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Chair:  @Paul Knapp

Scribe: @MaryKay McDaniel

Call Logistics:  This call is at 11 AM ET, 10 AM CT, 9 MT, 8 AM PT, join using https://join.freeconferencecall.com/fm4

Attendees - list maintained at the bottom of meeting notes.

REMINDER:

Planning to ballot an artifact in the May 2019 cycle? Email the Work Group Approved PSS to the PMO by January 27th.

Planning to ballot an artifact in the September 2019 cycle? Get TSC approval of the PSS by April 7th.

 

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)

Approve previous Minutes

2019-01-29 FM Interim Meeting Notes

2019 JAN WGM Meeting Notes

Deferred, notes not ready.



Proposed Agenda,

Ballot Reconciliation, Coverage Requirements Discovery

1) January Meeting, Follow-ups,

Updates from the January meeting

Hospice Indicator.

** Linda will create a tracker. What more does the FM WG need to do?

Paul: Will create the extension in Coverage. Will add into current build. There is no US Core for Coverage (Core was a project).

Tracker 20361, added for R5

Need for indicators for Hospice, LTC, Disability and ESRD.  There is a need to have an indicator when a particular coverage type was invoked. 

There is a monthly file between Medicare (IDR).  Need code to indicate the type of coverage and span for when it applies.

Benoit perhaps had possible business case as well. 

Going to add something to COVERAGE at least a dated data element.  Complex element to be a code and date.  For the US, will need a US CORE code set.  Need code set to ID the types of subplan.  If putting into coverage, will need to be included in any coverage for which it has been invoked.  Will only be for the actual coverage it has been invoked.  It isn’t a status about the person.  It won’t be able to be used for things like pregnancy indicator.  There are other things other than hospice and it must be invoked by the patient (or whatever the process is).   

There are some coverage and other member alerts that limit or impact coverage (high use individual limited to a single pharmacy).  There might be other alerts that would be in a clinical sense, but that wouldn’t necessarily be in coverage.    This new thing is specific to patient invoked rather than limitations imposed on coverage by someone else.   When will change in coverage resource be made so the Da Vinci project, when will it be available for use (R5 in 2 years), but extension can be used in the interim. FM would develop the universal extension.

2) PSS Updates:

PSS at: PSS for HL7 FM Survey

Update: awaiting TSC approval

PSS at: PSS for Payer Data Exchange (PDex)

Update: awaiting US Realm and TSC approvals

FM needs to review and approve: PSS

eHRx: PSS for eHealth Record Exchange (eHRx) Framework#menu-link-content

Reviewed the PSS

Discussion around Consent. Use Case: When patient has paid in cash and doesn't want the information shared with insurer. Bob: will follow up with FAST and include in IG as, provider do not send. Motion to approve: Linda M./Rachel = 11-0-0


3) Anesthesia Billing Outreach update - MK

No update. MK is a slacker.

4) Next meeting: 2/19.

5) CONTINUATION OF BALLOT RECONCILIATION, if needed

 


Methodology

Added Items


Ballot Reconciliation - FHIR Core Resources

Ballot Recon Meeting Minutes:

TrackerIDSummaryOutcome

Moved/

Seconder

VoteComment
17888

Coverage Requests should require mutual TLS (Joshua Mandel)


Was a shall, made a should. This a web centric protocol.

There is a discussion in the FHIR security module and came to the same conclusion.



Persuasive with ModAndy Gregorowicz / Mark Scrimshire15-0-0

Deferring to ITS, today 12/4/2018. Paul will bring up in call later today and will loop back to Andy G. Conflicts between hooks and the IG.

Paul Update from ITS: Not much discussion on the ITS call. Remind Paul on 12/18/2018, for next ITS call.

1/8/2019: should is appropriate.

2/5/2019: voted 1/8. Andy/Mark 15-0-0

Updates made to tracker

17890

 Clarify linkage between created resources (Joshua Mandel)

Persuasive














18972Add standard prefetch definitions for each hook - CRD #113 (Richard Ettema)Not Persuasive with Mod

Per Loyd McKenzie, there is no benefit in standardizing the prefetch document. Develop something that is nimble.

