2016-10-27 Patient Care FHIR Call
Meeting Information
Patient Care FHIR Resources Conference Call Location: Conference Call |
Date: 2016-10-27 Time: 5-6:30pm ET | ||
Facilitator | Michelle M Miller | Note taker(s) | Michelle M Miller |
Attendee | Name | Affiliation
| |
Elaine Ayres | NIH/Department of Clinical Research Informatics | ||
Stephen Chu | |||
Eric Haas | Haas Consulting | ||
Rob Hausam | Hausam Consulting LLC | ||
Laura Heermann-Langford | Intermountain Healthcare | ||
Emma Jones | Allscripts | ||
Russ Leftwich | InterSystems | ||
Tony Little | Optum 360 | ||
Jay Lyle | Ockham Information Services LLC, VA | ||
Sarah Maulden | VA | ||
Hank Mayers | ReliaTech Consulting | ||
Jim McClay | Univ of Nebraska Medical Center | ||
Rob McClure | MD Partners | ||
Russell McDonell | Telstra Health | ||
Lloyd McKenzie | Gevity (HL7 Canada) | ||
Larry McKnight | Cerner | ||
Michelle M Miller | Cerner | ||
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 | ||
Quorum Requirements Met: yes |
Agenda
Agenda Topics
- Agenda review
- Approve previous meeting minutes 2016-10-20_Patient_Care_FHIR_Call
- Motion: <moved>/<seconded>
- Prior Action Item Follow-up
- gForge change request
Supporting Information
STU 3 Timeline
From FHIR_Ballot_Prep
- Sun Oct. 9
- Last date for change requests (subsequent change requests are auto-punted to release 4)
- Sun Oct. 30
- NIBs due for any IGs balloting in the Jan. cycle
- Sun Nov. 20
- All ballot reconciliation complete
- Sun Nov. 27
- All substantive changes applied to Core
- Sun Dec. 4
- Content freeze for ballot & connectathon & publication QA review
- Sun Dec. 24
- QA review complete, Qa changes begin being applied
- Dec 29 - Jan 3ish
- 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
Resource |
Current FMM Level | Goal FMM Level | QA Status | QA Reviewer | Implementation | Comments |
AllergyIntolerance | 1 | 3 | Michelle | Argonaut | ||
Condition | 2 | 3 | Michelle | Argonaut | ||
Procedure | 1 | 3 | Michelle | Argonaut | ||
CarePlan | 1 | 3 | Michelle | Argonaut | ||
Goal | 1 | 3 | Michelle | |||
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 | Michelle | 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
- Block Vote #1 (approved last week) had 25 gForges in it.
- 6 were not persuasive / resolved - no change
- 17 have been applied already (http://hl7-fhir.github.io/)
- 2 (non-substantive) have not yet been applied
- Michelle Miller sent email to workflow listserv (http://lists.hl7.org/read/messages?id=302719) to highlight why PC doesn't believe the status recommendation applies to Condition (and AllergyIntolerance); Lloyd responded that workflow should discuss the exceptions, but he didn't think there is any issue with these two. It makes no sense for them to follow the usual "event" statuses; Michelle has added the group of related gForges to the next Block Vote #3.
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10642 - QA 5c: Default value needed for AllergyIntolerance.status since minOccurs=0 and is-modifier element
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11151 - Separate clinical status from clinical workflow status & align w/ Condition.status - 2016-09 core #305
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11920 - Required value set is missing "proposed" concept - 2016-09 daf #4
gForge Change Requests
Vote on Block Vote 2
Scheduled for Oct 27.
