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2014-05-19 Rx Conf Call

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  • John Hatem (Chair)
  • Melva Peters (Scribe)
  • Marla Albitz
  • Michelle Miller
  • Scott Robertson
  • Jean Duteau
  • Lisa Nelson


OOC Agenda

  • no further work

FHIR List Serve Discussions

  • Review current list questions
    • Question related to an attribute to distinguish a medication order that is inpatient, outpatient or other medication - Michelle Miller
      • there is a reference to the encounter that can be "typed"
      • intent of what was requested - who is the intended dispenser type (e.g. inpatient pharmacy vs community pharmacy, etc) and who is the intended administrator of the medications
        • may not have a place holder for this in our resource - would likely be an extension to the resource
Action: Discuss further with Hugh on how these requirements should be handled - either as an extension or add as attributes to Medication Order resource
Action:  Look at the FHIR resource to see what is included or if it should be included
  • Need to look at names of resource attributes - some additional ones related to PHER WG work
    • Name of "when given" attribute on Medication Administration resource - request to change name
    • Plan to submit a change request to change name - need to confirm what the plan to deal with this is
  • PSS for FHIR work
    • Need to create a PSS to do the updates and to develop a new resource
Action:  John will confirm with Hugh if he has availability.  FHIR group indicated that if we didn't have the bandwidth they will assign a resource
Action:  John to develop PSS for FHIR work

List Serve Discussions

Action:  Scott will review the request and propose what is required for this change - he will respond to Bonnie and PHER WG

Pharmacy's use of mood codes

  • Tom has made comments directly to Lisa and these have been incorporated into the documentation
  • For Structured Docs Brian Weiss is maintaining a blog CDAPRO with details of their guidance on use of CDA
  • Discussion then turned to nature and use of Medication Lists
    • Lisa pointed out that there will soon be a CCDA definition of a Medication list and now is a good time to get this correct
      • Lists may be for Physician to Physician communications others are for Physician to Patient or Patient to Physician
      • Its important to distinguish between actual as opposed to intent
    • There was agreement that lists only usefully exist in a context of use
    • This would be a good topic for discussion at the OOC
  • review of John's document
Action:  John will share to the list serve

Pharmacy Template Work

  • have started the work of mapping V3 to V2 to CCDA medication templates
  • will continue this work in Portugal

FHIR DSTU Questions

  • I am looking for the correct resource to use that can capture something like "daily aspirin use" with possible values of: taking as recommended, taking but not as recommended (maybe the patient is taking half dose daily), not taking, unable to obtain, etc. I also need the date when that patient told the provider of their compliance in case we need to reconcile across multiple sources. This seems like it could fit in a couple different places -- such as an Observation, Questionnaire, MedicationStatement (or List) -- each with their own pros and cons. Which resource and attributes are recommended for this medication compliance information?
    • compliance question rather than a medication statement
    • could be done by putting an extension on medication statement - code for compliance and actual dose that could be taken.
Action:  Hugh to post a response asking for clarification on the use case and suggest that an extension on medication statement resource might work.

Request for review of ISO definitions - Deferred


  • continue review


  • None

Next meeting - 2014-05-26 @ 1600 ET

  • Agenda
    • List serve discussion
    • FHIR DSTU question - compliance
    • Pharmacy use of Mood code etc.
    • ISO Definitions
    • Pharmacy Template project/work