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Difference between revisions of "2016-11-10 Patient Care FHIR Call"

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=== gForge Change Requests ===
 
=== gForge Change Requests ===
 +
====FHIR Publication / Backlog Status====
 +
* 50 unresolved tracker items (42 ballot + 8 high maturity resource non-ballot comments) to resolve by Nov 20
 +
**  7 scheduled in Block Vote 4 (Nov 10)
 +
** 18 requested input from vocab (value set related ballot comments)
 +
**  7 waiting for input
 +
**  5 waiting to be scheduled (joint with OO or in person requests)
 +
** 13 ready for discussion during our weekly conference call
 +
 +
====Block Vote #4 ====
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=9044 Need extension to track FHIR data type (Lloyd McKenzie) Persuasive
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=9275 Questionnaire reference to Valueset is only by reference  cannot link by URI as in elementdefinition (Brian Postlethwate) Not Persuasive
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10481 QuestionnaireResponse should have only one recursion point for nested "item"s (Josh Mandel) Not Persuasive with Mod
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11000 enableWhen.question -> enableWhen.enablingQuestion - 2016-09 sdc #66  (Stephen Chu) Not Persuasive
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12064 Abatement needs to be simplified (David Pyke) Not Persuasive
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12170 Clarification on Questionnaire item.repeats (Michele Mottini) Persuasive with Mod
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12173 New Questionnaire extension to specify exclusive multiple-choice item (Michele Mottini) Persuasive
 +
 +
====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=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
 +
 +
Joint with OO -- in the process of being scheduled
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11026 Relationship between Condition and Observation - 2016-09 core #45  (Jay Lyle)
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11119 Differentiate ProcedureRequest and DiagnosticRequest and align their elements - 2016-09 core #273  (Danielle Friend)
 +
 +
Feedback on prior resolutions - may need to revisit when Rob McClure can attend.
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11354 - add extension for condition findings
 +
** Resolution is inconsistent -- a terminology service would still need to extract out the substance from the product codes
 +
** In some jurisdictions, like the UK, the use of the condition codes is very much in the 80% (closer to 100%)
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11352 - category cardinality
 +
** Do 80% of systems support multiple categories? 
 +
** Our resolution conflicts with the FHIR GA guidelines 4e that say when constraining to the "code" data type, “ensure all codes are mutually exclusive or are defined in a proper hierarchy where siblings are mutually exclusive” – since the value set binding is required and cardinality is 0..*, the value set is neither mutually exclusive, nor defined in a proper hierarchy
 +
 +
==== Backlog - Ready to Discuss in Subsequent Calls ====
 +
Resources with higher maturity - target FMM Level 3
 +
 +
AllergyIntolerance
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11021 Increase cardinality of substance and make certainty relation to substance  not reaction - 2016-09 core #40  (Jay Lyle)
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11025 Need to explicitly assert presence vs. absence of a risk - 2016-09 core #44  (Jay Lyle)
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11155 Unclear how the negation value set will work - 2016-09 core #309  (Stephen Chu)
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12177 Review/expand the AllergyIntolerance.criticality valueset (Mohannad Hammadeh)
 +
 +
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
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12090 Rename goal attribute
 +
* 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) -- pulled from block vote
 +
 +
Condition
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10635 QA 5a: Resource references exist in both directions for Condition and ClinicalImpression (Michelle Miller)
 +
 +
Procedure
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=11162 Suggest include reference to remedial treatment(s) - 2016-09 core #316  (Stephen Chu)
 +
 +
Questionnaire / QuestionnaireResponse
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10998 Questionnaire.concept -> Questionnaire.code and update definitions - 2016-09 sdc #64  (Stephen Chu)
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12186 Proposed Changes to Questionnaire / Questionnaire Response from Tuesday evening discussion (Grahame Grieve)
 +
 +
Care Team
 +
* DAF - http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10715 Add entered in error to valueset-daf-careteam-status (Michelle Miller) - related to http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=10725, which is part of the Vocab set to review
 +
 +
 +
ProcedureRequest
 +
* http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=9335 Orders to not do things (Emma Jones)
  
 
=== Adjourn ===
 
=== Adjourn ===

Revision as of 22:20, 9 November 2016



Meeting Information

Patient Care FHIR Resources Conference Call

Location: Conference Call
Phone Number: +1 770-657-9270
Participant Passcode: 943377
WebEx: https://cerner.webex.com/cerner/j.php?MTID=mfc8969c4f77244480beee61d31385e79

Date: 2016-11-10
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
Danielle Friend Epic
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
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

  1. Agenda review
  2. Approve previous meeting minutes 2016-11-03_Patient_Care_FHIR_Call
    • Motion: <moved>/<seconded>
  3. Prior Action Item Follow-up
  4. 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 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 #3 (approved last week) had 36 gForges in it.
    • 2 were deferred
    • 5 were not persuasive / resolved - no change
    • 20 have been applied already (http://build.fhir.org/resourcelist.html)
    • 9 are not yet applied (3 non-substantive + 4 non-compatible + 2 substantive, compatible)

gForge Change Requests

FHIR Publication / Backlog Status

  • 50 unresolved tracker items (42 ballot + 8 high maturity resource non-ballot comments) to resolve by Nov 20
    • 7 scheduled in Block Vote 4 (Nov 10)
    • 18 requested input from vocab (value set related ballot comments)
    • 7 waiting for input
    • 5 waiting to be scheduled (joint with OO or in person requests)
    • 13 ready for discussion during our weekly conference call

Block Vote #4

In Person (Pending Schedule)

In Person Requests -- in the process of being scheduled

Joint with OO -- in the process of being scheduled

Feedback on prior resolutions - may need to revisit when Rob McClure can attend.

Backlog - Ready to Discuss in Subsequent Calls

Resources with higher maturity - target FMM Level 3

AllergyIntolerance

CarePlan / Goal

Condition

Procedure

Questionnaire / QuestionnaireResponse

Care Team


ProcedureRequest

Adjourn

Adjourned at <hh:mm am/pm> <timezone>.

Meeting Outcomes

Actions
Next Meeting/Preliminary Agenda Items
  1. Agenda review
  2. Approve previous meeting minutes
    • Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#>
  3. gForge change request

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