Difference between revisions of "2018-08-13 Rx Conf Call"

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=Attendees=
 
=Attendees=
 
* John Hatem (Chair)
 
* John Hatem (Chair)
 +
* Melva Peters (Scribe)
 +
* Christof Gessner
 +
* Peter Sergent
 +
* Lisa Nelson
 +
* Jean Duteau
 
* Scott Robertson
 
* Scott Robertson
* Melva Peters
+
* Michael Clifton
 +
* Joe Quinn
 +
* Stephen Chu
  
 
=Agenda Items and notes=
 
=Agenda Items and notes=
Line 31: Line 38:
 
* I recently started researching HL7 because as a pharmacy, we have received several HL7 Data Sharing agreements from 3rd party vendors.  I am trying to find out if the Segments/Components/Subcomponents are customizable and excludable from a data set.  For example, could we exclude PID from transmission through the interface, yet allow other segments to transfer outside our organization?
 
* I recently started researching HL7 because as a pharmacy, we have received several HL7 Data Sharing agreements from 3rd party vendors.  I am trying to find out if the Segments/Components/Subcomponents are customizable and excludable from a data set.  For example, could we exclude PID from transmission through the interface, yet allow other segments to transfer outside our organization?
 
  Action:  Scott to respond
 
  Action:  Scott to respond
 +
* August 13, 2018: no discussion
  
 
==Use of Confluence==
 
==Use of Confluence==
 
* further discussion after review done by Co-chairs
 
* further discussion after review done by Co-chairs
 +
* August 13, 2018: no discussion
  
 
==SNOMED on FHIR teleconference calls==
 
==SNOMED on FHIR teleconference calls==
Line 48: Line 57:
 
  Action:  Melva to [https://chat.fhir.org/#narrow/stream/9-committers/subject/Snomed.20on.20FHIR post question to Zulip] - complete
 
  Action:  Melva to [https://chat.fhir.org/#narrow/stream/9-committers/subject/Snomed.20on.20FHIR post question to Zulip] - complete
 
* August 6, 2018: John Hatem to attend call tomorrow to discuss - John attended, suggestions about the terminology value sets on Medication Administration will be discussed on August 13, 2018 call.  
 
* August 6, 2018: John Hatem to attend call tomorrow to discuss - John attended, suggestions about the terminology value sets on Medication Administration will be discussed on August 13, 2018 call.  
 +
* August 13, 2018: no discussion
  
 
==MedicationKnowledge Resource==
 
==MedicationKnowledge Resource==
Line 60: Line 70:
 
* August 6, 2018
 
* August 6, 2018
 
  Action:  do one more followup with implementers and Jose
 
  Action:  do one more followup with implementers and Jose
 +
* August 13, 2018: no discussion
  
 
==FHIR==
 
==FHIR==
Line 68: Line 79:
 
  Action:  Melva to reach out to Anesthesia Co-Chairs to get material
 
  Action:  Melva to reach out to Anesthesia Co-Chairs to get material
 
* August 6, 2018: no discussion
 
* August 6, 2018: no discussion
 +
* August 13, 2018: no discussion
  
 
===16042 - Add attribute to indicate type of drug===
 
===16042 - Add attribute to indicate type of drug===
Line 78: Line 90:
 
* July 30, 2018: no discussion
 
* July 30, 2018: no discussion
 
* August 6, 2018: no discussion
 
* August 6, 2018: no discussion
 +
* August 13, 2018: no discussion
  
 
===15800 - scope and description for MedStatement===
 
===15800 - scope and description for MedStatement===
Line 85: Line 98:
 
* July 30, 2018: no discussion
 
* July 30, 2018: no discussion
 
* August 6, 2018: no discussion
 
* August 6, 2018: no discussion
 +
* August 13, 2018: no discussion
  
 
===15772 - Definitions for identifiers in Pharmacy resources===
 
===15772 - Definitions for identifiers in Pharmacy resources===
Line 93: Line 107:
 
