thing with a status change in this scenario. There may be a consideration of the identifier, wherein it remains the same in the appointment and the fulfillment of the appointment (inpatient visit). This may cause issues if the identifier needs to be the same if these are two different resources. If OIDs are used, this may cause a problem as one OID cannot refer to two different objects.
In reading and discussion the feedback from the listserve is leaning to having two different resources: Visit vs. Appointment, however, it is clear that we will have to create some construct to handle the inpatient workflow. In the inpatient scenario we will need to assure that the identifier that is usually retained in the inpatient scenario (unlike outpatient which usually have different identifiers, one for the scheduled visit and one for the actual visit).
. As a question to the FHIR Management Group - If we were to take the route of different resources, that is for appointment and visit what is the appropriate link from the appointment and it’s fulfillment, especially within the inpatient scenario and retain the uniqueness of the instances of the visit?
Adjourned: 2:19 PM PST.

Meeting Outcomes

Next Meeting/Preliminary Agenda Items Next telecom meeting Monday, April 1, 2013 at noon PST

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