Everyone's end point will have a different name.

Deferring today. Group did not agree with no standardization. Concerned that the business side does not understand, have not been adequately educated with the potential outcomes. Templates/standardization seems to be needed. How do you test this?

2/5/2019: Voted 1/29

Andy/Kathleen 9-0-0







18875Client and server roles aren't defined yet. More context at this point in the spec would be helpful - CRD #1 (Andrew Gregorowicz)Persuasive

Deferred for Andy input.

1/16/2019:

Benoit/Mark, 9-0-1

18878 Link CDS Service and HTTP Request to the relevant parts of the CDS Hooks specification - CRD #4 (Andrew Gregorowicz)Persuasive

Deferred for Andy input.


1/16/2019:

MK/Benoit, 10-0-0

18880 Suggest that we state that “boolean” and “integer” conform to their specification in the FHIR base data types. - CRD #6 (Andrew Gregorowicz)Not Persuasive with Mod

Deferred for Andy input.

1/6/2019

Benoit/Mark, 10-0-0

18881



1/6/2019

Benoit/Mark, 10-0-0

18883 

Suggest this request for functionality to be added to prefetch be limited to CDS Hook Request context properties that are defined as FHIR Bundles - CRD #9 (Andrew Gregorowicz)

Not Persuasive

Deferred for Andy input.

1/29/2019

Andy/Kathleen, 8-0-0


  • 18893 Do not include narrative text in de-identified data - CRD #19 (Corey Spears) Not Persuasive with Mod





  • 18894 Finish TODO items. - CRD #20 (Corey Spears) Persuasive




18898Question about patient.id minimum cardinality - CRD #39 (Ken Lord) Persuasive with Mod



  • 18906 There should be a section number for Version History as well. - CRD #47 (Hans Buitendijk) Not Persuasive




18910Since EHR is largely human no need to specify. Alternative consider "individual health data" instead of "human EHR data" - CRD #51 (Hans Buitendijk) Persuasive with Mod









  • 18913 Should this be a STU 1 or a STU0.5? - CRD #54 (Hans Buitendijk) Not Persuasive





  • 18917 This page is confusing as to what the links are pointing to. - CRD #58 (Hans Buitendijk) Persuasive with Mod




18920 

Update the overview section to make it read better - CRD #61 (Jeffrey Danford)

Persuasive with Mod



  • 18922 Combine Developer's Introduction and (or Clinical Introduction) into one bullet point. - CRD #63 (Jeffrey Danford) Persuasive




18936Add a URL to what a profile is - CRD #77 (Mary Kay McDaniel)Persuasive



18937 Fix typos in the hooks section - CRD #78 (Mary Kay McDaniel) Persuasive with Mod




  • 18941 Sentence restructure for better flow/ comprehension. - CRD #82 (Mary Kay McDaniel) Persuasive




18942Needs clarity. - CRD #83 (Mary Kay McDaniel)Persuasive


18945 We need to decide what we're going to call what is out there now and then update all the references to it. Are they going to be Pre-existing 'standard' version 1.0 use case.... - CRD #86 (Mary Kay McDaniel) Persuasive



18947 Improve wording explaining need for configuration - CRD #88 (Mary Kay McDaniel) Persuasive



18948

There needs to be additional configuration options suggested within the IG. - CRD #89 (Mary Kay McDaniel) None

18948 - There needs to be additional configuration options suggested within the IG

This item was discussed in both the Da Vinci Use Case Group as well as on the 11/20 FM call. However, I have received a report from Lloyd McKenzie which states that Negative Major ballot comments are not able to have a resolution of Considered for Future Use. Given that we changed the resolution on the 11/20 call, I feel we need to readdress the issue on tomorrow’s call.




Originally discussed 11/20/2018 on WGM call.


1/8/2019: Per Paul, this is an allowable ballot disposition. Need to touch base with TSC for confirmation. Will bring back to the group after WGM.