  Action:  review and compare definitions for identifiers on pharmacy resources
 
  Action:  review and compare definitions for identifiers on pharmacy resources
 
* August 6, 2018 - John reviewing - will be ready for review next week
 
* August 6, 2018 - John reviewing - will be ready for review next week
 +
* August 13, 2018: Started review of spreadsheet
  
 
===15509 - Create example scenarios for Pharmacy===
 
===15509 - Create example scenarios for Pharmacy===
Line 108: Line 123:
 
** John will raise this question in the Workflow calls
 
** John will raise this question in the Workflow calls
 
** August 13 - there were no workflow calls Wednesday of last week or this week
 
** August 13 - there were no workflow calls Wednesday of last week or this week
 +
* August 13, 2018: no discussion
  
 
===15105 - MedicationStatement - alignment with WorkFlow===
 
===15105 - MedicationStatement - alignment with WorkFlow===
Line 145: Line 161:
 
** if it is a tag - need to make sure that there is documentation
 
** if it is a tag - need to make sure that there is documentation
 
  Action:  Michelle to reach out to Epic to get them to weigh in on the Zulip chat
 
  Action:  Michelle to reach out to Epic to get them to weigh in on the Zulip chat
 +
* August 13, 2018: no discussion
  
 
===12396 - Medication package and product===
 
===12396 - Medication package and product===
Line 158: Line 175:
 
* July 9, 2018: no discussion
 
* July 9, 2018: no discussion
 
* July 30, 2018: no discussion
 
* July 30, 2018: no discussion
* August 6, 2018
+
* August 13, 2018: no discussion
  
 
===17411 - Add category property to allow representation of Therapeutic category===
 
===17411 - Add category property to allow representation of Therapeutic category===
Line 166: Line 183:
 
  Action:  Ask John to join a Pharmacy WG Call to discuss further
 
  Action:  Ask John to join a Pharmacy WG Call to discuss further
 
* August 6, 2018: John to join next week
 
* August 6, 2018: John to join next week
 +
* August 13, 2018: no discussion
  
 
===17375 - Medication.quantity refers to "package" and "packaged product"===
 
===17375 - Medication.quantity refers to "package" and "packaged product"===
Line 175: Line 193:
 
* July 30, 2018: no discussion
 
* July 30, 2018: no discussion
 
* August 6, 2018:  continue the discussion when Jean is on the call - potential to change the datatype on amount
 
* August 6, 2018:  continue the discussion when Jean is on the call - potential to change the datatype on amount
 +
* August 13, 2018: no discussion
  
 
== Updates from Workflow==
 
== Updates from Workflow==
Line 272: Line 291:
 
* August 6, 2018
 
* August 6, 2018
 
  Action:  Melva to send spreadsheet to the list for review.  Will vote on this next week
 
  Action:  Melva to send spreadsheet to the list for review.  Will vote on this next week
 +
* August 13, 2018
 +
** Moved by Jean - seconded by Scott to accept dispositions for comments where in person reconciliation not requested or where not waiting for input or where not previously voted on. 6-0-1 Carried
 +
*** Stephen Chu Abstained
 +
Action:  Melva to update spreadsheet
  
==PSS Collaborative C-CDA R2.1 Template Review discussion by Lisa Nelson
+
==PSS Collaborative C-CDA R2.1 Template Review==
 +
discussion by Lisa Nelson
 
* Review PSS and determine if Pharmacy should be a co-sponsor
 
* Review PSS and determine if Pharmacy should be a co-sponsor
 
+
** idea to align CDA and FHIR better
 +
** CDA Management Group - trying to build better collaboration among Work Groups
 +
** Scope of this project is to pilot to see what it would take to build collaboration in some specific places - narrow scope
 +
*** explore changes needed for CCDA R2.1 templates - identify tangible set of issues to make templates align better
 +
**** list of deltas to bring views of the world align better
 +
**** CDA Management group is the sponsor with SD, PC, FM and Pharmacy as co-sponsors
 +
*** likely looking at Medication Activity template and Planned Medication Activity from Pharmacy
 +
*** Pharmacy participation - Melva, John, Jean and Tom
 +
*** discussion that Pharmacy would like to participate in the actual project work rather than as updates
 +
** Moved by Melva - seconded by Peter to approve Pharmacy as a co-sponsor contingent on the proposed changes 8-0-0 Carried
  
