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July 11 - Clinical Maturity - options

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  • Stephen Chu
  • Emma Jones
  • Russ Leftwich
  • Jay Lyle
  • Laura Heermann


Meeting Notes from June 27:
- Discussions on email from Lloyd McKenzie on:

~ QA Criteria for FHIR artifacts and IGs
~ The criteria are comprehesnive. But will be difficult to fit the clinical maturity criteria into the set of conformance and QA criteria

- Discussions on two different approaches:

~ Option 1: Continue to work on clinical maturity spreadsheet.
~ Then work out way(s) to fit the maturity criteria into
* Risk: unlikely that a fit is possible
~ Or use the maturity criteria as a separate assessment in addition to the existing FHIR maturity levels (Level 0 to 6)
* Risk: implementer resistance. There are expressions on preference to have only one set of maturity assessment criteria
~ Option 2: Formalise a set of robust and useful clinical use cases, and use them to test FHIR resources
* Advantage: may be fitted into FMM3 and FMM4 of the FHIR maturity model
* Issues: may not be as comprehensive as the Clinical Maturity Model (as use cases testing is one of the Clinical Maturity criteria)
~ There is suggestion to identify a small number of FHIR clinical resources (e.g. Care Plan, Care Team) for testing Option 2 to determine how best this option works

- Decision:

~ To present the options to a broader audience/participants after at the July 11 Conference call.

- Clinical Maturity Model: Early draft:

Clinical Maturity Model spreadsheet draft 2017-06-20

  • Discussion about the above options.
  • Determined:
    • Implementor resistance at this time should not deter the current work
    • We agree clinical fitness testing should be applied - the what and how clinical fitness is the work to be done.
    • There are different levels of clinical maturity evaluation needed.
      • Initial - the resource is brand new, (general discussion of the proposed resource against use cases) - directed at the FHIR chiefs using gForge etc to influence change.
      • mid - the resource is .... (spreadsheet criteria) - directed at the FHIR chiefs using gForge etc to influence change.
      • late - how the resource is being implemented. (review of implementations - and where there are issues - CCDA implementathon model? ClinFHIR does not currently support this eval) - directed at those who are putting resources in production. For now: have technical people ask Clinicians on FHIR what clinical resources they are implementing and if they are having any clinical difficulty from users and needing to do any extensions or things we haven't considered. A Review or a show and tell of things they are having trouble with. Need to talk about what we could do as soon as September in this area.
    • We should continue working on the early and mid levels of evaluation.
    • Next steps: finish the spreadsheet criteria, then move on to the use cases.
    • Goal: have an initial start at the September ClinonFHIR

how formal do we want to make the process.