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2017-09-25 Rx Conf Call

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  • Melva Peters (Chair)
  • John Hatem
  • Michelle Miller
  • Daniel Zhang

Agenda Items and notes

Recap WGM

  • Teleconference time - moved back to 4pm Eastern
  • Blood products discussion
  • Co-chair election results - John Hatem and Melva Peters re-elected
  • Electronic voting - comments?
    • much easier to do -
    • suggest some information on eligibility

Project Co-Sponsor

  • O&O request - Transplants, transfusions and grafts on FHIR

File:Transplant on FHIR PSS.docx

    • meeting held in San Diego - major outcome was that O&O would take the lead on the PSS
    • there are some products that should not be ordered through pharmacy
    • initially leaning toward pharmacy resources for ordering products - may actually need to be a new resource that are not managed by pharmacy
      • would mirror MedicationRequest but may need to have additional attributes
    • will be drafting a model - may be more specific for transfusions
    • Motion to co-sponsor PSS - John - Daniel - 3-0-0 Carried
      • involvement - will name an individual to participate on project calls - John volunteered plus formal review and updates
      • ask that John Hatem be added as a domain expert
Action:  Melva to notify O&O - complete

Project Co-Sponsor

  • BR&R - FHIR resources to support IDMP 11615 Product Standard

File:EHL7 PSS BRR FHIR IDMP Product 2017 Q3.docx

    • new project - clarify if this is an investigative project
    • Motion to co-sponsor PSS - John - Daniel - 3-0-0 Carried
      • involvement - will name an individual to participate on project calls -
Action:  Melva to notify BR&R - complete
Action: Melva to talk to Jean to see if he will participate - complete - he will


MedicationKnowledge Resource

  • discussion in San Diego about a new resource for medication knowledge
    • after a lengthy discussion Grahame told us to proceed with a project and a resource proposal
    • working name is MedicationKnowledge
    • goal is to include in Comment only ballot for January cycle
  • Review Project Scope Statement - need to review and approve
  • reach out to drug knowledge base vendors - FDB, MediSpan, etc; Apelon, IMO, Multum announcing new project
  • Michelle will reach out to Multum - are there requirements that should be included for medication knowledge?
  • Daniel - Epic - no plans to expose knowledge base via API
  • Motion to approve Project - Daniel - seconded by Michelle - 3-0-0 Carried
  • should we ask others to be interested party - BR&R, Patient Care, O&O and CDS
  • Review Resource Proposal - need to review and approve
    • MedicationKnowledge resource proposal
    • add Patient Care and Clinical Decision Support
    • expand on "some commercial systems" to be specific
    • update the scenario - "This resource can be used to query for a drug or set of drugs coverage details in a particular formulary"
    • Motion to accept resource proposal: John/Michelle - 3-0-0 Carried
Action:  Melva to update resource proposal and notify FMG for approval - complete
Action:  Melva to forward PSS to FMG for approval - complete

FHIR Tracker Items

FHIR Tracker

Medication Related (Group = A)

  • GF#13295: Add support for compounded or magistral products - was previously approved, but need to review in light of decisions made in San Diego
  • Other open tracker items
  • August 28, 2017: will discuss further in San Diego
    • may be 1 resource with multiple profiles or may be 3 resources that are harmonized - to be determined
      • we believe that Pharmacy WG should own "clinical Medication" and "drug knowledge" resources
  • July 31, 2017
    • Use cases - coded product vs non-coded product
      • John will work with others on how detailed we need to provide information on packaging
      • Discussion of when a medication is ordered that is included multiple products; or when medication is order with specific packaging - need to define use cases
Action:  Provide examples of the various medications that we would need to ship around in orders/dispenses/administrations/statements to see what we actually need
Action:  John to coordinate the analysis of packaging information needed for requests, dispenses, administrations and statements - additional attributes that are needed when code is not specific enough
  • August 7, 2017 - John will report on what type of "medication" information is needed in our Pharmacy Medication resource re: Packaging - complete

Dosage Related (Group = B)