 
==AOB==
 
==AOB==

Latest revision as of 21:02, 13 August 2018

Attendees

  • John Hatem (Chair)
  • Melva Peters (Scribe)
  • Christof Gessner
  • Peter Sergent
  • Lisa Nelson
  • Jean Duteau
  • Scott Robertson
  • Michael Clifton
  • Joe Quinn
  • Stephen Chu

Agenda Items and notes

Pharmacy List topic

  • I recently started researching HL7 because as a pharmacy, we have received several HL7 Data Sharing agreements from 3rd party vendors. I am trying to find out if the Segments/Components/Subcomponents are customizable and excludable from a data set. For example, could we exclude PID from transmission through the interface, yet allow other segments to transfer outside our organization?
Action:  Scott to respond
  • August 13, 2018: no discussion

Use of Confluence

  • further discussion after review done by Co-chairs
  • August 13, 2018: no discussion

SNOMED on FHIR teleconference calls

  • Every other Tuesday - June 23rd at 4pm Eastern
  • July 9, 2018: Peter Sergent attended recent call - 2 questions about MedAdmin
    • Is dosage going to be aligned with the complex type used in Medication Statement?
    • They are concerned that the reason was non administration is bound to different Snomed hierarchies
    • have discussed in the past - because MedAdmin is different - have previously discussed not to change
    • CodeableConcept - did not have a suggestion for what it should be bound to
    • next call is next week - Peter will ask what they think it should be bound to
  • July 30, 2018: accepted position on dosage
    • asked further on multiple hierarchy - referred to chat pages - Need to find out more
    • in allergy/adverse event work done in UK - value sets include multiple hierarchies - more of a global issue that should be posed to FHIR-I
Action:  Melva to post question to Zulip - complete
  • August 6, 2018: John Hatem to attend call tomorrow to discuss - John attended, suggestions about the terminology value sets on Medication Administration will be discussed on August 13, 2018 call.
  • August 13, 2018: no discussion

MedicationKnowledge Resource

  • July 9, 2018:
    • on the Zulip chat - how to reflect an instance of a medication - Medication resource does not have an identifier - intentionally left out - not part of the 80/20 - would use a code
    • need to answer the question about why there is no identifier on medication - identifies an instance of a "thing" - we have a code (which identifies the "kind" of thing)
    • use case - may be for a "bar code" on an IV bag -
    • we have "serial number" in the batch attribute - could we change the name to "identifier"
    • move the "serial number" to the top level and change to name to "identifier" - and change data type. Will discuss with implementers before making change
Action:  talk to implementers about how they deal with this - Cerner, Epic, Vince  - Melva to followup
Action:  talk to Jose - Melva to followup
  • August 6, 2018
Action:  do one more followup with implementers and Jose
  • August 13, 2018: no discussion

FHIR

Open Pharmacy FHIR Tracker Items

17222 - Review Pharmacy resources to see if requirements for Medical Gases are met

  • July 30, 2018: no discussion
Action:  Melva to reach out to Anesthesia Co-Chairs to get material
  • August 6, 2018: no discussion
  • August 13, 2018: no discussion

16042 - Add attribute to indicate type of drug

  • this is part of medicationKnowledge and formulary
  • June 11, 2018: no discussion
  • June 18, 2018: will be discussed as changes to MedKnowledge.productType
  • June 25, 2018: for incident reporting - could use AdverseEvent - references medication, medicationAdministration, MedicationStatement
    • Patient Care is debating whether instance is intending to be a specific instance or a more generic definition - GF#13698
    • continue the discussion for this tracker as part of MedicationKnowledge
  • July 30, 2018: no discussion
  • August 6, 2018: no discussion
  • August 13, 2018: no discussion

