2010-01-28 Call Minutes

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HL7 Ambulatory Oncology Functional Profile Meeting

Meeting Logistics

Date/Time: Thursday, January 28, 2010 / 1:00 PM – 3:00 PM EST

Location: Telecon 866 564 2805 x9306830#

Attendees

• Kevin Hughes (Dr. Kevin)
• Peter Harrison
• Mollie Ullman-Cullere
• John Ellerton
• Christine Bester
• Helen Stevens Love
• Marjorie van der pas
• Sandy Stuart

Agenda

1. Welcome and Introductions
2. Agenda review and approval
3. Review of HL7 WGM activities Media: HL7 Oncology Task Group Phoenix 20100119.pdf
   1. SAEAF and the NCI Engagement with the HL7 EHR WG
      • Charlie Mead presented SAIF in relation to NCI caEHR project and expected outcomes back to HL7 EHR WG. Work is driven by SOA approach. The NCI is building a reference implementation of SOA based Services; a tool used by application vendors to build their own solutions. They will be deploying business capability services e.g. Receive Referral. This would tie to the AOFP and demonstrate how the services and functions can be deployed.
      • Question: Will this be open source? Helen: Yes absolutely all NCI work will be open source and SAIF compliant services will be available to HL7
      • Question: What does SAEAF stand for? Helen: Services Aware Enterprise Architecture Framework (may be renamed to SAIF - Service Aware Interoperability Framework ). This is the HL7 architecture framework currently in development by the HL7 Archtecture Board (ArB). More information is available from the ArB wiki ( SAEAF document Location )
      • If the group would like more information on this topic, Helen can arrange to have Charlie attend a future call to further discuss the SAIF objectives further.
      • One area where the SAEAF alignment may influence this project is in the development of detailed use cases that NCI is currently undertaking.
      • ACTION: Christine to present overview of the NCI project structured use cases on Feb 11th call.
      • Question: How do you want to affect quality of care, if something is absolutely necessary for care then it is rather straight forward seems to be a heavily technically focused what is the intent? Helen: No the intent is to focus on the care specific to ambulatory oncology; recognizing that this care may occur in a hospital setting; however, it is not the intent of the project to define an inpatient EHR.
   2. Functional Profile Key Focus Areas
      • Support for Receive Referral not present in EHR-S FM R1.1 so a new section was proposed by the caEHR project
      • Question: If it necessary for the EHR to interoperate (i.e. receive something like a referral) will the NCI be committed to using an HL7 or HITSP approved standard? Helen: Yes – my understanding is that where a standard exists, or where an SDO is developing a standard, (e.g. receive referral if there is a HL7 CDA receive referral implementation guide) that is what would be used and would be referenced in the Profile.
      • Question: What is the expectation of caBIG interoperability? For example, genetic testing - caBIG started as being an expert in genetics is NCI caBIG planning to use approved HL7 or HITSP standards to transmit notes in this domain or a caBIG homegrown version? Helen: again my understanding is that this project will reference HL7 or HITSP standars; but I can't speak to the NCI caBIG objectives. We will need to invite someone from NCI who can speak on behalf of these issues.
      • ACTION: Helen to check if someone from NCI/caBIG can attend call to speak to this – or provide written position.
      • Question: Do we have the ability to indicate what standards should be used? Helen: The intent of the Profile is to be an HL7 compliant standard we can and should use HL7 standards were they are available. If there are gaps in standards, the intent is to work with the healthcare it Standards groups to fill them in vs. filling them in ourselves. The mandate of the NCI caEHR is to leverage existing HL7 standards.
      • Peter: We also need to impress on HL7 that they need to move quickly on this as they are typically slow moving as a group and we need to ensure they realize time is a critical component of this work. We can also define areas where there are future requirements and get the ball rolling in those areas for future standards needs.
   3. Discussion on the scope of the Profile and the types of oncology. We need to define what an Oncologist is (Surgical, Medical, Radiologist, Hematology, Pediatrics, Genecology).
      • ACTION: Dr. Kevin H., Peter H., Marjorie, John E. - provide a description for each specialty for the FP Overview
   4. Support for Clinical Research has been leveraged from the CR FP being incorporated into the EHR - S FM R 2.0
      • ACTION: Kevin H. to contact Sloan Kettering to encourage participation in the task group
   5. Review of meeting engagement strategy as per the slide deck.
   6. Conversation Documents will be created as required to go in depth discussion about a specific topic which once consensus is achieved it will be incorporated
   7. Dr. Kevin expressed concern over the length (2 hrs) of the calls. Propose discuss clinical content in the first hour whenever possible
4. Document Review Session - FP Overview Document
   • Comments recieved from Dr. Kevin Hughes and Mollie Ullman
   • Detailed review of the first half of section 2.1 in the overview document and adjustments made to the storyboard as shown in the updated document.
   • Decision that whenever interoperability is required we will primarily represent the desired electronic interoperability state, and also allow for the manual process that may be prevelant today. Examples from the storyboard include:
     • The office of Dr. Carl Cutter calls Eve Everywoman to schedule an appointment and direct her to the practice’s website where Eve will be able to complete online "new patient" forms including Patient Information Sheet, Medical History, a list of current medications and Privacy Practices/HIPAA form. If the patient has a Personal Health Record, the patient may request that the relevant information be automatically transferred from the PHR to Dr. Cutter's EHR system. If the patient does not have access to the internet, then the printed forms may be mailed to the patient for her to complete and bring them with her to her appointment.
     • Consent forms, and patient information sheets are generated automatically by the EHR and Eve signs the consents electronically. If electronic consents are not available they are printed, signed and scanned into the EHR.
     • A referral request form including all pertinent clinical, demographic and financial information is created electronically and sent to Dr. Scanner's EHR. If electronic referral is not available, the referral is printed and faxed.
   • Decision that will use standard language to describe EHR Capabilities regarding production of patient information documents:
     • Based on the patient requirements, the EHR automatically identifies appropriate patient information documents and makes them available to be printed for Eve to help her better understand her specific disease and reasons for consultation.
     • ACTION: Kevin H. to provide a definition for Algorithm for the AO EHR glossary
     • ACTION: Christine B. to verify if the use of the Staging Wizard results will also provide the user with relevant trial information in the FP
     • ACTION: Christine B. to follow up with the task group at a future meeting 2 weeks to provide overview of the structured UC invite Bill and/or Patrick along to discuss
5. Decision on document review for next 2 weeks.
   • Decision to continue working on the FP Overview document - specifically Sections 2.1 (Overview Storyboard), 1.5 (Glossary), and 3.16 (Genealogical Relationships narrative).
6. Other business
   • none raised
7. Meeting adjourned.
   • 2:55pm EST.