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2016-06-16 Patient Care FHIR Call

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Meeting Information

Patient Care FHIR Resources Conference Call

Location: Conference Call
Phone Number: +1 770-657-9270
Participant Passcode: 943377
Live Meeting:;Sc

Date: 2016-06-16
Time: 5-6:30pm ET
Facilitator Elaine Ayres Note taker(s) Elaine Ayres
Attendee Name Affiliation

X Elaine Ayres NIH/Department of Clinical Research Informatics
X Stephen Chu
Eric Haas Haas Consulting
X Rob Hausam Hausam Consulting LLC
Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
X Russ Leftwich InterSystems
Jay Lyle Ockham Information Services LLC, VA
Sarah Maulden VA
Jim McClay Univ of Nebraska Medical Center
Russell McDonell Telstra Health
Lloyd McKenzie Gevity (HL7 Canada)
Larry McKnight Cerner
Michelle M Miller Cerner
X Lisa Nelson Life Over Time Solutions
Viet Nguyen Lockheed Martin, Systems Made Simple
M'Lynda Owens Cognosante
Craig Parker Intermountain Healthcare
Scott Robertson Kaiser Permanente
Simon Sum Academy of Nutrition and Dietetics
Iona Thraen Dept of Veterans Affairs
X Lenel James Blue Cross Blue Shield
Quorum Requirements Met: yes


Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2016-06-09_Patient_Care_FHIR_Call
    • Motion: Stephen/Emma
  3. Prior Action Item Follow-up
  4. gForge change request

Supporting Information

STU 3 Timeline

  • Wed, June 1
    • All resource and IG proposals for STU3 have been completed, reviewed by WG and submitted
    • Connectathon tracks for Sept have been proposed
    • Feedback on gForge submitted to FMG
  • Sun, July 17 - Substantive content freeze for ballot -- core resources
  • Sun, July 24 - Total content freeze, start of QA
  • Wed, Aug 10 (midnight) - All QA changes applied
  • Fri, Aug 12 - FHIR ballot opens
  • Fri, Sept 12 - FHIR ballot closes
  • Fri, Sept 16 - FHIR triage complete and ballot content loaded to gForge (or alternate)
  • Sept 17-23 - Baltimore WGM
  • Sun, Dec 11
    • Reconciliation complete/substantive changes applied
    • Just over 10 weeks
    • Will re-evaluate at Baltimore based on volume of ballot comments
  • Dec 31 - Publish

FHIR Maturity Levels


  • Level 3 requires the artifact has been verified by the work group as meeting the DSTU_2_QA_guidelines and has been subject to a round of formal balloting; has at least 10 implementer comments recorded in the tracker drawn from at least 3 organizations resulting in at least one substantive change
    • Substantive changes (element names, sort order, vocabulary bindings, etc.) need to be applied by ballot freeze (Aug 10).
    • Unapplied QA checklist changes can be logged as ballot issues to be applied Sept-Dec. Substantive changes after ballot should be driven by ballot.
    • Non-substantive changes are fine
  • Level 2 requires artifact has been tested and successfully exchanged between at least three independently developed systems leveraging at least 80% of the core data elements using semi-realistic data and scenarios based on at least one of the declared scopes of the resource (e.g. at a connectathon). These interoperability results must have been reported to and accepted by the FMG.
Current FMM Level Goal FMM Level QA Status QA Reviewer Implementation Comments
AllergyIntolerance 1 3 Rob Argonaut
Condition 2 3 PCWG Argonaut
Procedure 1 3 Argonaut
CarePlan 1 3 Argonaut
Goal 1 3
QuestionnaireResponse 2 2 Lloyd Lloyd will QA to get to level 3
Questionnaire 0 2 Lloyd Lloyd will QA to get to level 3
CareTeam 0 2 NA NA Aggressive goal (e.g. whether we'll get the implementations needed)
FamilyMemberHistory 1 2 NA NA Aggressive goal (e.g. whether we'll get the implementations needed)
ClinicalImpression 0 1 NA NA
ReferralRequest 1 1 NA NA
ProcedureRequest 1 1 NA NA
Linkage 0 1 NA NA
Flag 1 1 NA NA
Communication 1 1 NA NA
CommunicationRequest 1 1 NA NA

Note: Bold denotes top 20 resource based on survey
Note: Contraindication and Risk Assessment are owned by CDS, not Patient Care


Prior Action Item Follow-up

Follow-up on maturity levels for FHIR resources.

Care Team member update. The participant roles in the care team member resource is unconstrained. There is a need to pick up the work to define the correct parameters for the value set(s). There is the care team relationship to the patients, vs. care team roles. There has not been a larger discussion of this issue of the correct value sets. The care team role within the team is often controlled by credential. There are many dimensions to these roles. What is the timing for this work -- NY would like to do care plan exchange soon. The care plan resource can't not be used until the care team can be defined.

  • The care plan DAM covers issues but did not cover the operational issues.
  • Have an immediate need for these value sets.
  • Does the CCS IG have participants?
  • The CCS Functional Model had participants included. The RFP is currently out via OMG. OMG met this past week for the next phase of the process. The functional model is up for publication through HL7.
  • One of these value sets is also needed in the provider directory domain.
  • The NPI database - you self select your role from a long list and you can only have one role.
  • There are vendors in production that do have value sets in their population health systems?
  • If we build something can vendors check it, or can vendors provide a starter set?
  • Is there a nursing vocabulary that may have some of these value sets?
  • Omaha classification system - is this mapped to SNOMED CT?
  • Is the value set for the Care Team member for use in the Care Plan reference to Care Team.
  • Lenel will look up the Omaha classification system and a contact.
  • There will also be concepts in SNOMED CT.
  • Discuss the findings on June 23.
  • Are the mappings issues between the Care Plan DAM vs. C-CDA complete? Working through issues.

gForge Change Requests -- Item completed during Allergy and Intolerance call on 6/15/16 -- AllergyIntolerance.substance discussed. Rob Hausam will present his work on 6/23/16 -- reviewed and discussed options of how to representation patient preference. Note differences and similarities to goal. Plan to revisit next week.


Adjourned at 6:35 EDT

Meeting Outcomes

  • Input from Viet, Russell, and Rob on Michelle's drafted ClinicalNote_FHIR_Resource_Proposal
  • Daniel Lanphear (submitter of gForge 8458) to draft new resource proposal for transfusion.
  • Rob to help fill in value sets for CareTeam status and type
Next Meeting/Preliminary Agenda Items
  1. Agenda review
  2. Approve previous meeting minutes
    • Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#>
  3. gForge change requests - 9692

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