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2017-05-11 PA WGM Minutes

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Patient Administration Work Group Minutes - May 11, 2017

Thursday Q1

HL7 Patient Administration Meeting Minutes

Location: Marriott Madrid Auditorium, Potsdam Conference Room

Date: 2017-05-11
Time: Thursday Q1
Facilitator Brian Postlethwaite Scribe Iryna Roy
Attendee Name Affiliation
X Helen Drijfhout HL7 Netherlands
X Brian Postlethwaite Telstra Health, Australia
X Iryna Roy Gevity
X Michael Donnelly Epic
X Andrew Torres Cerner
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics
Welcome/introductions

  1. Tracker Items

Supporting Documents

Minutes

  1. 9989 – Actor cardinality in a Slot resource.

The group discusses the business scenarios for booking multiple slots and multiple actors for a schedule. Brian explains the reasoning for the modeling of the current structure. The complexity can be either carried by the client or by a server that books an appointment. The current model supports the Outlook-style scheduling. Details of the discussion and thinking process are in the tracker comments.
Option 1: both actors defined on one slot
Option 2: having slot resources for each author
Both options introduce complexity related to searching of available slots/actors. The current scheduling project and proposed operations in this space will be working on resolution of these issues.
The issue stays as “Triaged”. The discussion over the phone to follow up

  1. 12363 – Add _include Endpoint support for Provider Directory related resources.

Already completed. Added to all Provider Directory resources. Fixed as part of QA for STU3 and no need to vote.

  1. 13366 – Clarification to be added to explain a difference between Endpoint and ContactPoint

The group agrees to add a clarification: Endpoints are used facilitate system to system communication vs ContactPoint that provides physical and official contact information. The details of the amendment are in the tracker.
Moved by Michael Donnelly/Second Andrew Torres
Discussion: None
Vote: 4-0-0

  1. 13235 – Add Endpoint to a group resource.

The PA group discussed possible scenarios. The group resource does not have a scenario for a system Endpoint. The group believes the request is non persuasive. Additional details are in the tracker.
Moved by Andrew Torres /Second Michael Donnelly
Discussion: None
Vote: 4-0-0



Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • None


Next Meeting/Preliminary Agenda Items
  • .

Thursday Q2

HL7 Patient Administration Meeting Minutes

Location: Marriott Madrid Auditorium, Potsdam Conference Room

Date: 2017-05-11
Time: Thursday Q2
Facilitator Brian Postlethwaite Scribe Iryna Roy
Attendee Name Affiliation
X Brian Postlethwaite Telstra Health, Australia
X Helen Drijfhout HL7 Netherlands
X Simone Heckmann Gefyra, Germany
X Andrew Torres Cerner, USA
X Paul Knapp Knapp Consulting Inc
X Iryna Roy . Gevity Consulting Inc
X Ashley Duncan Furore
X Attila Farkas CHI
X Marten Smits Furore
X Ardon Toonstra Furore
Quorum Requirements Met (Chair +2 members): Yes

Agenda

Agenda Topics
Welcome/introductions
• Tracker Items

Supporting Documents

Minutes

Minutes/Conclusions Reached:
The FM group didn’t have a representation. Paul was the only one attending. Decided to move the review of Account and ChargeItem resources to a PA call.
Agenda change: Tracker Items review is added.

  1. 13155 – Waiting for Ardon, a requestor
  2. 12685 – Linking of Accounts required.

Discussion about use cases for linking accounts. For example, an account that subsumes all the charges of a previous account (children reference a master). Simone will go back to a company requestor for more detailed information about types of possible account linkages. Andrew Torres will bring Cerner requirements as well. The discussion will continue during the next PA Call.

  1. 13155 – Clarification required for Encounter.serviceProvider.

A group discussed various use cases to challenge the description. Details of the discussion and examples are attached to the tracker. Persuasive. Moved by Ardon Toonstra/Second by Andrew Torres
Discussion: None
Vote: 8-0-0

Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • • None
Next Meeting/Preliminary Agenda Items
  • .

