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Difference between revisions of "Clinicians on FHIR - Jan 2018, New Orleans. LA"

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* '''Tool'''
 
* '''Tool'''
−
:- Participants registered for the Clinician-on-FHIR event are strongly recommended to familiarise themselves with the clinFHIR tool
+
:- Participants registered for the Clinician-on-FHIR event are strongly recommended to familiarise themselves with the [http://clinfhir.com/ 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
 
:: - 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:
 
:: - Logon to the clinFHIR site:
Line 89: Line 89:
 
*'''Supporting Information'''
 
*'''Supporting Information'''
  
−
: - To be included
+
*New FHIR Resource - [http://build.fhir.org/examplescenario.html ExampleResource]
 +
**See here [http://zeora.net/blog/mma/examplescenario-mma1-scenario.html for an example]
  
  
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==Track 1==
 
==Track 1==
  
−
===Chronic Care===
+
===Chronic Care (Care Planning)===
 +
*Track [https://mdrx.webex.com/mdrx/j.php?MTID=m9063a892ab787841dcc120cc51e4c963 Webex]
  
−
* Track co-lead: Emma Jones
+
* Track co-lead: Emma Jones/Jeff Danford/Dave Carlson
  
−
* Details - Will focus on care plan especially plan definition and activity definition.  Specifically the activity aspect of the care plan structure.   
+
* Details - Will focus on care plan especially plan definition and activity definition.  Specifically the activity aspect of the care plan structure.  
 +
**[[Media:PlanDefinitionFlow.pptx |PlanDefinition/ActivityDefinition for Care Planning - Overview]]
 +
**[[Media:PlanDefinition_High_level_Flow.pptx |PlanDefinition/ActivityDefinition for Care Planning - Process Flow]]
 +
**[[Media:StructureDefinition_FHIR_mappings.xlsx |ActivityDefinition Example Content]]
 +
 
 +
* FHIR Connectathon [http://wiki.hl7.org/index.php?title=201801_Care_Plan Care Management and Care Planning]
 +
   
 
* Preparations: - Will use the spreadsheet prepared.   
 
* Preparations: - Will use the spreadsheet prepared.   
  
−
** [[Media:FHIRCare_Plan_Resource_Maturity_Test_Chronic_Care.xlsx |FHIRCare_Plan_Resource_Maturity_Test_Chronic_Care]]
+
**[[Media:FHIRCare_Plan_Resource_Maturity_Test_Chronic_Care.xlsx |FHIRCare_Plan_Resource_Maturity_Test_Chronic_Care]]
 
<br>
 
<br>
  
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* Preparations: - Scope = Resources that are related to the hospital component and exclude Care Plan from the scope.  Will investigate the use of care team without the use of care plan.   
 
* Preparations: - Scope = Resources that are related to the hospital component and exclude Care Plan from the scope.  Will investigate the use of care team without the use of care plan.   
  
 +
**[[Media:Copy of FHIR_Resource_Maturity_Test_AcuteCare-Story_20180118.xlsx |Copy of FHIR_Resource_Maturity_Test_AcuteCare-Story_20180118]]
  
 
<br>
 
<br>
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==Track 3==
 
==Track 3==
  
−
===Perinatology===
+
===Perinatology - Cancelled===
  
 
* Track co-lead: Laura
 
* Track co-lead: Laura
Line 142: Line 151:
 
* Details - 2 day-old male infant that needs follow-up for serum bilirubin level following discharge from birth hospital to home.  
 
* Details - 2 day-old male infant that needs follow-up for serum bilirubin level following discharge from birth hospital to home.  
 
**Unique features include:
 
**Unique features include:
−
***modeling maternal data in infant's chart (associated person)
+
***modeling maternal data in infant's chart (related person; observation-focal-subject)
 
***examples of demographic and lab data that may be used for calculating risk of hyperbilirubinemia and potential need for intervention (phototherapy)
 
***examples of demographic and lab data that may be used for calculating risk of hyperbilirubinemia and potential need for intervention (phototherapy)
−
* Preparations: -  
+
 
 +
* Findings/ feedback:
 +
 
 +
** Unable to add the birthTime as an extension to birthDate (as recommended) using the ClinFHIR tool
 +
 +
** Using multiple users at the same time was troublesome
 +
*** will need to redo with a single person entering the information
 +
 
 +
** Learned that related person is not sufficient for maternal information
 +
***Need observations with a modified extension of observation-focal-subject
 +
***Need to establish analogous functionality for condition
 +
***Also need to determine how to document maternal medication exposure as relevant to fetus/infan
  
 
<br>
 
<br>
Line 156: Line 176:
 
* Details - focusing on the screening aspect of ED visit
 
* Details - focusing on the screening aspect of ED visit
 
* Preparations: -  
 
* Preparations: -  
 +
 +
The login credentials for the form builder is lforms/demo
 +
 +
[[media: FHIR_Resource_Maturity_EC_180202.xlsx | Use case spreadsheet]]
 +
 +
Use case notes
 +
# The conduct of the lab request task is an implementation decision; the use case can support any number of approaches.
 +
# The registration needs to be cleared up in the clinical process. The patient is triaged, given a room, and then registered. It’s unclear
 +
# Is the referral simply a phone number, or does the ED send a referral? Do they also send a CCD or some other report? How does the gastro report back?
 +
# Most of the focus for this group was on the L-Forms demonstration. NLM L-forms may be a nice way to make creating resources easier.
 +
 +
The url of the form builder is https://lhc-formbuilder.lhc.nlm.nih.gov
 +
 +
**[[Media:xxx.ppt |On the Fly data capture tool]]
  
