2017-06-19 Rx Conf Call

Related Links Pharmacy Home Page Conference call minutes

Attendees

• John Hatem (Chair)
• Scott Robertson (Scribe)
• Michelle Miller
• Nancy Westaway
• Yunwei Wang
• Jose
• Eric

Agenda Items and notes

Tracker Items

FHIR Tracker

June 12 - IDPM will be deferred for today

Medication Related (Group = A)

• 13392 Enhance the Medication resource for alignment with the IDMP Authorized Medicinal Product model
  • 12396 Medication package and product
  • 12395 Basis of Strength Substance
• 12671 Consider adding "maintenance drug Indicator" on medication when discussing formulary.

Dosage Related (Group = B)

• 13383 We need to be able to specify that a dosage timing must be obeyed exactly
• 13382 We need Dosage.text to be a CodeableConcept
• 13381 We need a way to express <daysAdministeredAmount> and <daysNotAdministeredAmount> in Dosage
• 13380 Possible new element in Dosage: calculationBasis
• 13317 Allow Dosage to express a medication should start/stop relative to an event
• 12791 Update dosage Instruction to include pre-condition and therapeutic target

Misc (Group = none)

• 13449 add medicationRequest.intendedPerformer to the search parameters
  • Jose clarified question. To add query parameter for performer in order to retrieve orders for that performer. similar to intended dispenser
  • Motion to add query for intendedPerformer (Jose/Eric) 6-0-0 motion passes

Action: Scott will update tracker item

Action: <someone> to add Search parameter

• 13044 Fix performer on MedicationAdministration - update description and add role back in with appropriate value set
  • waiting on changes from Workflow
  • Logical model for workflow has Performer (0..*) with roles from SNOMED
  • John - we were asked to constrain that role list but we decided at the time not to include role. Now we want to have it and need it to work with the definition in workflow.
  • Michelle - if role is a static aspect of the performer, then we don't need it (it's available in the specific resource describing that person). We need role if it related to the specific event and may not be consistent across related events.
  • extensive discussion ... does this include performer/verifier? That was previously advised (by FHIR) to be done with provenance. This may result in a "stack" of provenance events related to the order (ordered by, verified by, modified by, ...). This isn't how most systems are designed ... would be extensions(?) ... at least it would work. Event history (links to provenance) doesn't link to the most recent status ... would have to track through the provenance find the most recent state.
  • 6/12 we have not reach the end of this discussion (but we are at the end of the call)
    • John - the specific tracker can be addressed by adding role to medicationRequest, but this may not address the intent.
• 13043 Fix performer on MedicationDispense - update description and add role back in with appropriate value set
  • waiting on changes from Workflow
• 12473 Status Review - consider splitting clinical status from verification status

12332 Limitations on searches? - elements with type selection; chained searches

• • may be answered to FHIR Search page [1] chained parameters.
  • no further discussion needed. No further action by Pharmacy, no vote needed

Action:  Scott will review FHIR Search page to see if question is answered.  If not, will refer to FHIR-I.

Order Service Catalogue FHIR Project

• To follow the Order Catalog work, use the following listserv: ordercatalog@lists.hl7.org
• Background
  • under Orders.
  • Catalogue vs Formulary. Catalog is a superset of Formulary, includes orderable items beyond medications.
  • expect one or two new resources
  • Jose and John involved
• Update from John & Jose

International Chemotherapy Implementation FHIR IG

• Chemotherapy IG Wiki Page
• Background
  • NCCN and other European input to support broad requirements. Specific implementations would constrain as needed
• Update from John Hatem

CIMI Pharmacy Model Update

• Update from John Hatem

Blood Products/Transfusion/Tissue Update

• Background:
  • based in Patient Care. also includes Orders
  • Blood Products/etc moving into FHIR. Want to maintain alignment with Orders and Pharmacy resources
• update from Eric

v2 Chap 11 & 12 deprecation

• Background
  • Scott is contact
  • Patient Care has proposed to deprecate Chapters 11 Patient Referral & 12 Patient Care in v2
  • v2.9 already in publication process, could be deprecated in v2.10
  • Orders has already claimed interest in some segments
• Does Pharmacy have any interest or concern?

Action Item List

• Action item list - update from John Hatem

Next meeting

• Monday, June 26, 2017 at 1pm Eastern - NOTE, new time for weekly teleconference