2016-02-15 Rx Conf Call

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Attendees to be updated

  • Melva Peters (Chair)
  • Igor Sirkovich
  • John Hatem
  • Tim McNeil
  • Scott Robertson
  • Tom de Jong
  • Daniel Zhang


  • Link to Posting
  • Project in Ontario Ministry of Health
  • Suggested that if new requirements are identified during the project - submit to the Pharmacy WG
  • Current resources can support requirements

Medication Status - 'Entered in Error'

  • Discuss as group
  • Was not able to identify "explanation" narrative as to why "entered in error" for medication resource is not supported.
  • in the meantime the QA errors are addressed temporarily since Michele has inserted a placeholder.
Action:  John to confirm need of status on Medication

Renaming MedicationOrder to MedicationRequest Discussion - DEFERRED

  • From January 25 meeting: Lloyd shared the proposal to rename all request type resources to <resource>_Request. Seeking consistent name for all resources and term that encompasses larger swath of types of requests. An element beneath the tag instance would state the particular request, such as 'order'. This impacts the current Pharmacy Medication Order FHIR resource.
 Action: Rx WG to discuss to determine if we agree or not.
  • Lloyd suggested that we hold off on making the change, if we decide to make the change. Wait for FHIR Infrastructure group to workout additional details before we make the changes. May have impact on how other data elements are name or included.
  • Discussion: If we agree to the change, we'll need to review the description and other content for our resource to ensure that it accurately reflects the usage. This type of change will mean changes for implementers and it may not be as intuitive for implementers.
    • No decision to be made today. Will consider on a future call

FHIR Workflow Meetings Status

Action item:  Scott - find / asked for / create(?) a 1-pager explanation of what the business need and proposed solution.
  • discussion of whether is this is still needed - evolving - do not need at this point, but may need for the moment - Close this action item
  • For statuses - what we have so far is correct - may need to remove "superseded" as a status - need to find a different way to represent a relationship between 2 orders
Action:  Melva to add change request to GForge

FHIR Ballot Discussion Items

A = Dosage Related     B = Terminology     
C = Misc               D =
E = Examples           F = Multiple indications/reason for order
G = Status             H = Medication Related
I = Mappings

Ready for Review

  • 8778
    • options proposed by Chris and comments from Melva - see spreadsheet
  • 9334 - dose
  • 9295 - max dose per lifetime -
  • 8735 -example
  • 8730
  • 8603
  • 8016 - example
  • 8012
  • 7738 - example
  • 5925
  • Scott is working on the Terminology Items - proposed that we bring a full set of Tracker Items forward
  • Mapping to NCPDP - assigned to Tim and Scott - Tim has a draft - Scott to review and then will bring forward to the Pharmacy WG
  • Change 8016, 8735 and 7738 - moved by John, seconded by Scott - 6/0/0 - Carried
Action: Melva to update Gforge
  • 9344 - Change Quantity to "dose" in MedicationAdministration. Change MedicationOrder and MedicationDispense with MedicationStatement - change all 3 to be dose[x] - doseRange, doseQuantity and definition to "Amount of medication per dose". Moved by John - seconded by Tom - 6/0/0 - Carried
Action:  Melva to Update Gforge and assign
  • 9295 - max dose per lifetime - would need to represent "lifetime" in the denominator - continue the discussion
Action:  reach out to Lloyd/MnM - to determine how to represent

Other FHIR Items - Deferred

  • Build Error Items - Marla/Michelle/Rik
    • 9367
    • 9368
    • 9369
    • 9370
  • Tom will assist with items that have been assigned to John.
  • We are going to try to make the February 10th deadline if possible.
    • "packageitem" - need to determine how to handle - should be called "item" but that is ambiguous
Action:  Melva to send exemption to MnM and determine how to handle
    • RIM Mapping - John has forward to Tom for review.
Action:  Tom to review
    • Medication.product.ingredient - only remaining issue
Action: remove the "to do" - Michelle
Action: Consider status on Medication - 5827

Catalogue PSS

  • Jose to draft the start of a PSS

[Draft PSS Posting http://lists.hl7.org/read/messages?id=288115#288115]

Joint Meeting with ISO/IHE Pharmacy

Action:  Melva to check on availability of meeting room in Montreal - in progress

Template Work

  • Kai to let Pharmacy know when ready for review
Action:  Melva to followup with Kai to get a status

NCCN template orders - Deferred

  • Lee Suprenant requested input on the ChemotherapyOrderTemplates work.
 Action: Lee will document the items that should be targeted for Pharmacy.
  • Lee requests time in the next call for further discussion or a separate call.
  • Lee completed categorization, needs next steps identified for the columns marked as "maybe".
  • On 2/8 - reviewed Lee's categorizations
 Action: Lee to distribute updates to the group.
  • Lee plans to continue to join our calls as we work through the list.
  • John recommended we would through the list before Lee takes the list to the FHIR workgroup.

Other business

Next meeting

  • Monday, February 22, 2016