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Clinician on FHIR - January 2017, San Antonio

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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 Baltimore Clinicians on FHIR - January 2017 - draft - date: 2016-10-25


Tracks to be addressed

  • Allergy/Intolerance and Adverse Reaction
  • 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:
- Instruction
- Care Team


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.


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

Track lead/co-leads:

- Grant Wood
- Gil Alterovitz


Scope:

- To include clinical genomics


Goals/Objectives



Lessons from previous Clinician-on-FHIR



Use cases / Scenarios



Processes



Allergy/Intolerance and Adverse Reaction

  • For discussion on: 8 November 2017 conference call

Track lead/co-leads:

- Russ
- Elaine
- Rob


Goals/Objectives



Lessons from previous Clinician-on-FHIR



Use cases / Scenarios



Processes



Clinical documentation

  • For discussion on: 22 November 2017 conference call

Track lead/co-leads:

- Russ
- Emma
- Stephen (tentative)


Scope

- to cover Past Medical History


Goals/Objectives



Lessons from previous Clinician-on-FHIR



Use cases / Scenarios



Processes



Emergency care, covering

  • For discussion on: 29 November 2017 conference call

Track lead/co-leads:

- Jim
- Laura


Scope
- To include: Condition, Procedure, Referral Request


Goals/Objectives



Lessons from previous Clinician-on-FHIR



Use cases / Scenarios



Processes



Medication

  • For discussion on: 6 December 2017 conference call

Track lead/co-leads:

- Melva
- John Hatem


Scope:

- To include: Medication, Medication Order, Medication Dispense, Medication Administration, Medication Statement


Goals/Objectives



Lessons from previous Clinician-on-FHIR



Use cases / Scenarios



Processes



Diagnostic Request, Report and Observation

  • For discussion on: 13 December 2017 conference call

Track lead/co-leads:

- Rob


Goals/Objectives



Lessons from previous Clinician-on-FHIR



Use cases / Scenarios



Processes



Care Plan, covering

  • For discussion on: 01 November 2016 conference call

Track lead/co-leads:

- Laura
- Emma


Scope:

- To include: Instruction, Care Team


Goals/Objectives

- 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?)
  • Use the list resource and list them as text (why does this work or why not?)


Lessons from previous Clinician-on-FHIR



Use cases / Scenarios

- define what is meant by instruction
  • Discharge instruction (Take this med, get this follow up, follow this activity or diet)
  • First set (MU)
-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 (MU)
-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 - (See slide deck) (Instruction to pharmacy)
  • Post procedure protocol instruction (post CABG instructions to patient (the full written page of instructions), post colonoscopy intsruction sheet) - post a couple of these here
  • Goals - MU allows text only.
-a. Get rid of intermittent fever that is occurring every few weeks.
-b. Need to gain more energy to do regular activities
-"c. Negotiated Goal for Body Temperature

LOINC 8310-5 98-99 degrees Fahrenheit Date-6/22/2015 Related problem: 386661006 SNOMED-CT Fever (finding) 6/22/2015 – Start Date Active "

  • Health Status evaluation outcomes -
-"a. Outcome Observation #1:
-i. Refers to Goal Observation for Weight
-ii. Refers to the Intervention Act #1
-iii. Progress Towards Goal of Weight – Goal Not Achieved as of 6/22/2015"
-"b. Outcome Observation #2:
-i. Refers to Goal Observation for Body Temperature
-ii. Refers to Intervention Act #2
-iii. Progress Towards Goal of Body Temperature – Goal Achieved as of 6/24/2015"



Processes



ClinFHIR Tool Review

  • Date: 3 January 2017 Conference call


  • Details - TBA



Technical Connectathon


The HSSP community is running a project, which is a FHIR based Care Coordination Service.
The project:

- 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.

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.

More details about the proposal can be found at this link:

http://wiki.hl7.org/index.php?title=201701_Care_Plan