Thursday Q3

HL7 Patient Administration Meeting Minutes

Location: Marriott Madrid Auditorium, Potsdam Conference Room

Date: 2017-05-11
Time: Thursday Q3
Facilitator Line Saele Scribe Helen Drijfhout
Attendee Name Affiliation
X Helen Drijfhout HL7 Netherlands
X Brian Postlethwaite Telstra Health, Australia
X Peter Jordan Gevity Consulting Inc.
X Christian Hay GS1, Switzerland
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  1. FHIR R4 work

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Brian spoke with Lloyd about the Patient Active stuff. He is supporting it.
So this would need some clarification and then this can be voted on.

  1. 11368 coveragePeriod -> period - 2016-09 core #526

The requested change on the Account resource has already been applied in STU3, it is even published.
There is a wording issue in the active period, it still refers to “coveragePeriod”.
Action for Brian to file a new tracker item to change the text.

  1. 11367 Change description of Coverage - 2016-09 core #525

Brian: This will be put on the joint session with FM, Q2 on Thursday.

  1. 13345 Organization, Location include alias elements and extensions

The Organization resource has received an alias item in STU3, before that there was a standard alias extension on Organization and Location. This can be removed.
The datatype is string, 0..* cardinality, same as the extension.
Motion to remove the extensions made by Brian, seconded by Helen, accepted with 4-0-0.

  1. 13264 Organization, Location, and Practitioner need support for Merge/Link/Unmerge

Needs more discussion.

  1. 13235 add endpoint to group

Brian thinks we need more information on this. Practitioner already has an e-mail address, also Care Team will get an Contact Point. Is it then still needed in Group?

  1. 10762 Wrong system used in practitioner example file

This is part of QA changes. The examples will be updated.

  1. 13074 QA: Valueset warnings cleanup for Encounter and ChargeItem (draft)

The QA warning is about update casing.
This seems to be already applied as part of QA.
Motion to accept the change made by Brian, seconded by Helen, accepted with 4-0-0.

  1. 13020 Encounter Length is Quantity search, not Number

Length of the Encounter has been changed from positive integer to duration, so the Search example doesn’t fit anymore.
Motion made by Brian to update the search parameter for length from number to quantity. This datatype is compatible to duration. Seconded by Helen, accepted 4-0-0.

  1. 12888 Add "Alternate Home" to EncounterDischargeDisposition value set

In Canada there is a need for a concept like “discharged to home, but not the patients own home”.
This sounds reasonable.
Helen remarks that the proposed code is “ALTDISHM”, why the “DIS” in this code? Brian agrees there is no need for this. All the codes are for Discharge Disposition.
Suggestion to make this “alt-home”.

Motion to accept the change made by Brian, seconded by Peter, accepted with 4-0-0.

  1. 12722 Replace organization type Insurance Company with Payer

Discussion about deprecating Insurance Company: there are several countries, like The Netherlands and Norway, in which still insurance companies are paying for the hospital services.
We are quite happy with adding Payer, but not with dropping “Ins”.
The valueset is an Example, so this will likely will be overruled locally.
Motion to add the concept Payer as indicated made by Brian, seconded by Helen, accepted with 4-0-0.

  1. 12854 Remove/anonymize ical mappings from Appointment resource definition

The present examples have Brains name and e-mail in it. Suggestion to remove that.
Brian moves to anonymize the examples. Peter seconds. Accepted with 4-0-0.

  1. 13066 QA: Location.mode should not be an modifier

Location.mode has a modifier on it, which according to Grahame is not appropriate.
Brian moves to remove the modifier as requested. Peter seconds. Accepted 4-0-0.




Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • None
Next Meeting/Preliminary Agenda Items
  • .

