2016-08-25 Patient Care FHIR Call

Meeting Information

Patient Care FHIR Resources Conference Call Location: Conference Call Phone Number: +1 770-657-9270 Participant Passcode: 943377 WebEx: https://cerner.webex.com/cerner/j.php?MTID=mb400e38da885ce6d7a79e53077c729c5		Date: 2016-08-25 Time: 5-6:30pm ET
Facilitator	Michelle M Miller	Note taker(s)	Michelle M Miller
Attendee	Name	Affiliation
	Elaine Ayres	NIH/Department of Clinical Research Informatics
	Stephen Chu
	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
	Sarah Maulden	VA
	Hank Mayers	ReliaTech Consulting
	Jim McClay	Univ of Nebraska Medical Center
	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
	Scott Robertson	Kaiser Permanente
X	Simon Sum	Academy of Nutrition and Dietetics
	Iona Thraen	Dept of Veterans Affairs
Quorum Requirements Met: yes

Agenda

Agenda Topics

1. Agenda review
2. Approve previous meeting minutes 2016-08-18_Patient_Care_FHIR_Call
   • Motion: Rob/Russ
3. Prior Action Item Follow-up
4. Patient Instructions - Clinicians on FHIR
5. gForge change request

Supporting Information

STU 3 Timeline

• Wed, June 1
  • All resource and IG proposals for STU3 have been completed, reviewed by WG and submitted
  • Connectathon tracks for Sept have been proposed
  • Feedback on gForge submitted to FMG
• Sun, July 17 - Substantive content freeze for ballot -- core resources
• Sun, July 24 - Total content freeze, start of QA
• Wed, Aug 10 (midnight) - All QA changes applied
• Fri, Aug 12 - FHIR ballot opens
• Mon, Sept 12 - FHIR ballot closes
• Fri, Sept 16 - FHIR triage complete and ballot content loaded to gForge (or alternate)
• Sept 17-23 - Baltimore WGM
• Sun, Dec 11
  • Reconciliation complete/substantive changes applied
  • Just over 10 weeks
  • Will re-evaluate at Baltimore based on volume of ballot comments
• Dec 31 - Publish

FHIR Maturity Levels

[1]

• 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
  • Substantive changes (element names, sort order, vocabulary bindings, etc.) need to be applied by ballot freeze (Aug 10).
  • Unapplied QA checklist changes can be logged as ballot issues to be applied Sept-Dec. Substantive changes after ballot should be driven by ballot.
  • Non-substantive changes are fine
• Level 2 requires artifact has been tested and successfully exchanged between at least three independently developed systems leveraging at least 80% of the core data elements using semi-realistic data and scenarios based on at least one of the declared scopes of the resource (e.g. at a connectathon). These interoperability results must have been reported to and accepted by the FMG.

Resource	Current FMM Level	Goal FMM Level	QA Status	QA Reviewer	Implementation	Comments
AllergyIntolerance	1	3		Rob	Argonaut
Condition	2	3		PCWG	Argonaut
Procedure	1	3			Argonaut
CarePlan	1	3			Argonaut
Goal	1	3
QuestionnaireResponse	2	2		Lloyd		Lloyd will QA to get to level 3
Questionnaire	0	2		Lloyd		Lloyd will QA to get to level 3
CareTeam	0	2	NA	NA		Aggressive goal (e.g. whether we'll get the implementations needed)
FamilyMemberHistory	1	2	NA	NA		Aggressive goal (e.g. whether we'll get the implementations needed)
ClinicalImpression	0	1	NA	NA
ReferralRequest	1	1	NA	NA
ProcedureRequest	1	1	NA	NA
Linkage	0	1	NA	NA
Flag	1	1	NA	NA
Communication	1	1	NA	NA
CommunicationRequest	1	1	NA	NA

Note: Bold denotes top 20 resource based on survey
Note: Contraindication and Risk Assessment are owned by CDS, not Patient Care

Minutes

Prior Action Item Follow-up

Per Russ Leftwich: "I doubt if the AAAAI has agreed upon definitions for biologics or a distinction between non-tissue biologics and tissues. But I will ask. My first inclination is to keep the value set with biologics knowing that not all are "drugs". The fact is that most biologics, even if "tissues" would still fall under the category of "allergy and intolerance" in terms of adverse reactions. The only exception I can think of would be graft vs host disease."

Both Rob Hausam and Russ are at the Clinical LOINC meeting today and this topic was discussed, so we will postpone further discussion until they can share those updates.

gForge Change Requests

CarePlan

• gForge 10476: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10476 - Add search parameter for CarePlan.identifier
• gForge 10477: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10477 - per Grahame's comment on gForge 7897, the pattern should be that resources with a 'patient' element just have a 'patient' search parameter, and resources with a subject that could be a patient have both subject and patient search parameters
• gForge 10495: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10495 - remove reference to SupplyRequest from CarePlan and ClinicalImpression

Goal

• gForge 10461: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10461 - Minor cleanups to goal-relationship extension

Adjourn

Adjourned at <hh:mm am/pm> <timezone>.

Meeting Outcomes

Actions

Next Meeting/Preliminary Agenda Items Agenda review Approve previous meeting minutes Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#> gForge change request

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