Latest revision as of 00:17, 31 January 2017

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Introduction

The January 2017 Clinician-on-FHIR event will be hosted on Friday January 20, 2017.

Weekly preparatory conference calls are being hosted on Tuesdays at 5:00 - 6:00 pm US Eastern.

First Clinician-on-FHIR call starts: Tuesday October 4, 2016

Conference call details: please see HL7 email broadcast

Planning

Master Plan for San Antonio Clinicians on FHIR - January 2017 - draft - date: 2016-10-25

Tracks to be addressed

Care Plan
Emergency care, covering:
Medication
Diagnostic Request, Report and Observation
Family Member History - Clinical Genomics

- Details of planning notes for each track can be accessed through the following wiki page:

- January 2017 Clinician-on-FHIR Planning Notes

Goal = create at least one (or more if possible) meaningful example(s) (actual JSON resource instance) for each FHIR resource otherwise the limitation of the FHIR resource is identified.

Supporting Tool and Information

Tool

- Participants registered for the Clinician-on-FHIR event are strongly recommended to familiarise themselves with the clinFHIR tool

- A new user interface has been created to support creation of clinical story built from a set of FHIR resources based on the clinical scenario described in the Tracks section below

- Logon to the clinFHIR site:

- [clinFHIR.com/]

- Connect to the FHIR servers by selecting the appropriate Data Server (e.g. Public HAPI DSTU3), Conformance Server and Terminology Server

- click on the "Tool" icon on the top right hand corner of the clinFHIR page and select "simple builder" option

(Note - "simple builder" will soon be changed to "scenario builder")

Supporting Information

- Dr David Hay has provided some very useful information on this new "simple builder" ("scenario builder") tool.

- clinFHIR "simple builder" Getting started guide (created by Emma Jones)

- Information on this tool can be accessed from his blog:

- Building a set of Resources in FHIR

Clinician-on-FHIR Tracks

Care Plan

Track lead: Emma Jones/Laura
Clinical Secenario

- Patient with Type 2 Diabetes managed by multi-disciplinary care team with PCP as care coordinator

- Multi-disciplinary care plan created by PCP after discussions with patient to coordinate care management

FHIR resources used in this track:

- CarePlan which references the following resources:

CareTeam, Goal, Condition, Observation, DiagnosticRequest, ReferralRequest, MedicationRequest

+/- Vaccination

Issue to be resolved - what to use for Patient Instruction?

Diabetic Care Plan Test Data

Emergency care

Track lead: Jim McClay/Laura
Clinical Scenario

- Patient presents at ED suspected of exhibiting communicable disease signs and symptoms

- ED intake/triage workflow is initiated

- Physician/Nursing evaluation workflow is initiated

- Travel history screening, Observation and diagnostic tests, triggering CDC communicable diseases management protocol

FHIR Resources used:

Questionnaire, QeustinnaireResponse, Observation, DiagnosticRequest, DiagnosticReport, ClinicalImpression, Condition

+/- MedicationRequest, ReferralRequest

ED Workflow information: Refer to HL7 Domain Analysis Model: Emergency Care Release 1 - US Realm January 2016

Diagnostic Track

Track lead: Rob Hausam
Clinical Scenario

- Type 2 Diabetes patient

- PCS instructs patient to perform the following at home as per CarePlan

- BSL x 3/day; BP x 1/day; Body weigh x1/week

- At follow-up consultation in 4 weeks, PCP reassess patient and requested:

- Fasting blood glucose, Fasting lipids

- At follow-up consultation, patient also complains of productive cough (greenish sputum) and fever

- PCP requested: sputum for microbiology test

FHIR Resources used:

Observation, DiagnosticRequest

Medication

Track leads: Melva/John Hatem
Clinical Scenario

- Type 2 DM patient

- PCP reviews patient's medication history, performs medication reconciliation where necessary, requests diabetic medications (and other relevant medications, e.g. antibiotics for respiratory infection), updates medication list, medications dispensed by pharmacist, and administered by patient

FHIR Resources used:

Medication, MedicationRequest, MedicationDispense, MedicationAdministration, MedicationStatement, MedicationList (List resource)

Questions: what about new instructions to patient? recommendation to prescriber?

