Clinicians on FHIR - Jan 2018, New Orleans. LA
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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
Planning
Planning Calendar and Meeting Minutes
- Sept 19 -
- Sept 26 -
- Oct 3 -
- Oct 10 -
- Oct 17 -
- Oct 24 -
- Oct 31 -
- Nov 7 -
- Nov 14 -
- Nov 21 -
- Nov 28 -
- Dec 5 -
- Dec 12 -
- Dec 19 -
- Dec 26 - Not Meeting - Christmas Break
- Jan 2 - Not Meeting - New Years Break
- Jan 9 - Review detailed spreadsheet
- Jan 16 - David Hay to attend
- Jan 23 - Prep for F2F
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
- - ClinFHIR Demo 2017-09-05 for San Diego CoF
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
- New FHIR Resource - ExampleResource
- See here for an example
Clinician-on-FHIR Tracks
Track 1
Chronic Care (Care Planning)
- Track Webex
- 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.
- FHIR Connectathon Care Management and Care Planning
- 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)
- Unique features include:
- 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
- Using multiple users at the same time was troublesome
- 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
- Learned that related person is not sufficient for maternal information
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 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
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