15800 - scope and description for MedStatement

  • June 4, 2018: no discussion
  • June 11, 2018: no discussion
  • June 18, 2018: no discussion - will be discussed in the context of GF# 15105
  • July 30, 2018: no discussion
  • August 6, 2018: no discussion
  • August 13, 2018: no discussion

15772 - Definitions for identifiers in Pharmacy resources

  • June 4, 2018: no discussion
  • June 11, 2018: no discussion
  • June 18, 2018:
  • July 30, 2018: no discussion
Action:  review and compare definitions for identifiers on pharmacy resources
  • August 6, 2018 - John reviewing - will be ready for review next week
  • August 13, 2018: Started review of spreadsheet

15509 - Create example scenarios for Pharmacy

  • Create example scenarios for Pharmacy
  • need to draft some scenarios
  • April 16, 2018: no discussion
  • May 7, 2018: no discussion
  • June 4, 2018: no discussion
  • June 11, 2018: no discussion
  • June 18, 2018: no discussion
  • June 25, 2018: no discussion
  • July 9, 2018: no discussion
  • July 30, 2018: no discussion
  • August 6, 2018: no update on where we are with this
    • John will raise this question in the Workflow calls
    • August 13 - there were no workflow calls Wednesday of last week or this week
  • August 13, 2018: no discussion

15105 - MedicationStatement - alignment with WorkFlow

    • notTaken was removed
    • need to consider how to reflect what the prescriber thinks should be taken by the patient - is this a medStatement or is this a MedRequest?
  • Lloyd believes should be using a MedRequest with a "plan" status
  • Choices:
    • take MedStatement back to the way it was
    • US Core - embrace List
    • follow Lloyd's suggestion to use MedRequest with "Plan" status
    • use status field to identify if a prescriber believes the patient should be on this med and uses taken element to identify if the patient is following the order and taking the medication - could previous do this before we aligned MedStatement with workflow
  • March 5, 2018: - deferred until March 12, 2018
    • Ask Lloyd to join call - complete - he can't join on March 12. Need to provide an update to him
  • March 12, 2018:
    • Lloyd believes that MedStatement should only be an indicator of whether the patient/provider says they are taking the medication
    • Options:
      • revert back to having "notTaken"(pre workflow harmonization)
      • provider instructions for medication - should use MedicationRequest - with intent element
      • implement List resources to get active medication list - not preferred
      • current resource with "not taken" as a status - not preferred
    • Need to take this conversation more public -
      • Workflow group - Melva to ask Lloyd to add to Workflow agenda
      • Zulip - posting to Zulip
        • add Workflow discussion
  • April 16, 2018: no discussion
  • April 23, 2018:
  • April 30, 2018
  • June 4, 2018: no discussion
  • June 11, 2018: no discussion
  • June 18, 2018: waiting for feedback from Lloyd on whether new value will be added to "intent" value set
  • June 25, 2018: Michelle to send notes from meeting in Cologne with Lloyd
Action:  Melva to followup with Lloyd on tracker item related to request for new value in intent and copy Michelle on email - complete
  • July 9, 2018: no discussion
  • July 30, 2018: no discussion
  • August 6, 2018: Zulip conversation - somewhat stalled
    • intent is not a modifier - outcome of the discussion may hinge on this
    • if it is a tag - need to make sure that there is documentation
Action:  Michelle to reach out to Epic to get them to weigh in on the Zulip chat
  • August 13, 2018: no discussion

12396 - Medication package and product

  • Medication package and product
  • April 9, 2018 - brought back to discuss
  • April 16, 2018 - no discussion
  • April 23, 2018: no discussion
  • April 30, 2018:
  • May 7, 2018:
  • June 4, 2018: no discussion
  • June 11, 2018: no discussion
  • June 18, 2018: will be discussed with MedKnowledge
  • July 9, 2018: no discussion
  • July 30, 2018: no discussion
  • August 13, 2018: no discussion

