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2017-12-04 Rx Conf Call

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  • Scott Robertson (Chair)
  • John Hatem (Scribe)
  • Stephen Chu
  • Michelle Miller

Agenda Items and notes

Pharmacy List

Joint Meeting

  • 2017-11-27 discussion
    • During the last meeting of IHE Pharmacy in Bordeaux we discussed if there is any ground to use the moment of Cologne for a get together with HL7 Pharmacy, IHE Pharmacy and ISO WG 6.
    • From the IHE Pharmacy viewpoint we have our new profiles Mobile medication administration ( MMA) and Uniform Barcode Processing ( UBP) to present to you. If the HL7 Pharmacy group is interested we could set up initiatives to organize an one day meeting with IHE and ISO. This could for example be the Thursday, since you always participate with the ClinFHIR on the Fridays.
    • Please bring this forward in your conference call and let me know if there is any interest in a joint session in Cologne in May 2018.
    • May not all Co-Chairs present.
    • If we held it on a day, they would have to pay the daily rate.
    • could we do this as an online call at another time?
    • could may be do this at HL7 Pharmacy meeting in Cologne for this who are joining
  • 2017-12-04 Waiting for feedback from Michael re: IHE and ISO interest in either an online meeting or other alternative.


  • Freeze
    • Substantive changes - must be applied no later than December 10
    • Final freeze - December 17
  • 2017-12-04
    • No new changes to FHIR came from today's meeting

FHIR Tracker Items

FHIR Tracker

Workflow Changes (Group = Workflow)

  • Workflow harmonization changes have been made - should be reviewed


  • Need to review table in MedStatement and update/remove
    • No discussion on Dec 4 call, pushed out to Dec 11
Action:  Draft new table to discuss on call on Dec 11
  • GF#14020 - MedicationRequest Alignment
  • November 6, 2017 - review any additional changes
    • Instantiates type - should be URI
  • October 9, 2017 -See analysis spreadsheet
    • Definition - new Workflow name is "instantiates" -
    • StatusReason - add
    • "doNotPerform"
    • requester - change from backbone to align with pattern
      • PractitionerRole needs to be added in as a reference
      • remove agent
      • remove onBehalfOf
    • add practitionerType to recorder
    • performer - references - add CareTeam and PractitionerRole
    • add insurance
    • Motion - to make the changes as identified in spreadsheet - Melva/Jean - 3-0-0 Carried
Action:  John to reach out to Tom to see if there is a NL use case for "do not perform" using MedicationRequest.  Tom has been asked via email. 
  • Discuss "do not perform" on Dec 4 call
    • After a long discussion we decided to review additional information on how this type of information is documented using FHIR more broadly. There was no decision or vote on adding "do not perform" to the Medication Request resource.

Medication Related (Group = A)

  • Medication.Status
    • November 13, 2017
      • discussion of the response from MnM
        • asked how pharmacy is dealing with "entered in error"
          • status on catalogentry would handle this
          • long discussion of options
          • need to discuss further with Lloyd - what to understand whether the need to represent status - a short term need until catalog entry resource exist or does he see the need both options to exist
Action:  Melva to ask Lloyd to join a pharmacy call and discuss further
    • Medication.status - is mandatory - have an exemption from previous request to MnM
    • need to reapply the exemption
    • November 6, 2017
      • MnM to consider Nov 7th
    • November 13, 2017
      • discussion planned on the need for Medication.status in response to MnM questions.
    • November 27, 2017
      • Discussion of the need for a status on Medication.
      • There have been discussions about leaving the status in
      • Motion by Jean - seconded by John by to update the definitions and descriptions for Medication.status and give examples of how it would be used - 4-1-0 Carried
    • 2017-12-04 discussion
      • There was no discussion on Medication.status on today's call

Dosage Related (Group = B)

Action: Reach out to submitter and ask him to join a call

Misc (Group = none)

Action:  Melva to create 2 examples for discussion next week

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
    • October 2: actively being discussed - John attending calls
    • October 9: no update
    • November 13: discussions over the past few weeks have been on prep for Connectathon and cleaning up new resource for Catalog Entry, Observation Definition. Per latest discussions there will be no formal pharmacy workflow specific connectathon activity in New Orleans WGM.
    • November 20: No updates from this week
    • November 27: No updates - lab folks will be testing at Connectathon
    • Dec 4: No updates this week

International Chemotherapy Implementation FHIR IG

  • Dec 4: This project is now closed with no future meetings planned

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
    • October 9: no update
    • November 13: no update
    • November 20: no update
    • November 27: no update
    • December 4: no issues to discuss. Expect to see this issues discussed at next WG meeting in Jan/Feb 2018

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
  • September 25 update: Claude believes more information needs to be provided to navigate through the material
    • he is willing to come to Pharmacy WG
  • October 2 update: CIMI was pulled from the ballot
    • October 9: no update
    • November 13: Claude has reached out to discuss updates and follow up presentation to pharmacy - no time for this discussion has been set.
    • November 20: no update
    • November 27: no update
    • December 4: Claude responded that he is willing to attend the Dec 11 meeting to discuss CIMI model pharmacy related content. Will add to Dec 11 agenda.

Action Item List

  • December 4: no updates

Ballot Reconciliation - Templates

MedicationKnowledge Resource

  • November 13, 2017
    • was approved by TSC today
    • can consider aligning with definitional concepts - Specimen Definition, etc
  • Should be approved by the TSC by next Monday
  • Discussion of how we want to work on this project
Action:  Determine if we will schedule a separate call
Action:  Consider a joint meeting with BR&R in New Orleans


Next meeting

  • Monday, December 11, 2017 - 4pm Eastern
  • Monday, December 18, 2017 - 4pm Eastern
  • Monday, December 25, 2017 - Cancelled
  • Monday, January 1, 2018 - Cancelled
  • Monday, January 8, 2018 - 4pm Eastern