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20170727 OO FHIR conCall

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HL7 OO on FHIR (for Orders and Observations)

Call in details:
Phone: +1 770-657-9270, Passcode: 398652

Join the meeting at:
https://join.me/vernetzt.us

Date: 2017/07/27
2015 - 02:00 PM (Eastern Time, GMT -04 DST)
Quorum = chair + 4 yes


scope="col" Co chairs Chair Notetaker
Riki Merrick
Rob Hausam X
Lorraine Constable
Patrick Lloyd
KD Nolan
Hans Buitendijk


Attendees
X Eric Haas
Riki Merrick
Hans Buitendijk
X Jose Costa-Teixeira
X Dan Rutz
Jonathan Harber
David Burgess
Lloyd McKenzie
X Rob Hausam
X Andrea Pitkus
Francois Marcary
Robert Dieterle
Brian Reinhold
John Rhoads
KD Nolan
X Ben Atkinson
X Elaine Ayeres
X Lindsey Hoggle
X Karen Nocera
X James Allain
X David Cleveland
X Paul Adams
X Erik Mol

  • Roll Call


Agenda

Nutrition

Margarets Summary documents

Trackers:

  • #13475: Add DeviceRequest to NutritionOrder.

Discussion:

  • Looked at MedicationRequest and Request Pattern resources -
  • 2 ways to handle:
      1. 1 request what commenter is asking for. not currently done in other requests.
      2. 2 requests linked by a grouper ID ( How modelled in request pattern and recommended approach )
Scenario: Order  Diet A using Feeding Device B 
Requisition A  = Diet A + Feeding Device B 
Diet A request using NutritionOrder with `NutritionOrder.groupID` = Requisition A
Device B request using DeviceRequest with `DeviceRequest.groupID` = Requisition A
Changes required add element groupID to NutritionOrder - which is already covered by a tracker to aling NutritionOrder using the request pattern.
  • #13464 No way to specify "no liquids"

(recommendation voted on by nutrition committee) OO on FHIR vote: Persuasive with mod

Use .excludeFoodModifier element and the code for "oral liquids e.g., for SNOMED 439051000124101 | Dietary fluid (substance) | to accomplish this and modify the description

"Order-specific modifier about the type of food that should not be given" CHANGE TO: "Order-specific modifier about the type of oral food or oral fluids that should not be given."

Eric Haas/Ben Atkinson For-Against-Abstain 9-0-1


  • #13294 Add a note element to NutritionOrder

(recommendation voted on by nutrition committee) OO on FHIR vote: Persuasive

add .note 0..* (Annotation)

add to comments field to make sure not used for feeding instructions...

'This element SHALL NOT be used to supply free text instructions for the diet. This data is represented in the .oralDiet.instruction, supplement.instruction, or enteralFormula.administrationInstruction.'

(With links)

Eric Haas/Lindsey Hoggle: 10-0-0


NutritionIntake Model

Use Case: see attachment

Observation vs new Resource?:

  • how best to combine food items with nutritional values which is a "sequence of observation plus nutrients" and doesn't fit Observation
  • RH suggested looking at how med administration is formulated and maybe using that as a guide
  • Follow up with offline discussions to flesh out use case and DEs then a call.

Vitals Profile and LOINC(magic codes)

  • #13652 Observation requires Vital Signs Profile support which requires LOINC, which is too strict

see Gforge followups.

See prior GForge and Zulip chats regarding this topic

  • LOINCs can be considered 'magic values" and are needed for broad semantic interoperability. You can always translate domain specific codes to them.
  • No requirement to use the profile in .meta
  • only required for the dozen vital listed on in the specification

For PHD devices there are issues:

  • would like to use fhir
  • using domain specific codes
  • bandwidth issues
  • others

Follow up on Zulip link = https://chat.fhir.org/#narrow/stream/implementers/topic/vitals.20profile.2C.20LOINC.20and.20PCHA.20.2F.20Continua.20guidelines but OO position is still to require these codes.


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