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20170928 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:

Date: 2017/09/28
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 X

X Eric Haas
Riki Merrick
X Hans Buitendijk
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
Ben Atkinson
Elaine Ayeres
Lindsey Hoggle
Karen Nocera
James Allain
X Marti Velezis
X Margaret Dittloff
X Bob Milius

  • Roll Call


Status updates:

  • Media/Observation/DocumentReference/Binary/Attachment Dataype
    • See attached slides
    • Next steps to circulate within OO for feedback before joint discussion with representattive from other WGs next week.
  • 13318 Observation example for findings%2Fsigns%2Fsymptoms (Michelle Miller) Persuasive with Mod
    • continued discussion in TermInfo
    • concern re “option 3” confirmed that is a pattern used commonly in certain jurisdictions
    • revise document to discuss
      • Boundaries with Condition
      • When to use ValueAbsentReason
      • Choosing a preferred approach is problematic.
  • 13652 Observation requires Vital Signs Profile support which requires LOINC%2C which is too strict (Erik Moll) In Person Not Persuasive
  • Serafina’s update (email):

1) maintain a MDC to LOINC 'Magic code" mapping  - tentatively maintained by Regenstrief or NIST.

2) Add a new 'magic" value of "unknown" for the rare situation for when a brand new MDC is created and the mapping to the LOINC can not be determined. ( e.g. when the code is hardcoded into a gateway which cannot be updated)

On this morning's weekly DEV meeting I learned that the follow up meeting with Dr. Abhyank?ar (Swapna) from Regenstrief will be held on 10/18 @ 7 AMPacific/10 Eastern.  The intent is to follow up on the San Diego discussions that took place in two sessions onThursday.

My understanding for the 10/18 agenda is to cover:

Decision related to using LOINC in FHIR Vital Signs (details to be discussed since thinking may have changed since SD - see comment below)

Overarching principles and process for creating/maintaining the IEEE/LOINC map - Dr. Abhyankar to present

DEV will take lead on developing an IEEE nomenclature page that will be included on the FHIR external terminologies / code systems page  similar to ones for LOINC, SNOMED CT as well as what is available at NIST

With respect to using LOINC in vital signs, I believe on todays DEV call, it may be that the idea to add a "generic"/magic code for "unknown" might still be under consideration. As you recall, during the meeting it was discussed that the lead time getting devices onto the market (FDA approval) allows plenty of time to harmonized MDC code(s) and map to existing LOINC (or create new codes if necessary) when new device-type measurement values arise over time.

Review QA criteria for Observation - postponed

Trackers: =

Comment Submitters

  • Ardon Toonstra
  • Eric Haas
  • Erik Moll
  • Harri Honko
  • Jamie Hignite
  • Lloyd McKenzie
  • Riki Merrick
  • Line Items
  • 11217 Thoughts on combining SupplyRequest%2C DeviceUseRequest and VisionPrescription - 2016-09 core %23371 (Riki Merrick) Considered for Future Use
    • postpone until Jose can attend
  • 12913 Create a profile for %22Patient characteristics%22 (Lloyd McKenzie)
    • postpone
  • 12966 ProcedureRequest - add DosageInstructions or Quantity (Jamie Hignite)
    • postpone
  • 13144 Add Core extension to identfy Personal HealthCare Device (Eric Haas)
    • postpone
  • 13801 Vital signs profiles - Body Height (Ardon Toonstra)
    • discussed- concern within Nutrition Community since a key ped measure
    • Will reach out to get more feedback Margaret and Eric through Argonaut
    • May need to split out USCore from Base Profile
  • 13938 Add phsyical activity profiles like vitals (Harri Honko)
    • postpone
  • 10118 review .related.type codes (Eric Haas)  - awaiting implementer feedback whether worth it.
    • postpone
Review next batch of trackers for block vote (3):
  • 13964 add system as code discriminator to Vitals profiles persuasive
  • 13945 Observation resource constraint obs-7 incorrect persuasive with mod
  • 13809 missing / in lastN examples persuasive
review pulled item from today oo block vote:
  • 13868 category missing valueset binding
    • will get community feedback on the category values and whether need a distinct element to represent referral, procedure and or diagnostic.

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