Misc (Group = none)

  • GF #13905 prn medications need boolean and optional reason
  • GF #13537 13537 Collapse medicationAdministration.notDone into status
    • we discussed 13537 which is a request to update Medication Administration by removing the NotGiven Boolean and adding in a new status code - not done. Since this is coming from workflow we decided to wait until this is added to the Event logical model for Workflow and evaluate the definition of "not done" and assess it's relevance for Pharmacy. In general there was a positive reaction to this request.
  • GF #13538 13538 Collapse medicationDispense.notDone into status
    • we discussed 13538 which is a request to update Medication Dispense by removing the notGiven Boolean and adding in a new status code - not done. Since this is coming from workflow we decided to wait until is added to the Event logical model for Workflow, and evaluate the definition of "not done" and assess it's relevance for Pharmacy.
      • Michelle mentioned we may also want to review Patient Care 12592 before we make our changes since there was some discussion about how this change should/should not impact the Request resource.
    • August 28 - John checking to see what changes have happened to Workflow
  • GF #13881 Definitions for MedDispense
  • GF #13878 Clarify definition for reasonNotTaken on MedicationStatement

Order Service Catalogue FHIR Project

  • To follow the Order Catalog work, use the following listserv:
  • Background
    • under Orders WG.
    • Catalogue vs Formulary. Catalog is a superset of Formulary, includes orderable items beyond medications.
    • expect one or two new resources
    • Jose and John involved
  • Updates
    • New Lab resource was created. John Hatem will continue to monitor and attend meetings.
    • August 14: last meeting was specific to lab specimen
      • content of the resource is generic
    • August 28: no update. There will be a meeting this week
      • specimen resource - believed to be a definitional resource
    • September 25: not started up

International Chemotherapy Implementation FHIR IG

  • Chemotherapy IG Wiki Page
  • Background
    • NCCN and other European input to support broad requirements. Specific implementations would constrain as needed
  • Update from John Hatem
    • Next meeting will be held August 15
    • no update - meeting will be held this week - John will attend
Action:  John will ask about ballot time frame
  • August 28 - meeting this week
  • September 25: no update - meetings have been cancelled

Blood Products/Transfusion/Tissue Update

  • Background:
    • based in Patient Care. also includes Orders
    • Blood Products/etc moving into FHIR. Want to maintain alignment with Orders and Pharmacy resources
  • Eric H has sent out a Doodle poll to determine a meeting time for OO, PC and Pharmacy to discuss.
    • Meeting is currently scheduled for Aug 10, 2017
  • Updates
    • August 14, 2017
      • Minutes
      • meeting was held on August 10
      • scoped to Blood Transfusion for now - profiles on Pharmacy resources may work for the requirements
      • will continue to investigate requirements in preparation for the WGM Quarter
      • Michelle will post to Zulip inviting participation at WGM - complete

CIMI Pharmacy Model Update

  • Update from John Hatem
    • July 17, 2017 - Claude Nanjo provided an overview of the CIMI logical model that incorporates the Pharmacy FHIR resource work. This work will be balloted as Informative in the HL7 September 2017 ballot.
    • July 31, 2017 - concerns raised about how Pharmacy will be involved and be expected to manage the content
      • will be balloted as informative
    • August 7, 2017 - John Hatem is following up with Claude N. on what type of commitment is expected from Pharmacy going forward.
    • August 14, 2017 - John has reached out to Claude. He has a general slide deck but will have to re-create a pharmacy specific version.
    • August 28, 2017 - ballot is open. It is not easy to read the ballot content without using the mapping spreadsheet and even then it isn't clear
Action: John to reach out to Claude and indicate that we believe a pharmacy specific is needed - complete

Action Item List

  • August 7 update: John is working on cleaning up the action item list
  • September 25 update: Claude believes more information needs to be provided to navigate through the material
    • he is willing to come to Pharmacy WG


  • John will attend WorkFlow calls

Next meeting

  • Monday, October 2nd, 2017 - 4pm Eastern