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Date:February 4, 2020

Quarter: 3

Discussion items

1 hourSession hosted by Orders and Observation WG - see OO Minutes for further details. OO WGM Meeting Minutes: February 4 - 7, 2020 Highlights documented here.

Review and Discussion FHIR resources/topics owned by OO

  • ServiceRequest priority 22786
  • Nutrition intake resource
  • Blood Administration
  • DeviceRequestnotDoneReasonCode
  • DeviceUseStatement notDoneReasonCode
  • Discuss use of DiagnosticReport-Lab, DiagnosticReport-Note, and any other DiagnosticReport vs just Observation for reference in CDS or eCQM expressions

Floyd Eisenberg (CQI), Lorraine Constable (OO)

with input from Stan Huff and Susan Matney

  • Nutrition intake and output - US Academy of Nutrition and Dietetics working on Connectathon and implementation guide with input from Australia and Canada - considering resource proposal and requests to prep for May Connectathon. Has weekly call (was on Fridays, now moving to biweekly Wednesday 2pm ET - check Draft proposal from OO will be refactored in this effort. Hoping to have something done this year.
  • ServiceRequest.priority - should the elective concept be a separate element entirely - not necessarily parallel to urgent, routine.  The encounter value set for priority includes elective. The question is whether the two value sets should be harmonized. It seems that the use case to determine if a routine procedureRequest that changes to urgent, the order may not be changed. However, the Encounter.priority should be changed from elective. 
  • Blood administration - weekly calls Monday afternoon. Will discuss Wed Q2 in this WGM - also Thursday Q2 with Clinical Genomics. 
  • DeviceUseStatement originally came from CDS - now managed by OO. Clarification - no clear realistic use yet. Recommendation is to use Observation. For something like wheelchair use suggest requesting a specific LOINC code "device used" and then reference the device.
  • DiagnosticReport - there is still a lot of discussion about the appropriate use of DiagnsticReport. There are a number of calls weekly. OO will notify CQI when there are related discussions that could use input from CQI use cases.
30 minCIMI discussion led by Stan HuffStan Huff

Stan presented current CIMI efforts to represent observation detail.

LOINC allows pre-coordinated models (e.g., glucose in blood by test strip) and post-coordinated models (e.g., Glucose in blood with method = text strip and units). CIMI is working on profiles to allow use of pre-coordinated or post-coordinated expressions to handle observations.

5 minutesValue of combined meetings at future WGMsAllContinued combined meetings - OO, CQI, CIMI and CDS preferred but may need to find a different schedule time since USRealm meets day 1 Q3 which conflicts with this session.

Action items

Quarter: 4

Discussion items


CQI Business Meeting

  • Due to limited attendance (3), we reviewed the agenda for week
  • We did review CQI activities and Clinical Quality Framework activities with Australian folks.

Due to expected attendance and limited agenda items, Wednesday Q1 session cancelled

Action items