Plan medication management in CarePlan resource: medication order through to administration

Family Member History

Track lead/co-leads:Grant Wood/Gil Alterovitz
Scenario

- To be completed

Technical Connectathon

The HSSP community is running a project, which is a FHIR based Care Coordination Service.
Details about this project are available at the Clinicial-on-FHIR planning notes wiki page:

January 2017 Clinician-on-FHIR Planning Notes

What's new for the January 2017 Technical Connectathon?

- There will be a small team of clinicians working alongside the FHIR developers to test how well the clinical workflow may work alongside the technical workflow

- The CarePlan track has been selected for this new joint initiative

- Care Plan test data created by the Care Plan team will be used in this track

- Lessons learnt from the technical connectathon will be used as inputs into the Clinician-on-FHIR CarePlan track in the Friday event

Difference between revisions of "Clinician on FHIR - January 2017, San Antonio"

Latest revision as of 00:17, 31 January 2017

Contents

Introduction

Planning

Tracks to be addressed

Supporting Tool and Information

Clinician-on-FHIR Tracks

Care Plan

Emergency care

Diagnostic Track

Medication

Family Member History

Technical Connectathon

Navigation menu

Personal tools

Namespaces

Variants

Views

More

Search

Navigation

groups

meetings

general

Tools

@@ Line 23: / Line 23: @@
 =Planning=
-[[Media:Clinicians on FHIR Jan 2017 Master Plan_2016-10-25.docx | Master Plan for Baltimore Clinicians on FHIR - January 2017 - draft - date: 2016-10-25]]
+[[Media:Clinicians on FHIR Jan 2017 Master Plan_2016-10-25.docx | Master Plan for San Antonio Clinicians on FHIR - January 2017 - draft - date: 2016-10-25]]
+<br>
 <br>
 ==Tracks to be addressed==
-* Allergy/Intolerance and Adverse Reaction
+* Care Plan
-* Family Member History - Clinical Genomics
-* Clinical documentation:
-: - Past Medical History
 * Emergency care, covering:
-: - Condition
-: - Procedure
-: - Referral Request
 * Medication
 * Diagnostic Request, Report and Observation
-* Care Plan, covering:
+* Family Member History - Clinical Genomics
-: - Instruction
-: - Care Team
-<br>
-Goal = create at least one (or more if possible) meaningful example(s) (actual JSON resource instance) for each FHIR resource otherwise the limitation of the FHIR resource is identified.
-<br>
-==Planning Notes for Each Track==
-Seven tracks have been identified for the January 2017 Clinician-on-FHIR event.
-===Family Member History===
-* For discussion on: 1 November 2017 conference call<br>
-''Track lead/co-leads'':<br>
-: - Grant Wood
-: - Gil Alterovitz
-<br>
-''Scope'':<br>
-: - To include clinical genomics
-<br>
-''Goals/Objectives''<br>
-<br>
-''Lessons from previous Clinician-on-FHIR''<br>
-<br>
-''Use cases / Scenarios''<br>
-<br>
-''Processes''<br>
-<br>
-===Allergy/Intolerance and Adverse Reaction===
-* For discussion on: 8 November 2017 conference call<br>
-''Track lead/co-leads'':<br>
-: - Russ
-: - Elaine
-: - Rob
-<br>
-''Goals/Objectives''<br>
-<br>
-''Lessons from previous Clinician-on-FHIR''<br>
-<br>
-''Use cases / Scenarios''<br>
-<br>
-''Processes''<br>
-<br>
-===Clinical documentation===
-* For discussion on: 22 November 2017 conference call<br>
-''Track lead/co-leads'':<br>
-: - Russ
-: - Emma
-: - Stephen (tentative)
-<br>
-''Scope''<br>
-: - to cover Past Medical History
-<br>
-''Goals/Objectives''<br>
-<br>
-''Lessons from previous Clinician-on-FHIR''<br>
-<br>
-''Use cases / Scenarios''<br>
-<br>
-''Processes''<br>
-<br>
-===Emergency care, covering===
-* For discussion on: 29 November 2017 conference call<br>
-''Track lead/co-leads'':<br>
-: - Jim
-: - Laura
-<br>
-''Scope''<br>
-- To include: Condition, Procedure, Referral Request
-<br>
-''Goals/Objectives''<br>
-<br>
-''Lessons from previous Clinician-on-FHIR''<br>
-<br>
-''Use cases / Scenarios''<br>
-<br>
-''Processes''
-<br>
-===Medication===
-* For discussion on: 6 December 2017 conference call<br>
-''Track lead/co-leads'':<br>
-: - Melva
-: - John Hatem
 <br>
-''Scope'':<br>
