2018-03-28PC DrugAllergySubstance Call Minutes

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Meeting Information

HL7 Negation Requirements Meeting Minutes Location: Phone		Date: 2018-03-28 Time: 5:00-6:00 ET
Facilitator	Jay Lyle	Note taker(s)	Jay Lyle
Attendee	Name	Affiliation
y	Jay Lyle	JP Systems / VA
y	Russ Leftwich
y	Elaine Ayres
y	Stephen Chu
y	George Dixon
y	Sue Kent
y	Nancy Orvis
y	Yanyan Hu

Agenda

Agenda Topics

1. Review changes applied to document

Minutes

Minutes/Conclusions Reached:

1. Shellfish
   1. Added 'shellfish-mollusk' to support guidance.
   2. Corrected 'shellfish' count, 'shellfish - crustacean' count
   3. Note: SCT concepts are for terrestrial mollusks; request parent concept for terrestrial and marine mollusks.
   4. Question: do we need a similar approach for marine crustaceans? No identified consumption of terrestrial crustaceans.
2. G-SRS
   1. No response from FDA. We will adopt G-SRS values if and when guidance if provided; if it's not available before we are ready to publish, we will publish without it.
      1. The only identified source for G-SRS data is clearly labeled 'demo,' and the first sample we tried identified an issue.
      2. We can build (have built) an RxNorm-UNII map from NLM RxMix, but since G-SRS is using IDMP we don't know if vanilla UNII is correct.
   2. We'll need some explanatory text either way.

1. FHIR & CCDA adoption
   1. CCDA: Emma, Lisa
   2. FHIR: Michelle

Proposed VSAC definitions

element	text
Drug substances - reviewed 3/14
OID	NLM-assigned
Name	Common Drug Substances for Allergy and Intolerance Documentation
Author
Steward
Clinical focus	Documentation of a medication substance commonly suspected of causing an allergy or intolerance reaction in an individual
Date element Scope	Reactant element of allergy or intolerance record
Inclusion criteria	RxNorm substances of term type ingredient (IN) or multiple ingredient (MIN)
Exclusion criteria	Other RxNorm term types
Drug classes - reviewed 3/14
OID	NLM-assigned
Name	Common drug classes for allergy and intolerance documentation
Author	TBD
Steward	TBD
Clinical focus	Documentation of a class of medication substances suspected of causing an allergy or intolerance reaction in an individual
Date element Scope	Reactant element of allergy or intolerance record
Inclusion criteria	NDF-RT drug classes commonly relevant to allergy or intolerance cross-reactivity
Exclusion criteria	NDF-RT drug classes not commonly relevant to allergy or intolerance cross-reactivity
Foods
OID	NLM-assigned
Name	Common dietary substances for allergy and intolerance documentation
Author	TBD
Steward	TBD
Clinical focus	Documentation of a class of foods and dietary substances suspected of causing an allergy or intolerance reaction in an individual
Date element Scope	Reactant element of allergy or intolerance record
Inclusion criteria	SNOMED-CT dietary substances ingested by patients, both specific (e.g., strawberry) and general (e.g., crustaceans); Substances that may be either foods or drugs (e.g., ethanol)
Exclusion criteria	SNOMED-CT prodcuts; environmental substances; expressions asserting absence of conditions; Actual conditions caused by exposure (reactions, allergies)
Environmental substances
OID	NLM-assigned
Name	Common environmental substances for allergy and intolerance documentation
Author	TBD
Steward	TBD
Clinical focus	Documentation of environmental substances to which patients may be exposed suspected of causing an allergy or intolerance reaction in an individual
Date element Scope	Reactant element of allergy or intolerance record
Inclusion criteria	SNOMED-CT environmental substances suspected of causing reactions
Exclusion criteria	Drugs and foods; expressions asserting absence of conditions; Actual conditions caused by exposure (reactions, allergies)
Negations
OID	NLM-assigned
Name	Common negations of substance causes for allergy for allergy and intolerance documentation
Author	TBD
Steward	TBD
Clinical focus	Refutation of associations between substances and reactions
Date element Scope	Reactant element of allergy or intolerance record
Inclusion criteria	Assertions that a substance or class of substance does not cause adverse reactions in the patient
Exclusion criteria	Substances; Actual conditions caused by exposure (reactions, allergies)
Negations
OID	NLM-assigned
Name	Common substances for allergy and intolerance documentation
Author	TBD
Steward	TBD
Clinical focus	Documentation of substances suspected of causing an allergy or intolerance reaction in an individual
Date element Scope	Reactant element of allergy or intolerance record
Inclusion criteria	Specific or general substances to which a patient may be exposed and which may be suspected of causing an adverse reaction
Exclusion criteria	Actual conditions caused by exposure (reactions, allergies); negations of these conditions
Negations
OID	NLM-assigned
Name	Common values for allergy and intolerance documentation
Author	TBD
Steward	TBD
Clinical focus	Documentation of substances suspected of (or not suspected of) causing an allergy or intolerance reaction in an individual
Date element Scope	Reactant element of allergy or intolerance record
Inclusion criteria	Specific or general substances to which a patient may be exposed and which may be suspected of causing an adverse reaction; assertions negating these suspicions
Exclusion criteria	Actual conditions caused by exposure (reactions, allergies)

Meeting Outcomes

Actions Please review proposed text

Next Meeting/Preliminary Agenda Items Review text Review HTA feedback Review overlap findings

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