17411 - Add category property to allow representation of Therapeutic category

  • Category Property
  • believe this is an extension as it is not part of the 80/20 for prescribing, dispensing, administering
  • July 30, 2018: no discussion
Action:  Ask John to join a Pharmacy WG Call to discuss further
  • August 6, 2018: John to join next week
  • August 13, 2018: no discussion

17375 - Medication.quantity refers to "package" and "packaged product"

  • Medication.quantity
    • need to update the definition -
    • change the Ingredient.amount - to medication.ingredient.strength - need to update the definition to clarify
    • update the usage notes for medication.amount - update definition - update how used with strength
    • continue discussion next week
  • July 30, 2018: no discussion
  • August 6, 2018: continue the discussion when Jean is on the call - potential to change the datatype on amount
  • August 13, 2018: no discussion

Updates from Workflow

  • April 23, 2018: meeting held today
    • Workflow issues - Lloyd will be fixing the report and re-issuing
    • MedicationDispense.statusReason - is okay that this will be either a reference or a CodeableConcept - will not be added to the pattern for event
  • April 30, 2018: reviewed tracker items. nothing specific to pharmacy
  • May 7, 2018: reviewed tracker items during Workflow meetings. No specific pharmacy issues.
  • June 4, 1018: no updates
  • June 11, 2018: no updates
  • June 18, 2018: no meetings until July
  • July 9, 2018: No participation through end of July from Pharmacy
  • July 30, 2018: no discussion
  • August 6, 2018: no workflow meetings
  • August 13, 2018: no workflow meetings

US Meds - PDMP Mapping

  • work on GitHub
  • April 16, 2018: In ballot - no discussion until after ballot close
    • will be on the agenda for WGM or subsequent teleconference
  • April 23, 2018: no discussion
  • April 30, 2018: no discussion
  • May 7, 2018:
  • June 4, 1018: Block vote
    • Comment Submitters
      • Arvind Jagannathan
      • Jose Costa Teixeira
      • Mark Cacciapouti
      • Michele Hudak
      • Ruth Berge
      • Scott Robertson
      • Thomson Kuhn
      • William Goossen
    • Line Items
      • 17196 Agree with approach - 2018-May Medication #23 (Jose Costa Teixeira) Considered - No action required
      • 16326 NCPDP mapping (Scott Robertson) Considered - Question Answered
      • 16327 Ballot name and link (Scott Robertson) Considered - Question Answered
      • 16629 Confirm if SSN is only identifier - 2018-May Medication #4 (Michele Hudak) Considered - Question Answered
      • 16032 Link is incorrect (Ruth Berge) Not Persuasive
      • 16093 Use indicator (Ruth Berge) Not Persuasive
      • 16094 Medicinal Product use indicator (Ruth Berge) Not Persuasive
      • 17197 Seems not to adhere to the Identification of Medicinal Products IDMP from ISO. - 2018-May Medication #24 (William Goossen) Not Related
      • 16091 garbled text in table legends (Ruth Berge) Persuasive
      • 16625 Remove specific call-out of Opioid abuse - 2018-May Medication #2 (Michele Hudak) Persuasive
      • 16626 Drop phrase %27any%27 on controlled substance - 2018-May Medication #3 (Michele Hudak) Persuasive
      • 16636 Did you actually mean MedicationStatement here when you wrote MedicationRequest%3F - 2018-May Medication #6 (Arvind Jagannathan) Persuasive
      • 16639 Reword this sentence within the PDMP section. - 2018-May Medication #7 (Arvind Jagannathan) Persuasive
      • 16642 Just a typo correction within the PDMP section. - 2018-May Medication #8 (Arvind Jagannathan) Persuasive
      • 16645 Change the format of the header for the PDMP Data Elements and Mappings section to properly show this is a new major section of this page. - 2018-May Medication #9 (Arvind Jagannathan) Persuasive
      • 16648 Provide a link to the FHIR RESTful specification within the CapabilityStatement description. - 2018-May Medication #10 (Arvind Jagannathan) Persuasive
      • 17161 “asterisk” misspelt - 2018-May Medication #20 (Thomson Kuhn) Persuasive
      • 17162 What is the meaning of the asterisk for this element. - 2018-May Medication #21 (Thomson Kuhn) Persuasive
      • 17195 Patient Profile Search Requirements - 2018-May Medication #22 (Mark Cacciapouti) Persuasive
      • 16623 Update reference to Opioids - 2018-May Medication #1 (Michele Hudak) Persuasive with Mod
      • 16624 Update reference to Opioids - 2018-May Medication #1 (Michele Hudak) Persuasive with Mod
      • 16633 Make the scope statement include the Argonaut Project scope statement for convenience. - 2018-May Medication #5 (Arvind Jagannathan) Persuasive with Mod