+- Details of planning notes for each track can be accessed through the following wiki page:
-: - To include: Medication, Medication Order, Medication Dispense, Medication Administration, Medication Statement
+: - [[January 2017 Clinician-on-FHIR Planning Notes]]
 <br>
-''Goals/Objectives''<br>
+* Goal = create at least one (or more if possible) meaningful example(s) (actual JSON resource instance) for each FHIR resource otherwise the limitation of the FHIR resource is identified.
 <br>
-''Lessons from previous Clinician-on-FHIR''<br>
-<br>
+==Supporting Tool and Information==
-''Use cases / Scenarios''<br>
+* '''Tool'''
+:- Participants registered for the Clinician-on-FHIR event are strongly recommended to familiarise themselves with the clinFHIR tool
+:: - A new user interface has been created to support creation of clinical story built from a set of FHIR resources based on the clinical scenario described in the Tracks section below
+:: - Logon to the clinFHIR site:
+::: - [clinFHIR.com/]
+::: - Connect to the FHIR servers by selecting the appropriate Data Server (e.g. Public HAPI DSTU3), Conformance Server and Terminology Server
+::: - click on the "Tool" icon on the top right hand corner of the clinFHIR page and select "simple builder" option
+:::: (Note - "simple builder" will soon be changed to "scenario builder")
+* '''Supporting Information'''
+:: - Dr David Hay has provided some very useful information on this new "simple builder" ("scenario builder") tool.
+::: - [[Media:Clinfhir cheatSheet Jan 2017.docx | clinFHIR "simple builder" Getting started guide (created by Emma Jones)]]
+:: - Information on this tool can be accessed from his blog:
+::: - [https://fhirblog.com/2017/01/09/building-a-set-of-resources-in-fhir/#more-159489 Building a set of Resources in FHIR]
 <br>
-''Processes''<br>
-<br>
+=Clinician-on-FHIR Tracks=
-===Diagnostic Request, Report and Observation===
+==Care Plan==
-* For discussion on: 13 December 2017 conference call<br>
+* Track lead: Emma Jones/Laura
+* '''Clinical Secenario'''
+:: - Patient with Type 2 Diabetes managed by multi-disciplinary care team with PCP as care coordinator
+:: - Multi-disciplinary care plan created by PCP after discussions with patient to coordinate care management
+*  FHIR resources used in this track:
+: - CarePlan which references the following resources:
+:: CareTeam, Goal, Condition, Observation, DiagnosticRequest, ReferralRequest, MedicationRequest
+:: +/- Vaccination
+:: Issue to be resolved - what to use for Patient Instruction?
-''Track lead/co-leads'':<br>
+* [[Media:FHIRCare Plan_Resource_Test_DataV2-1.xlsx |Diabetic Care Plan Test Data]]
-: - Rob
 <br>
-''Goals/Objectives''<br>
+==Emergency care==
-<br>
+* Track lead: Jim McClay/Laura
-''Lessons from previous Clinician-on-FHIR''<br>
+* '''Clinical Scenario'''
+: - Patient presents at ED suspected of exhibiting communicable disease signs and symptoms
+:: - ED intake/triage workflow is initiated
+:: - Physician/Nursing evaluation workflow is initiated
+::: - Travel history screening, Observation and diagnostic tests, triggering CDC communicable diseases management protocol
+* FHIR Resources used:
+: Questionnaire, QeustinnaireResponse, Observation, DiagnosticRequest, DiagnosticReport, ClinicalImpression, Condition
+:: +/- MedicationRequest, ReferralRequest
+* ED Workflow information: Refer to HL7 Domain Analysis Model: Emergency Care Release 1 - US Realm January 2016
 <br>
-''Use cases / Scenarios''<br>
+==Diagnostic Track==
-<br>
+* Track lead: Rob Hausam
-''Processes''
+* '''Clinical Scenario'''
+: - Type 2 Diabetes patient
+:: - PCS instructs patient to perform the following at home as per CarePlan
+::: - BSL x 3/day; BP x 1/day; Body weigh x1/week
+:: - At follow-up consultation in 4 weeks, PCP reassess patient and requested:
+::: - Fasting blood glucose, Fasting lipids
+:: - At follow-up consultation, patient also complains of productive cough (greenish sputum) and fever
+::: - PCP requested: sputum for microbiology test
+* FHIR Resources used:
+: Observation, DiagnosticRequest
 <br>
-===Care Plan, covering===
+==Medication==