2/5/2019. Andy: status was marked as deferred, considered for future use

Andy/Andy, 9-0-0


18949More guidance on 'gracefully handle' - CRD #90 (Mary Kay McDaniel)Persuasive


18951Explain bolded paragraph - CRD #92 (Mary Kay McDaniel)Persuasive


18952How would you determine what configuration options are supported? - CRD #93 Persuasive



  • 18955 Fix the hooks to read better - CRD #96 (Mary Kay McDaniel) Persuasive





  • 18956 Be consistent with EHR vs EMR - CRD #97 (Mary Kay McDaniel) Persuasive





  • 18957 Be consistent with EHR vs EMR - CRD #98 (Mary Kay McDaniel) Persuasive





  • 18958 Provide examples and fix TODOs - CRD #99 (Mary Kay McDaniel) Persuasive





  • 18960 Provide examples and fix TODOs - CRD #101 (Mary Kay McDaniel) Persuasive





  • 18961 Fix the hooks to read better - CRD #102 (Mary Kay McDaniel) Persuasive




18962How do we 'expose' other project's profiles earlier in the IG so implmeenters are aware of the knowledge needed up front? - CRD #103 (Mary Kay McDaniel)Persuasive



  • 18964 Improve wording on redundancy - CRD #105 (Mary Kay McDaniel) Persuasive





  • 18966 Provide examples and fix TODOs - CRD #107 (Mary Kay McDaniel) Persuasive





  • 18967 Provide examples and fix TODOs - CRD #108 (Mary Kay McDaniel) Persuasive





  • 18973 Overall the ballot documentation is still very drafty with incomplete sections (for example 2.2) with text still referenced as “To Do”. - CRD #114 (Walter Suarez) Persuasive





18974 Add description of Da Vinci to spec - CRD #115 (Walter Suarez) Persuasive



18977We suggest having an introduction section to Resources that identify and describe the structure of the Resources section rather than simply including a set of URLs. - CRD #118 (Walter Suarez)Persuasive



  • 18978 This section seems a sum of all URLs referenced elsewhere in the implementation guide. Is it really necessary? What is it adding? - CRD #119 (Walter Suarez) Not Persuasive with Mod




18980Can this be HIPPA compliant without a regulation change? - CRD #123 (Nancy Orvis)Not Persuasive
















 Andy has done a compare of the notes and the tracker items.

Block vote next meeting on these items.