 
<br>
 
<br>
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===Medications ===
 
===Medications ===
  
−
* Track co-lead: Melva Peters John Hatum
+
* Track co-lead: Melva Peters / John Hatem
 +
 
 +
* Typically this track has reviewed the existing Pharmacy resources by testing any of the existing examples found in the Resource documentation. 
 +
* The current resources are:
 +
** Medication Request - use for orders, prescriptions
 +
** Medication Dispense - use the pharmacy dispense event as a response to a medication order
 +
** Medication Administration - use to document the administration of a medication
 +
** Medication Statement - used to capture medication history re: statements of medication use; also used to represent 'derived' medication statements from medication orders
 +
** Medication - used to capture the details associated with a specific medication, including compounded medications
 +
*** Medications are referenced by the Request, Dispense, Administration and Statement resources
  
−
*Need to discuss documentation of what has been accomplished. 
+
* Discussions
 +
** Review of resources
 +
** Identification of gap in dosage - can not currently support complex dosing with conditions such as sliding scale for insulin or give medication when BP is "x"
 +
** Review of Observation to confirm if recording of input/output is supported based on MedAdmin
 +
** Review what is expected for example scenarios - potential scope of scenario
  
 
<br>
 
<br>

Latest revision as of 22:05, 6 February 2018

Back to: Patient Care
Return to: FHIR Clinical Resources - PCWG
Return to: Clinicians on FHIR
Return to: Clinician on FHIR 2018

Introduction

The January 2018 Clinician-on-FHIR event will be hosted on Friday February 2, 2018.


Conference calls


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


Conference call details: please see HL7 email broadcast Phone Number: +1 770-657-9270 Participant Passcode: 943377

https://intermountainmeetings.webex.com/intermountainmeetings/j.php?MTID=m285042c1dfaad164ef45fcf2b7aa8619


Planning

Planning Calendar and Meeting Minutes


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.


Resources

Demo Videos

- Useful demo video
- ClinFHIR Demo 2017-09-05 for San Diego CoF
- Useful information on document building capabilities
- David Hay Update demo Browser Setting Instructions - if needed



Powerpoint Slides


Tooling and Supporting 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



Clinician-on-FHIR Tracks


Track 1

Chronic Care (Care Planning)

  • Track co-lead: Emma Jones/Jeff Danford/Dave Carlson
  • Preparations: - Will use the spreadsheet prepared.


Track 2

Acute Care

  • Track co-lead: Rob Hausem/Stephen Chu
  • Details - will focus on the inpatient section at this time.
  • Preparations: - Scope = Resources that are related to the hospital component and exclude Care Plan from the scope. Will investigate the use of care team without the use of care plan.


Track 3

Perinatology - Cancelled

  • Track co-lead: Laura
  • Details - Look at focus on discharge from hospital.
  • Preparations: -


Track 4

Newborn

  • Track co-lead: Mike Padula and Viet Nguyen
  • Details - 2 day-old male infant that needs follow-up for serum bilirubin level following discharge from birth hospital to home.
    • Unique features include:
      • modeling maternal data in infant's chart (related person; observation-focal-subject)
      • examples of demographic and lab data that may be used for calculating risk of hyperbilirubinemia and potential need for intervention (phototherapy)
  • Findings/ feedback:
    • Unable to add the birthTime as an extension to birthDate (as recommended) using the ClinFHIR tool
    • Using multiple users at the same time was troublesome
      • will need to redo with a single person entering the information
    • Learned that related person is not sufficient for maternal information
      • Need observations with a modified extension of observation-focal-subject
      • Need to establish analogous functionality for condition
      • Also need to determine how to document maternal medication exposure as relevant to fetus/infan


Track 5

Emergency Care (NLM L Forms)

  • Track co-lead: Clem McDonald and Jim McClay
  • Details - focusing on the screening aspect of ED visit
  • Preparations: -

The login credentials for the form builder is lforms/demo

Use case spreadsheet

Use case notes

  1. The conduct of the lab request task is an implementation decision; the use case can support any number of approaches.
  2. The registration needs to be cleared up in the clinical process. The patient is triaged, given a room, and then registered. It’s unclear
  3. Is the referral simply a phone number, or does the ED send a referral? Do they also send a CCD or some other report? How does the gastro report back?
  4. Most of the focus for this group was on the L-Forms demonstration. NLM L-forms may be a nice way to make creating resources easier.

The url of the form builder is https://lhc-formbuilder.lhc.nlm.nih.gov


Track 6

Medications

  • Track co-lead: Melva Peters / John Hatem
  • Typically this track has reviewed the existing Pharmacy resources by testing any of the existing examples found in the Resource documentation.
  • The current resources are:
    • Medication Request - use for orders, prescriptions
    • Medication Dispense - use the pharmacy dispense event as a response to a medication order
    • Medication Administration - use to document the administration of a medication
    • Medication Statement - used to capture medication history re: statements of medication use; also used to represent 'derived' medication statements from medication orders
    • Medication - used to capture the details associated with a specific medication, including compounded medications
      • Medications are referenced by the Request, Dispense, Administration and Statement resources
  • Discussions
    • Review of resources
    • Identification of gap in dosage - can not currently support complex dosing with conditions such as sliding scale for insulin or give medication when BP is "x"
    • Review of Observation to confirm if recording of input/output is supported based on MedAdmin
    • Review what is expected for example scenarios - potential scope of scenario


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