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September 2016 WGM Baltimore: Sep 18 to Sep 23

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Baltimore, WGM - September 2016 Patient Care WG Meeting Approved agenda:

Note - All PCWG members: Due to Plenary Sessions and joint meetings with other WGs, the PCWG Administrative and House Keeping meeting quarter has been moved to Sunday Q4. Please join this meeting as there are important agenda items that need to be discussed and approved by PCWG members. Thank you




Baltimore Plenary and WGM - September 2016. Patient Care WG Meeting Meeting Minutes

  • Sunday, September 18 - International Council Meeting
- No PCWG meeting


Patient Care WGM, Monday, May 19, 2016


Monday Q1

  • Plenary Session
- No PCWG meeting



Monday Q2

  • Plenary Session
- No PCWG meeting



Patient Care Monday Q3

Present:

  • Jones, Emma (Allscripts)
  • Lyle, Jay (Ockham Information Services LLC)
  • Mandel, Josh (Boston Children's Hospital)
  • McKnight, Larry (Cerner Corporation)
  • Miller, Michelle (Cerner Corporation) -- chair/scribe
  • Shekleton, Kevin (Cerner Corporation)
  • Tan, Michael (NICTIZ Nat.ICT.Inst.Healthc.Netherlands)


Minutes (joint with FHIR-I):

PC agenda includes gForges related to Condition.category and scope of Condition

-- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10091 QA: switch category value set to SNOMED

-- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10404 ask for balloter feedback on data type and binding strength of category

-- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10611 add more codes to value set for problem and concern

-- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11156 add more codes to value set for problem and issue

-- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10614 which category to use when it's a condition due to a procedure in the past

-- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10662 medical history

-- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10090 QA: include concern in scope

-- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11211 support for required binding strength of Conditon.category

-- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10544 Add condition extension(s) to represent a role in context of Condition.encounter (e.g. Primary/Sequence Admit Discharge etc.)

Discussion, but no vote....

Condition.category 0...* CodeableConcept with extensible binding to value set with codes:

  1. Chief Compliant -- in context of encounter
  2. Symptom -- review of systems or HPI - very close to "S"ubjective of SOAP
  3. Past Medical History - includes conditions as a result of procedures
  4. Assessment Problem from "A"ssessment and "P"lan (of SOAP) -- includes diagnosis
  5. Problem on Problem List -- if homeless or financial barriers or lack of transportation are being managed, then it could be a problem; clinician expresses concern about social history; can be patient-stated concerns (doesn't need to be on a clinician's problem list) such that asserter will differentiate between them -- could include risks / fears as well.
  6. Discharge Diagnosis -- in context of encounter
  7. Billing Diagnosis- in context of encounter, In US, would have ICD-x (one problem has 0..* billing diagnosis codes)


or

Condition.category 0…1 CodeableConcept with extensible binding to value set with codes:

  1. Billing Diagnosis - In US, ICD-x, in context of encounter
  2. Problem - In US, SNOMED, on the "problem list" and managed over time by provider - includes pregnancy
  3. Other Concern -


Other discussion topics:

  • Category is like the C-CDA Problem Type, but hard to define codes to be mutually exclusive
  • Use Observation for exam findings
  • Use FamilyMemberHistory
  • Use Questionnaire/Observation if captured as part of Social History



Patient Care Monday Q4

Present:



Minutes:




Patient Care Monday Q5: Placeholder for extra meeting if necessary

Present:



Minutes:




Patient Care WGM, Tuesday, May 20, 2016


Patient Care Tuesday Q1 FHIR/PCWG/ECWG/CIMI

Agenda

  • SDC update from CIC (~ 15 min)
  • CIMI - Skin Care model meeting
    • Recap patterns from yesterday (Q4 CIMI semantics)
    • Review elements for Skin exam question & Lesion in spreadsheet


Present:
Attendees:

Last Name First Name Organization
Emma Jones Allscripts
Laura Heerman Intermountain


Minutes:



Patient Care Tuesday Q2

Present:


Minutes:



Patient Care Tuesday Q3

Present:



Minutes:




Patient Care Tuesday Q4

Joint meeting - PCWG, OO, FHIR, Vocab, Clinical Genomics - CIMI, Struc Docs. Topic: Negation, others

Agenda

  • Survey of draft document
  • Review of principles & open issues
  • Review of pattern description
    • including open questions for deficits, goals
    • including proposal for "query" chapter of requirements
  • How to make patterns useful


Present:



Minutes:



Patient Care WGM, Wednesday, May 21, 2016


Patient Care Wednesday Q1

Present:


Minutes:



Patient Care Wednesday Q2

Present:


Minutes:



Patient Care Wednesday Q3

Present:



Minutes:




Patient Care Wednesday Q4

Present:



Minutes:




Patient Care WGM, Thursday, May 22, 2016


Patient Care Thursday Q1

Present:


Minutes:



Patient Care Thursday Q2 (PCWG, SDWG, Template Joint meeting)

Agenda

  • CDA updates
  • Clinical status & act

Present:


Minutes:



Patient Care Thursday Q3

Present:



Minutes:




Patient Care Thursday Q4

Present:



Minutes:




Patient Care WGM, Friday, May 23, 2016


Patient Care Friday Q0: PCWG Co-Chairs meeting

NOTE: co-chairs to determine whether this will be moved to Thursday Q-Lunch

Present:


Minutes:




Patient Care Friday Q1


(1) Template WG meeting

- PCWG representative(s) to attend

(2) Agenda: open

- Possible: Clinical Connectathon



Present:


Minutes:



Patient Care Friday Q2


Agenda: open

Possible: Clinical Connectathon


Present:


Minutes:



Patient Care Friday Q3


Agenda: open

Possible: Clinical Connectathon


Present:



Minutes:




Patient Care Friday Q4


Agenda: open

Possible: Clinical Connectathon


Present:



Minutes:



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