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11171 Clarify CarePlan.context and CarePlan.duration - 2016-09 core #325 (Stephen Chu) Not Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11177 Change CareTeam definition - 2016-09 core #331 (Stephen Chu) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11337 Clarify order set - 2016-09 core #495 (David Tao) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11345 Add CarePlan.activity.detail.prohibited.reason - 2016-09 core #503 (Emma Jones) Not Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=7045 2015May core #110 - Allow the protocol data element to be multi-typed as either text or uri. (Andy Bond) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10403 add condition.onsetDateTime (Marten Smits) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10429 QuestionnaireResponse.questionnaire should be URI (Lloyd McKenzie) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10634 QA 5a: Resource references exist in both directions for CarePlan and ReferralRequest (Michelle Miller) Not Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10723 Add a search parameter for status for the ProcedureRequest resource (Emmanuel Helm) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10755 Questionnaire item required when enabled (Sean McIlvenna) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11001 enableWhen.hasAnswer -> enableWhen.answerEnabled - 2016-09 sdc #67 (Stephen Chu) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11002 item.maxLength -> item.answerMaxLength - 2016-09 sdc #68 (Stephen Chu) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11003 item.initial -> item.prePopInfo - 2016-09 sdc #69 (Stephen Chu) Not Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11004 What's the difference between Questionnaire.subjectType and QuestionnaireResponse.subject? - 2016-09 sdc #70 (Stephen Chu) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11005 Questionnaire.useContext sounds too much like QuestionnaireResponse.context - 2016-09 sdc #71 (Stephen Chu) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11165 Reword short description for ClinicalImpression.code - 2016-09 core #319 (Stephen Chu) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11166 The goal to use as short as possible concept name should not be at the expense of semantic accuracy - 2016-09 core #320 (Stephen Chu) Not Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11167 ClinicalImpression shouldn't include plan - 2016-09 core #321 (Stephen Chu) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11202 Flag information should support machine processing and human readability - 2016-09 core #356 (Stephen Chu) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11203 Add invariant to ensure Flag.duration and Flag.encounter align - 2016-09 core #357 (Stephen Chu) Not Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11204 Suggest rename to "Alert and Warming" - 2016-09 core #358 (Stephen Chu) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11380 Communication basedOn(any) seems too broad - shouldn't it be limited to CommunicationRequest? - 2016-09 core #538 (Paul Knapp) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11923 Required value set is missing "entered-in-error" concept - 2016-09 daf #7 (Calvin Beebe) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12071 Need to differentiate when to use each nesting approach for item (Lloyd McKenzie) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12168 Future observations need to be included in goals (Floyd Eisenberg) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12169 Expand the scope of the entryFormat Questionnaire extension (Michele Mottini) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12171 careplan.activity.detail.prohibited description "Do NOT do" is misleading and confusing (Emma Jones) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12172 The spec use Questionnaire in many places where they should use QuestionnaireResponse (Michele Mottini) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12188 Add search parameters to ProcedureRequest (Elliot Silver) Persuasive
Block Vote 3 Preview
Scheduled for TBD
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=8048 2015May core #1373 - Add communicaton-request as a code to the MessageEvents (Tim McNeil) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10468 New populate structures are broken (Lloyd McKenzie) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10607 QA 2a: Add more goal examples to cover all contexts and elements (Michelle Miller) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10617 QA 4e: consider adding unknown and other to CarePlan code element value sets (Michelle Miller) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10625 QA 4e: consider adding unknown to Procedure.status value set since minOccurs =1 (Michelle Miller) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10642 QA 5c: Default value needed for AllergyIntolerance.status since minOccurs=0 and is-modifier element (Michelle Miller) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10643 QA 5c: Default value needed for CarePlan.activity.detail.status since minOccurs=0 and is-modifier element (Michelle Miller) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10999 Questionnaire.item.concept -> questionItemCode - 2016-09 sdc #65 (Stephen Chu) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11020 Need use-case for reaction.certainty - 2016-09 core #39 (Jay Lyle) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11022 How is unknown different from absence of judgement? - 2016-09 core #41 (Jay Lyle) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11023 Why isn't AllergyIntolerance.reaction an Observation? - 2016-09 core #42 (Jay Lyle) Not Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11027 Scope of negation is unclear - 2016-09 core #46 (Jay Lyle) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11051 Explain or remove Questionnaire datatype allowed for CarePlan.activity.detail.definition - 2016-09 core #70 (Dave Carlson) Not Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11077 How does one assert that the subject does NOT have a condition? - 2016-09 core #96 (Galen Mulrooney) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11089 Inconsistencies between AllergyIntolerance and Condition - 2016-09 core #170 (Chris Moesel) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11090 Make performer consistent across Procedure & ProcedureRequest - 2016-09 core #171 (Chris Moesel) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11134 Clarify linkId - 2016-09 core #288 (Daniel Rutz) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11151 Separate clinical status from clinical workflow status & align w/ Condition.status - 2016-09 core #305 (Stephen Chu) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11153 lastOccurrence should be on reaction - 2016-09 core #307 (Stephen Chu) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11154 AllergyIntolerance.onset and reaction.onset are duplicates - 2016-09 core #308 (Stephen Chu) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11163 Logically age is estimated property should be a child of age - 2016-09 core #317 (Stephen Chu) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11168 Clarify ClinicalImpression.action - 2016-09 core #322 (Stephen Chu) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11170 Include "risk" as an element in the CarePlan structure Will accept this as suggested to be implemented as extension - 2016-09 core #324 (Stephen Chu) Not Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11173 CarePlan needs support for reviews - 2016-09 core #327 (Stephen Chu) Considered for Future Use
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11176 Differentiate CareTeam.type and name - 2016-09 core #330 (Stephen Chu) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11181 Will accept inclusion of "supporting clinical information" as extension to ProcedureRequest - 2016-09 core #335 (Stephen Chu) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11229 Why are SNOMED codes being used for Questionnaire.item.concept in example? - 2016-09 core #383 (Riki Merrick) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11332 Acknowledge Advance Directives as type of Care Plan - 2016-09 core #490 (David Tao) Considered for Future Use
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11335 Allow multiple organizations for care plan - 2016-09 core #493 (David Tao) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11343 Add CarePlan.definition - 2016-09 core #501 (Emma Jones) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11344 Allow CarePlan.activity.detail.performer to be CareTeam - 2016-09 core #502 (Emma Jones) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11347 CareTeam.type -> CareTeam.category - 2016-09 core #505 (Emma Jones) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11379 Make Communication.topic choice of Reference and Identifier - 2016-09 core #537 (Paul Knapp) Not Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11381 Expand CommunicationRequest.encounter to topic - 2016-09 core #539 (Paul Knapp) Persuasive with Mod
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11473 Add more use-cases with List - 2016-09 core #637 (Lloyd McKenzie) Persuasive
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11920 Required value set is missing "proposed" concept - 2016-09 daf #4 (Calvin Beebe) Persuasive with Mod
In Person (Pending Schedule)
In Person Requests -- in the process of being scheduled
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12136 Searching on optional attribute is dangerous (e.g., allergyintolerance.category)- Mark Kramer - Nov 3
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11281 Overall Condition.clinicalStatus and Condition.verificationStatus Condition body site - 2016-09 core #435 - Clem McDonald - TBD
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11290 clinical impression and condition - 2016-09 core #444 - Clem McDonald - TBD
Discussion
AllergyIntolerance
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11354 Substance identified in both AllergyIntolerance.code and reaction.substance is problematic - 2016-09 core #512 - Robert McClure
CarePlan / Goal
- http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11116 Better define the careplan.activity.outcome field - discussion occurred during the CarePlan (Wed, Oct 26) conference call. PCWG agreed that outcome is needed on both the activity and goal. For example, a goal of losing 20 pounds might include activities to 1) reduce caloric intake via diet and 2)exercise 30 minutes per day. The outcome associated with the weight loss goal might be an observation with the updated body weight whereas the outcome on the activity side might be the number of calories burned via exercise or calories consumed via diet. Next steps:
- expand/clarify the outcome definitions on both the activity and goal.
- harmonize the outcome structure to allow the activity to reference an observation (like the goal outcome allows)
- bind the outcome codeableconcepts to value sets
Adjourn
Adjourned at <hh:mm am/pm> <timezone>.
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