-* For discussion on: 01 November 2016 conference call<br>
+* Track leads: Melva/John Hatem
+* '''Clinical Scenario'''
+: - Type 2 DM patient
+:: - PCP reviews patient's medication history, performs medication reconciliation where necessary, requests diabetic medications (and other relevant medications, e.g. antibiotics for respiratory infection), updates medication list, medications dispensed by pharmacist, and administered by patient
+* FHIR Resources used:
+: Medication, MedicationRequest, MedicationDispense, MedicationAdministration, MedicationStatement, MedicationList (List resource)
-''Track lead/co-leads'':<br>
+* Questions: what about new instructions to patient? recommendation to prescriber?
-: - Laura
+:  Plan medication management in CarePlan resource: medication order through to administration
-: - Emma
 <br>
-''Scope'':<br>
-: - To include: Instruction, Care Team
-<br>
+==Family Member History==
-''Goals/Objectives''<br>
-:- What is the best way to do instruction?
-* Communication does not seem to meet the needs of what is needed (demonstrate why. meta data? what is missing).
-* Careplan.activity.... does not seem to mee the needs (demonstrate why, what is missing?)
-<br>
+* ''Track lead/co-leads'':Grant Wood/Gil Alterovitz
-''Lessons from previous Clinician-on-FHIR''<br>
+* '''Scenario'''
+: - To be completed
-<br>
-''Use cases / Scenarios''<br>
-:- define what is meant by instruction
-* Discharge instruction (Take this med, get this follow up, follow this activity or diet)
-* First set
-:-a. Diet: Diabetic low salt diet
-:-b. Medications: Take prescribed medications as advised.
-:-c. Appointments: Schedule an appointment with Dr Seven after 1 week. Follow up with Outpatient facility for Immunosuppression treatment.
-:-d. For Fever of > 101.5 F, or onset of chest pain/breathlessness contact Emergency.
-* Second Set
-:-a. Appointments: Schedule an appointment with Dr Seven after 1 week. Follow up with Outpatient facility.
-:-b. In case of fever, take Tylenol as advised in plan of treatment.
-* Vaccine Instruction
-* Care activity instruction
-* Fellow provider instruction
-<br>
-''Processes''<br>
-<br>
-==ClinFHIR Tool Review==
-* Date: 3 January 2017 Conference call
-<br>
-* Details - TBA
@@ Line 285: / Line 139: @@
 <br>
 The HSSP community is running a project, which is a FHIR based Care Coordination Service. <br>
-The project:
+Details about this project are available at the Clinicial-on-FHIR planning notes wiki page:
+* [[January 2017 Clinician-on-FHIR Planning Notes]]
-- plans to define services and profiles that allow care coordination across clinical teams for a patient (e.g. manage teams, care plans, etc)
-- expects to use FHIR resources, profiles, operations etc to define a "Care Coordination Service"
-- has use cases, and some preliminary architecture
-- plans to hold a connectathon track at the January meeting
-- is working towards an initial submission date of Feb 2017, and is being lead by AllScripts
-The project is seeking participation from the FHIR community, including all those that are already working on (or have in production) solutions around coordinated care, both inside USA and outside as well.
+* What's new for the January 2017 Technical Connectathon?
+: - There will be a small team of clinicians working alongside the FHIR developers to test how well the clinical workflow may work alongside the technical workflow
-A proposal has been initiated for a Care Plan track to be run at the Jan FHIR connectathon (technical connectathon) that would focus on testing CarePlan, CareTeam, and Goal.  And any any profiles that are available or proposed at that time, e.g. US-Core profiles and the IHE Dynamic Care Plan IG.
+: - The CarePlan track has been selected for this new joint initiative
+: - Care Plan test data created by the Care Plan team will be used in this track
-More details about the proposal can be found at this link:
+: - Lessons learnt from the technical connectathon will be used as inputs into the Clinician-on-FHIR CarePlan track in the Friday event
-http://wiki.hl7.org/index.php?title=201701_Care_Plan
 <br>