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2017-01-05 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

Date: 2017-01-05
Time: 5-6:30pm ET
Facilitator Michelle M Miller Note taker(s) Michelle M Miller
Attendee Name Affiliation

X Elaine Ayres NIH/Department of Clinical Research Informatics
X Stephen Chu
Danielle Friend Epic
X Eric Haas Haas Consulting
X Rob Hausam Hausam Consulting LLC
Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
X Russ Leftwich InterSystems
X 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
X 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 Joe Quinn Optum
X Serafina Versaggi Dept of Veterans Affairs
Quorum Requirements Met: yes


Agenda Topics

  1. Agenda review
  2. Approve previous meeting minutes 2016-12-15_Patient_Care_FHIR_Call
    • Motion: Stephen/Rob
  3. Prior Action Item Follow-up
  4. gForge change request

Supporting Information

STU 3 Timeline

From FHIR_Ballot_Prep

  • Sun. Nov. 27 Ballot substantive resource freeze (prioritize resources that IGs will be based on)
  • Sun. Dec. 4 Ballot total freeze
  • Sun. Dec. 9 (or a day or two earlier) Freeze released - all changes allowed
  • Sun. Feb. 5 Ballot reconciliation deadline - All ballot comments must be reconciled, tracker issue report must be clean
  • Sun. Feb. 19 Publication substantive resource freeze
  • Sun. Feb 26 Publication total freeze
  • Mon. Feb 27 QA period opens
  • Tue. Feb 28 FMM QA spreadsheet updated for all WG resources
  • Sun. Mar. 13 QA period closes
  • Sun. Mar. 20 All QA applied

The "following week" STU 3 is published!

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

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


Prior Action Item Follow-up

WGM agenda:,_Jan_14_to_Jan_20

  • Tues Q4 is on the PC agenda as Negation (chaired by Jay) - Russ wouldn't be able to join; Elaine, Rob H. can attend;
  • Thurs Q1 is on the PC agenda as a CarePlan (chaired by Laura) -- Russ & Rob H. can attend
  • Wed Q1 is on the PC agenda as FHIR topics (chaired by me) -- Rob H and Russ can't attend

As a follow-up to our discussion on Dec 15 about finding a WGM quarter when Lloyd can join us to discuss pulling AdverseReaction back out into its own resource (, Lloyd said:

“I'll be with you Thurs Q1 and Tue Q4. I might be able to pop by briefly at the start of Wed Q1”

Check with Lloyd to see if he can attend Thurs, Jan 12 conference call (5-5:30pm Central Time)

gForge Change Requests

Questionnaire / QuestionnaireResponse Ownership - Transfer ownership of Questionnaire to FHIR-I from PC (Grahame) - questionnaires are really an infrastructure thing that are cropping up all over the place, and the discussions around them are mostly driven by infrastructure concerns - types, metadata, processing requirements, form vs function, questionnaires vs profiles. Obviously PC will continue to have an interest in patient focused questionnaires, but I think that this is just one valid usage

  • Russ/Stephen would prefer to retain ownership of the Questionnaire. Data that comes from the questionnaire is an important part of the clinical workflow; would like to figure out a joint ownership process
  • Rob H. thinks most of the SDC discussion is more like infrastructure
  • Serafina & Lisa - feels more infrastructure-related, though needs more clinical input during infrastructure discussions
  • Lisa - Questionnaires are used by vital records, public health, patient administration - structure is independent of the content of the questionnaire

FHIR Publication / Backlog Status

  • 43 unresolved tracker items (34 ballot + 9 high maturity resource non-ballot comments)
    • 16 requested input from vocab (value set related ballot comments) -- 5 of which require input from Patient Care first
    • 3 waiting for input
    • 2 waiting to be scheduled (joint with OO)
    • 14 ready for discussion during our weekly conference call
    • 8 Block Vote 1
  • 21 Resolved - Change Request tracker items
    • 19 ballot or high maturity resource (+ 2 non-ballot, non-priority resource)
    • 9 are substantive (+ 12 are non-substantive)
      • 4 related to new extensions/profiles
      • 1 workflow pattern
      • 3 ready to be applied
      • 1 new resources (AdverseEvent/Reaction)

Waiting for Input

In Person (Pending Schedule)

Joint with OO -- in the process of being scheduled -- hopefully at WGM

Discussed Today



Backlog - Ready to Discuss in Subsequent Calls

Resources with higher maturity - target FMM Level 3


CarePlan / Goal / CareTeam

Care Team

Value Set topics:



Questionnaire / QuestionnaireResponse



Block Vote 1 (scheduled for Jan 12)


Adjourned at 6:36PM Eastern.

Meeting Outcomes

  • Ask Lloyd to join us next Thurs, Jan 12 to discuss AllergyIntolerance
  • Follow up with Eric about OO/PC WGM quarters
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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