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20160421 OO FHIR conCall

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HL7 OO on FHIR (for Orders and Observations)

Call in details:
Phone: +1 770-657-9270, Passcode: 398652

Join the meeting at:
https://join.me/vernetzt.us

Date: 2016/04/21
2015 - 02:00 PM (Eastern Time, GMT -04 DST)
Quorum = chair + 4 yes


Co chairs Chair Notetaker
Riki Merrick
Rob Hausam
Lorraine Constable
Patrick Lloyd
Ken McKaslin
Hans Buitendijk


Attendees
X Eric Haas
Riki M
X Hans Buitendijk
X Jose Costa-Teixicara
Dan R
X Jonathan Harber
Kamalini
Mark Jones
X Rob Hausam
Margaret D


    • Review Device QA criteria for FMM proposal - not done
  1. SupplyRequest and delivery SupplyDelivery


Look at boundaries between SupplyRequest, DeviceUseRequest, and VisionPrescription Resources


The boundary Supply-DeviceUseRequest would be the same as between Supplyand medicationOrder (and others): The latter is for the patient-specific order, specifying part of a treatment. If, to provide for that, any supply/resupply has to be done (e.g. bulk resupply of stock) then we use the SupplyRequest. Meaning that the Supply can be used to order a bunch of devices to refill stock, but not implying a treatment.

Patient-specific treatment-related -->DeviceUse Bulk supply, treatment-independent --> Supply.

There is a gray zone where both resources wculd work. e.g. from an order, the clinic purchasing department decides to order that device for that patient from the manufacturer. It's a patient-specific order, but may not contain the details for the treatment (for example: the name may be conveyed for labeling purposes) this could be Supply.

This leads to question Whether SupplyRequest should reference Patient element or just use the reason resource generically [create trackers]

Likely need a special request comment/annotation on the resource as well. [create trackers]

VisionPrescription not needed the custom detail should be attribute of ordered item DeviceUseRequestdevice (i.e. Device) but this is a Device specialization (Profile) or Resource or separate resource is an open question for FMG.

especially for common stuff like , glasses, hearing aid, teeth, and prothetics.

As well as delivery SupplyDelivery and dispense Medication Dispense'

How is Delivery different from Dispense?

Workflow

 |	Requests: MedicationOrder, DeviceUseRequest, SupplyRequest
 |	Delivery: SupplyDelivery,
 |	Dispense:  MedDispense  (here is med - take this BID etc....),  '`no DeviceDispense``, SupplyDispense not needed?
 |  	Admin/Use:
 V 

NOTE: Inconsistent use of request resources between different WG. ( no DeviceDispense ) - Bring up at FMG

Wheelchair example : delivery = dispense? Delivery - act of sending not necessay of being received. vs Dispense Patient get it.

Other Notes

  • From and to location missing in SupplyRequest
  • From location missing in SupplyDelivery


  • There should be separate instances of SupplyDelivery for each way point
    • .destinations where supply sent to, this is like a rreport of something sent to location A which is either an intermediate or final destination.
    • Issue brought on whether SupplyDelivery's.destination changes the resource statuses meaning
    • Suggest that Task indicates fulfilment of request not the SupplyDelivery



xxxRequest comparison

RequestResource

RequestResource

Template

SupplyRequest Inventory

DeviceUseRequestClinical Use

Name

Flags

Card.

Type

W5

Description & Constraints

identifier

identifier

identifier

S

0..*

Identifier

id

Business identifier for request/order



basedOn

S

0..*

Reference()


Request fulfilled by this request



parent

S

0..1

Identifier


Composite request this is part of

status

status

status

S

1..1

code

status


draft | active | suspended



category

S

1..1

CodeableConcept

class


proposal | plan | orig. order | encoded +

   orderedItem

(reference to Medication|Substance|Device)


Device (reference)

code

S

0..1

CodeableConcept

what

What’s being requested/ordered

  patient 

(Is this need for supply can use reason for this since not a patient specific resource)


Subject( should be Patient)

subject

S

1..1

Reference(Patient | Group? | ??)

who.focus

Individual the service is ordered for

(use cases? Billing?) 

encounter

context

S

0..1

Reference(Encounter | EpisodeOfCare)

context

Encounter or Episode during which request was created

when.code

when.schedule 


Priority,


timingTiming,


timingDateTime,


timingPeriod

occurrence[x]

S

0..1

dateTime| Period| Schedule?

when.planned

When service should occur

date

recordedOn

orderdedOn ( more of a Task thingy)

authored

S

0..1

dateTime

when.recorded

When the request transitioned to being actionable

source


requester

S

0..1

Reference(Device | Patient | Practitioner | RelatedPerson | Organization?)

who.author

Who/what is requesting service



performerType

S

0..1

CodeableConcept

who.performer

Desired type of performer for service

 supplier



performer

S

0..1

Reference(Practitioner | Organization | Patient | Device | RelatedPerson)

who.performer

Desired performer for service

 reasonCodeableConcept,reasonReference


Indication, PRNreason ( really more of a protocol thingy)

reason[x]

S

0..1

CodeableConcept | Reference(??)

why

Why is service necessary?




supportingInfo


0..*

Reference(Any)


Additional information to be used in fulfilling request


Notes

note


0..*

Annotation


Comments made about the service request

Kind (e.g. central stock, non-stock)








From and to location missing in SupplyRequest need for logistics














    • Jose C-T proposals
  1. Review outstanding Trackers
  2. Connectathon review

Minutes

Next Steps

Actions (Include Owner, Action Item, and due date)
Next Meeting/Preliminary Agenda Items

2015mmdd_OO_FHIR_concall


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