2017-01-12 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: https://cerner.webex.com/cerner/j.php?MTID=mfc8969c4f77244480beee61d31385e79		Date: 2016-01-12 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 2017-01-05_Patient_Care_FHIR_Call
   • Motion: <moved>/<seconded>
3. WGM agenda review
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

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

WGM agenda

Quarters dedicated to FHIR ballot reconciliation

• Mon Q3 - CarePlan, CareTeam, and Goal
  • GF#11116 - Better define the careplan.activity.outcome field. - 2016-09 core #270
  • GF#11342 - Add CareTeam.relatedTeam or other composition relationship - 2016-09 core #500
  • GF#11344 - Allow CarePlan.activity.detail.performer to be CareTeam - 2016-09 core #502
  • GF#12567 - Rename component to milestone within valueset-goal-relationship-type
  • GF#10620 - QA 7a: CarePlan.activity.outcome needs a binding to a value set
  • GF#10623 - QA: Goal CodeableConcept elements are missing a binding to a value set

• Tues Q2 - Condition/Concern
  • GF#10090 - Condition Introduction (taking into account concerns)

• Tues Q3 - CareTeam value set discussion
  • GF#10725 - QA 4: CareTeam CodeableConcepts need a binding to a value set
  • GF#11334 - Constrain participant role value set - 2016-09 core #492

• Wed Q1 - FHIR ballot reconciliation
  • GF#11162 - Suggest include reference to remedial treatment(s) - 2016-09 core #316
  • GF#10626 - QA: Procedure.usedCode needs a binding to a value set
  • GF#10627 - QA 4a: Consider binding Procedure.focalDevice.action (CodeableConcept) to codes from an external coding system - vocab
  • GF#10393 revisit workflow patterns; review gap analysis attached to the gForge

• Thurs Q3 - FHIR ballot reconciliation - joint with OO for second half
  • GF#10635 - QA 5a: Resource references exist in both directions for Condition and ClinicalImpression
  • GF#11209 - Feedback on ClinicalImpression - 2016-09 core #363
  • GF#10391* - Communication.reason needs to be searchable (John Moehrke)
  • GF#10390* - CommunicationRequest query on reason (John Moehrke)
  • GF#10387* - CommunicationRequest needs ability to describe the location that the communication is about (John Moehrke)
  • GF#11026 – Relationship between Condition and Observation (Jay Lyle)
  • GF#11119 – Differentiate ProcedureRequest and DiagnosticRequest and align their elements (Danielle Friend) - related Zulip Chat

gForge Change Requests

FHIR Publication / Backlog Status

• 40 unresolved tracker items (31 ballot + 9 high maturity resource non-ballot comments)
  • 11 requested input from vocab (value set related ballot comments)
  • 1 waiting for input
  • 17 ready for discussion at WGM (including 2 that are joint with OO) or conference calls
  • 3 ready for discussion during conference call today
  • 8 Block Vote 1

• 19 Resolved - Change Request tracker items
  • 17 ballot or high maturity resource (+ 2 non-ballot, non-priority resource)
  • 7 are substantive (+ 12 are non-substantive)
    • 4 related to new extensions/profiles
    • 1 workflow pattern
    • 1 new resources (AdverseEvent/Reaction)
    • 1 ready to be applied

Waiting for Input

• GF#7185 ClinicalImpression is poorly thought out (ClemMcDonald@mail.nih.gov)

Block Vote 1 (scheduled for Jan 12)

• GF#9044 - Need extension to track FHIR data type
• GF#12400 - Add Goal search parameter for startDate
• GF#12418 - add status search parameter to CarePlan
• GF#12442 - QA: Questionnaire.item.enableWhen.answer and Questionnaire.item.initial bindings missing
• GF#12434 - Remove answerInstant from Questionnaire(Response)
• GF#12517 - add diagnosticrequest to context of procedure-targetbodysite
• GF#12511 - Questionnaire.item.type optional problem
• GF#12430 - Make clear that QuestionnaireResponse must align with corresponding Questionnaire

Ready for Discussion

Continue discussion on...

• GF#11346 - suggest adding 'modified' element to indicate when the careTeam was last updated. - 2016-09 core #504

Questionnaire

• GF#12186 - Proposed Changes to Questionnaire / Questionnaire Response from Tuesday evening discussion

Communication/CommunicationRequest

• GF#10391 - Communication.reason needs to be searchable (John Moehrke)
• GF#10390 - CommunicationRequest query on reason (John Moehrke)
• GF#10387 - CommunicationRequest needs ability to describe the location that the communication is about (John Moehrke)

Vocab Assistance

• GF#10613 - QA 4e: Clean up valueset-goal-status
• GF#10615 - QA 4: Clean up valueset-goal-status-reason
• GF#10621 - QA 4a: Consider whether CarePlan.activity.detail.category should be bound to an external code system
• GF#10622 - QA 4a: Consider whether Goal.category should be bound to codes from an external code system
• GF#10624 - QA 4a: Consider whether Goal.priority (CodeableConcept) should be bound to an external code system such as SNOMED
• GF#11351 - AllergyIntoleranceCategory should be SNOMED - 2016-09 core #509
• GF#11355 - CarePlan category value set is out of date or wrong - 2016-09 core #513
• GF#11357 - Re-use the procedure value set instead of wrapping it - 2016-09 core #515
• GF#11358 - Should not make a new value set ehre - use the Problem value set that also includes Events and SWEC concepts. - 2016-09 core #516
• GF#11359 - Why only one medication in an activity? And the value set is problematic (but example) - 2016-09 core #517

Adjourn

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

Meeting Outcomes

Actions

Next Meeting/Preliminary Agenda Items Agenda review Approve previous meeting minutes 2017-01-05_Patient_Care_FHIR_Call Motion: <moved>/<seconded> Abstain - <#>, Negative - <#>, Approve - <#> gForge change request

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