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2017-03-09 Patient Care FHIR Call
Contents
Meeting Information
| Patient Care FHIR Resources Conference Call Location: Conference Call |
Date: 2017-03-09 Time: 5-6:30pm ET | ||
| Facilitator | Michelle M Miller | Note taker(s) | Michelle M Miller |
| Attendee | Name | Affiliation
| |
| X | Elaine Ayres | NIH/Department of Clinical Research Informatics | |
| X | Pushpalatha Bhat | ||
| X | Stephen Chu | The Australian Digital Health Agency (ADHA) | |
| Evelyn Gallego | EMI Advisors LLC | ||
| X | Eric Haas | Haas Consulting | |
| X | Rob Hausam | Hausam Consulting LLC | |
| Laura Heermann-Langford | Intermountain Healthcare | ||
| X | Emma Jones | Allscripts | |
| X | Russ Leftwich | InterSystems | |
| Tony Little | Optum 360 | ||
| Jay Lyle | Ockham Information Services LLC, VA | ||
| Russell McDonell | Telstra Health | ||
| Lloyd McKenzie | Gevity (HL7 Canada) | ||
| Larry McKnight | Cerner | ||
| X | Michelle M Miller | Cerner | |
| Lisa Nelson | Life Over Time Solutions | ||
| Viet Nguyen | Lockheed Martin, Systems Made Simple | ||
| M'Lynda Owens | Cognosante | ||
| Craig Parker | Intermountain Healthcare | ||
| X | Joe Quinn | Optum | |
| Simon Sum | Academy of Nutrition and Dietetics | ||
| Iona Thraen | Dept of Veterans Affairs | ||
| Serafina Versaggi | Dept of Veterans Affairs | ||
| x | Chris Melo | Philips Healthcare | |
| x | Nick Radov | Optum | |
| Quorum Requirements Met: yes | |||
Agenda
Agenda Topics
- Agenda review
- Approve previous meeting minutes 2017-03-02_Patient_Care_FHIR_Call
- Motion: Eric/Rob
- STU3 FMM Levels
- STU3 QA Work (checklist, warnings, and suggested changes/clarifications)
- STU3 Substantive Changes (post-freeze)
- gForge Change Request
- Zulip - ClinicalImpression for a cancer therapy decisions
Supporting Information
STU 3 Timeline
From FHIR_Ballot_Prep
- Sun. Feb. 19 Publication substantive resource freeze
- Sun. Feb 26 Publication total freeze
- Mon. Feb 27 QA period opens
- Tue. Feb 28 FMM QA spreadsheet updated for all WG resources
- Sun. Mar. 13 QA period closes
- Sun. Mar. 20 All QA applied
The "following week" STU 3 is published!
FHIR Maturity Levels
Maturity Levels Level 3 requires the artifact has been verified by the work group as meeting the DSTU_2_QA_guidelines and has been subject to a round of formal balloting; has at least 10 implementer comments recorded in the tracker drawn from at least 3 organizations resulting in at least one substantive change
Target FMM levels for STU3 publication
- AllergyIntolerance = 3
- Condition = 3
- Procedure = 3
- CarePlan = 2
- Goal = 2
- CareTeam = 1
- FamilyMemberHistory = 2
- ReferralRequest = 1
- Flag = 1
- Communication = 1
- CommunicationRequest =1
- ClinicalImpression = 0
- Linkage = 0
STU3 Action Items
- Review Tracker Issues - https://docs.google.com/a/lmckenzie.com/uc?id=0B285oCHDUr09Mzh3b09rMFhEV1E
- Resolve QA Warnings to have resource FMM > 0
- Resolve QA Information messages to achieve FMM = 3
- Update QA checklist for resources that we want to be FMM = 3
- Apply changes (all "substantive" changes have been applied, except workflow patterns)
Minutes
STU3 FMM Levels
- MOTION: CareTeam to FMM=1; Eric/Russ: 9-0-0
- MOTION: Condition to FMM=4; Eric/Russ: 9-0-1
- Note: Lloyd suggested FamilyMemberHistory move to FMM=2 due to past Clinical Genomics connectathon tracks
STU3 QA Work
- New QA warnings! GF#12973 QA Warnings for Condition.onset search parameters
- Update QA checklist for resources that we want to be FMM = 3
- QA Topics
- extension-procedure-causedby -- review beefed up description - "This procedure is because of the related item"
- extension-condition-criticality -- no value set binding -- log tracker to address after STU3
- flag -- questionable QA feedback
- As “flag” has numerous usages in FHIR, this particular use should somehow be distinguished. Might it be a “clinical flag?”
- A flag is typically presented as a label in a prominent location in "the a paper chart or visual rendering of an electronic" record to notify the clinician of the potential issues
- given the volume of information frequently found in patients' records and the potentially serious consequences of losing sight of some facts, this redundancy is deemed appropriate -- Deemed by whom? HL7? We don’t make this kind of policy. Suggest “deemed important by the users of an information system.”
- Patient has large dog at home -- This doesn’t seem like a credible example of the semantics for a flag, even under the “other” category.
- The Flag resource is sometimes known as "patient notes" -- This is definitely beyond the scope of QA but there seems to be a serious conflict here between the notion of flags as a highly concise representation of information preselected for its urgency or relevance to workflow and a more general topic of patient notes, which could be wide ranging, couldn’t they?
- Change The Flag resource is sometimes known as "patient notes" to be The Flag resource is sometimes used as "patient notes"
- goal - HgbA1c level =<5.6% -- Is this a clinically credible example? Yes
STU3 Substantive Changes (post-freeze)
FMG Patch Approval
- GF#12942 Change AllergyIntolerance.category data type to code -- patch sent to Grahame and Lloyd to apply
FMG Rejected / Deferred to R4
- GF#12943 Condition.stage cardinality
No Approval Needed
- GF#12973 QA Warnings for Condition.onset search parameters
gForge Change Requests
- GF#12988 Wrong mapping for Condition.clinicalStatus to HL7 V2 DG1-6
- GF#12973 QA Warnings for Condition.onset search parameters
Zulip
Adjourn
Adjourned at 6:32pm Eastern.
Meeting Outcomes
Actions
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