Thursday Q4

HL7 Patient Administration Meeting Minutes

Location: Marriott Madrid Auditorium, Potsdam Conference Room

Date: 2017-01-11
Time: Thursday Q4
Facilitator Line Saele Scribe Helen Drijfhout
Attendee Name Affiliation
X Helen Drijfhout HL7 Netherlands
X Line Saele HL7 Norway
X Andrew Torres Cerner
X Michael Donnelly Epic
Quorum Requirements Met (Chair + 2 members): Yes

Agenda

Agenda Topics

  1. Tracker items

Supporting Documents

Minutes

Minutes/Conclusions Reached:
Tracker items

  1. 12270 Add DICOM mappings for Organization

This item has no extra information provided. Line changes this to “wait for input” from Brad Generaux.

  1. 10304 Organization Affiliation

Will be discussed later.

  1. 13264 Organization, Location, and Practitioner need support for Merge/Link/Unmerge

We ask John Moehrke if he will be available tomorrow to discuss this.

  1. 12920 Person definition/description needs work

Lloyd suggests a change of the definition text:
The resource needs to state in the first line of its definition that "Person is a linking resource used to convey shared demographics for one or more other Patient, Practitioner and/or RelatedPerson resources". A later sentence needs to say "Person instances are never directly referenced as actors (authors, subjects, performers, etc.) Individual actors are identified as either Patient, Practitioner or RelatedPerson, depending on the role of the individual when undertaking the action"
This looks reasonable.
Moved to accept the proposed change by Michael: the text will be updated as requested. Seconded by Drew, accepted 3-0-0.

  1. 13033 8.3.3 De-normalized Data

Suggestion to change the text of the Person resource:
The second sentence in the first paragraph states:

    This is intentional and highlights that the "disconnectedness" of the resources.

Since the word "disconnectedness" portrays a negative connotation, you might consider using the words "loose coupling" instead. For instance:

    This is intentional and highlights the loose coupling of the resources.


Moved to accept the proposed change by Drew: the text will be updated as requested. Seconded by Michael, accepted 3-0-0.

  1. 12726 Appointment needs a property for the actual arrival time.

Drew: finds this not persuasive, because the Appointment is in the future. Arrival time can already be put in the Encounter with the Status history.
Drew moves to make this non-persuasive, Michael seconds, accepted 3-0-0.

  1. 12739 Need a per-participant period for Appointment

Cooper Thompson asks to add the period on the participant backbone item in the Appointment resource, because participants may be involved with the appointment for different periods in time.
After having some discussion of the options the motion is made by Michael to add period 0..1 to the participant. Drew seconds, accepted 3-0-0.

  1. 12304 Add IHE PCD MEMLS data items to FHIR DSTU2 Location resource

Monroe Pattillo asks to align the Location resource with MEMLS profile from IHE.
Drew remarks that some of the extra attributes, like accuracy and speed, are attributes of the device which has been used, not of the Location itself. The Location is fixed and has GPS coordinates.
Drew moves to make this not-persuasive. Michael seconds. Accepted 3-0-0.

  1. 9249 Manage the Provenance of Practitioner (and Other Resources) using an Extension

The suggestion is to use the Provenance resource.
There has been voted on this in January 2016, to refer this for future use. It would be tested in a connectathon by Brian, but there has not been a follow-up. We ask Brian for more information.

  1. 12365 How should we represent an Endpoint.address for a v2 mllp connection?

There is an example in the tracker item.
We need an IP address and a port number. Michael types the example in the resolution.
Michael moves to add the example, Drew seconds, accepted 3-0-0.

  1. 11367 Change description of Coverage - 2016-09 core #525

The Coverage resource is owned by FM, so we will not vote on this today.

  1. 12364 Added 'Direct-project' to valueset-endpoint-connection-type

Michael: This is about direct messages, not about the project “direct-project”, that doesn’t exist anymore. But looking at the wiki page for the Direct project (http://wiki.directproject.org/), he changes his mind and finds this persuasive. Drew seconds the motion. Accepted 3-0-0.

Line has just heard that Alex deLeon has been re-elected as a co-chair of PA!


Meeting Outcomes

Actions (Include Owner, Action Item, and due date)
  • Action item: Andrew Torres to check implication of changing the relationship from 0..1 to 0..*
Next Meeting/Preliminary Agenda Items
  • .

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