2016-07-14 Patient Care FHIR Call

Meeting Information

Patient Care FHIR Resources Conference Call Location: Conference Call Phone Number: +1 770-657-9270 Participant Passcode: 943377 WEBEX: www.webex.com Meeting number: 198 139 396		Date: 2016-07-14 Time: 5-6:30pm ET
Facilitator	Rob Hausam	Note taker(s)	Rob Hausam
Attendee	Name	Affiliation
	Elaine Ayres	NIH/Department of Clinical Research Informatics
X	Stephen Chu
X	Eric Haas	Haas Consulting
X	Rob Hausam	Hausam Consulting LLC
	Laura Heermann-Langford	Intermountain Healthcare
	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
X	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	Paul Knapp	Knapp Consulting
X	Vivek Menon	EZDI
X	Herman Singh
Quorum Requirements Met: yes

Agenda

Agenda Topics

1. Agenda review
2. Approve previous meeting minutes 2016-07-07_Patient_Care_FHIR_Call
   • Motion to approve: Stephen Chu/Lloyd McKenzie
3. Prior Action Item Follow-up
4. Block vote on GFORGE change requests
5. gForge change requests requiring discussion

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

[1]

• 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.

Resource	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

Minutes

Prior Action Item Follow-up

• None.

Block Vote GFORGE Requests:

• 10291:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10291&start=0
• 10290: http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10290&start=0
• 10284:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10284&start=0
• 10272:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10272&start=0
• 10270:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10270&start=0
• 10259:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10259&start=0
• 10102:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10102&start=0
• 10101:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10101&start=0
• 10078:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10078&start=0
• 10077:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10077&start=0
• 10035:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10035&start=0

As most of the participants on the call hadn't had a chance to review the block vote items, each items was presented and discussed prior to the block vote.

10262 and 10090 were pulled from the block vote as originally proposed.

• Motion to approve the block vote as above.

Stephen Chu/Lisa Nelson Against: 0 Abstain: 0 In favor: 7

gForge Change Requests

• 10090:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10090&start=0

The discussion and vote on this item was deferred to next week, as any changes involved should be considered as non-substantive, allowing us to discuss it next week prior to the final freeze on July 24.

• 10262:http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10262&start=0

This was discussed, but the vote was deferred to next week. The primary sense of the discussion is that this is likely non-persuasive, as all allergies are to substances. Rob feels that adding a specific "substance" category would have to include hierarchy (as it would be the parent of the other categories) and it would not really add value. The existing categories of either "environmental" or "other" should be adequate for covering this. It is OK to defer the vote on this one to next week, as if non-persuasive no change is required, and even if persuasive adding a code to the value set should be non-substantive.

Additional agenda items brought forward by Paul Knapp from FM

1. Discussion and proposal to make changes to the Communication resource to support wider use.
   • Motion: We already have agreed to change Communication.encounter' to a reference to 'Episode of care' and 'Encounter'. Add a 'topic' element with cardinality 0..* which is a reference to ANY resource. Lloyd McKenzie/Paul Knapp Against: 0 Abstain: 0 In Favor: 7
2. Paul brought forward an additional item from FM for discussion. We need to find a consistent way in resources for WGs to specify business identifiers as an alternate to references where that is appropriate. Will propose to include discussion of this on the relevant WG agenda(s) in Baltimore. The suggestion is that this would be an item for MnM/FHIR-I, but it also should be discussed with the relevant domain WGs.

Adjourn

Adjourned at 6:55 pm Eastern.

Meeting Outcomes

Actions 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 Agenda review Approve previous meeting minutes Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#> gForge change request

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