Block Vote

  • have posted the block vote for 2 weeks - no requests to pull
  • Motion by Brett - Dragan to approved disposition based on block vote and published spreadsheet - 7/0/0
Action: Brett to update Gforge 
Action: Melva to get spreadsheet extracted and posted on Ballot reconciliation
Action:  Melva to send Brett vote - complete
  • June 11, 2018
    • Missed 2 tracker items in block vote - belong to a different ballot - have been forwarded
      • 16032 Link is incorrect
      • 16094 Medicinal Product use indicator
    • Motion to find these two comments "not related" - Jean/Brett - 4-0-0 Carried
Action: Melva to review email from Austin to determine what has to be done about other comments
  • July 9, 2018:
  • July 30, 2018: no discussion
Action:  Melva will followup with Brett on next steps
  • August 6, 2018 - Brett working on getting the changes applied

Catalogue Project

  • April 9, 2018: all Catalogue project meetings cancelled until after HL7 Workgroup meeting in Cologne
  • April 23, 2018: no updates
  • April 30, 2018: no meetings until after Cologne WGM
  • May 7, 2018: no discussion
  • June 4, 1018: no updates
  • June 11, 2018: no updates
  • June 18, 2018: meetings have been held but John hasn't been able to attend.
  • June 25, 2018: they are finalizing the resources for their meetings with FMG and the September WGM.
    • The resources they are working on include Entry Definition.
    • The are also seeking interested parties to use their resources in the next Connectathon
  • July 9, 2018: next meeting will be July 11th - no participation from Pharmacy through the end of July
  • July 30, 2018: no discussion
  • August 6, 2018: no updates
  • August 13, 2018: last week there were discussion related to the upcoming connectathon and use of the Catalogue resources. No action items for Pharmacy.

Pharmacy template ballot reconciliation

Action:  Melva to reach out to submitters who wanted in person resolution - complete
Action: Melva to reach out to submitter where we needed clarification - complete
  • August 6, 2018
Action:  Melva to send spreadsheet to the list for review.  Will vote on this next week
  • August 13, 2018
    • Moved by Jean - seconded by Scott to accept dispositions for comments where in person reconciliation not requested or where not waiting for input or where not previously voted on. 6-0-1 Carried
      • Stephen Chu Abstained
Action:  Melva to update spreadsheet

PSS Collaborative C-CDA R2.1 Template Review

  • discussion by Lisa Nelson
  • Review PSS and determine if Pharmacy should be a co-sponsor
    • idea to align CDA and FHIR better
    • CDA Management Group - trying to build better collaboration among Work Groups
    • Scope of this project is to pilot to see what it would take to build collaboration in some specific places - narrow scope
      • explore changes needed for CCDA R2.1 templates - identify tangible set of issues to make templates align better
        • list of deltas to bring views of the world align better
        • CDA Management group is the sponsor with SD, PC, FM and Pharmacy as co-sponsors
      • likely looking at Medication Activity template and Planned Medication Activity from Pharmacy
      • Pharmacy participation - Melva, John, Jean and Tom
      • discussion that Pharmacy would like to participate in the actual project work rather than as updates
    • Moved by Melva - seconded by Peter to approve Pharmacy as a co-sponsor contingent on the proposed changes 8-0-0 Carried

AOB

Next meeting

  • August 20, 2018 at 4pm Eastern