  • 18920 Update the overview section to make it read better - CRD #61 (Jeffrey Danford) Persuasive with Mod
  • 18910 Since EHR is largely human no need to specify. Alternative consider "individual health data" instead of "human EHR data" - CRD #51 (Hans Buitendijk) Persuasive with Mod
  • 18898 Question about patient.id minimum cardinality - CRD #39 (Ken Lord) Persuasive with Mod
  • 18936 Add a URL to what a profile is - CRD #77 (Mary Kay McDaniel) Persuasive
  • 18942 Needs clarity. - CRD #83 (Mary Kay McDaniel) Persuasive
  • 18945 We need to decide what we're going to call what is out there now and then update all the references to it. Are they going to be Pre-existing 'standard' version 1.0 use case.... - CRD #86 (Mary Kay McDaniel) Persuasive
  • 18949 More guidance on 'gracefully handle' - CRD #90 (Mary Kay McDaniel) Persuasive
  • 18951 Explain bolded paragraph - CRD #92 (Mary Kay McDaniel) Persuasive
  • 18952 How would you determine what configuration options are supported? - CRD #93 (Mary Kay McDaniel) Persuasive
  • 18962 How do we 'expose' other project's profiles earlier in the IG so implmeenters are aware of the knowledge needed up front? - CRD #103 (Mary Kay McDaniel) Persuasive
  • 18977 We suggest having an introduction section to Resources that identify and describe the structure of the Resources section rather than simply including a set of URLs. - CRD #118 (Walter Suarez) Persuasive
  • 18980 Can this be HIPPA compliant without a regulation change? - CRD #123 (Nancy Orvis) Not Persuasive
  • 17890 Clarify linkage between created resources (Joshua Mandel) Persuasive
  • 18978 This section seems a sum of all URLs referenced elsewhere in the implementation guide. Is it really necessary? What is it adding? - CRD #119 (Walter Suarez) Not Persuasive with Mod
  • 18974 Add description of Da Vinci to spec - CRD #115 (Walter Suarez) Persuasive
  • 18973 Overall the ballot documentation is still very drafty with incomplete sections (for example 2.2) with text still referenced as “To Do”. - CRD #114 (Walter Suarez) Persuasive
  • 18967 Provide examples and fix TODOs - CRD #108 (Mary Kay McDaniel) Persuasive
  • 18966 Provide examples and fix TODOs - CRD #107 (Mary Kay McDaniel) Persuasive
  • 18964 Improve wording on redundancy - CRD #105 (Mary Kay McDaniel) Persuasive
  • 18961 Fix the hooks to read better - CRD #102 (Mary Kay McDaniel) Persuasive
  • 18960 Provide examples and fix TODOs - CRD #101 (Mary Kay McDaniel) Persuasive
  • 18958 Provide examples and fix TODOs - CRD #99 (Mary Kay McDaniel) Persuasive
  • 18957 Be consistent with EHR vs EMR - CRD #98 (Mary Kay McDaniel) Persuasive
  • 18956 Be consistent with EHR vs EMR - CRD #97 (Mary Kay McDaniel) Persuasive
  • 18955 Fix the hooks to read better - CRD #96 (Mary Kay McDaniel) Persuasive
  • 18947 Improve wording explaining need for configuration - CRD #88 (Mary Kay McDaniel) Persuasive
  • 18941 Sentence restructure for better flow/ comprehension. - CRD #82 (Mary Kay McDaniel) Persuasive
  • 18937 Fix typos in the hooks section - CRD #78 (Mary Kay McDaniel) Persuasive with Mod
  • 18922 Combine Developer's Introduction and (or Clinical Introduction) into one bullet point. - CRD #63 (Jeffrey Danford) Persuasive
  • 18917 This page is confusing as to what the links are pointing to. - CRD #58 (Hans Buitendijk) Persuasive with Mod
  • 18913 Should this be a STU 1 or a STU0.5? - CRD #54 (Hans Buitendijk) Not Persuasive
  • 18906 There should be a section number for Version History as well. - CRD #47 (Hans Buitendijk) Not Persuasive
  • 18894 Finish TODO items. - CRD #20 (Corey Spears) Persuasive
  • 18893 Do not include narrative text in de-identified data - CRD #19 (Corey Spears) Not Persuasive with Mod

 


Management Next agenda

Tuesday, February 19, 2018 at 11:00 - 12:30 ET

  • CRD Ballot reconciliation

 Adjournment
 Adjourned at 12:30 ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval


Action items



ATTENDEES: 

Present

Name

email

Affiliation

  •  
Kathleen Connor
  •  
Paul Knapppknapp@pknapp.comKnapp Consulting Inc.
  •  
MaryKay McDanielmarykay.mcdaniel@cognosante.comCognosante
  •  
Benoit Schoefflerbenoit.schoeffler@almerys.comAlmerys
  •  
Alex Beckneralex.beckner@cerner.comCerner
  •  
Lou BedorLouis.Bedor@cognosante.comCognosante
  •  
Laurie Burckhardtlaurie.burckhardt@wpsic.comWPS
  •  
Tricia Chitwoodtricia.chitwood@cerner.comCerner
  •  
Rachel FoersterRachel@rfa-edi.com
  •  
Susan LangfordSusan_Langford@bcbst.comBCBST
  •  
Linda Michaelsenlinda.michaelsen@optum.comOptum
  •  
Joe QuinnJoseph.Quinn@optum.comOptum
  •  
Mark Scrimshiremark@ekivemark.comCMS/NewWave
  •  
Najee Shafinajee.shafi@cognosante.comCognosante
  •  
Andy Stechishinandy.stechishin@gmail.com
  •  
Katie Sullivankatie.sullivan@cognosante.comCognosante
  •  
Andy Gregorowiczandrewg@mitre.org

The MITRE Corporation

  •  
Patrick J LaRocqueplarocque@mitre.orgThe MITRE Corporation
  •  
Ray Delanoray.delano@cerner.comCerner
  •  
Larry Decellesldecelles@mitre.comMITRE
  •  
Robert Dieterlerdieterle@enablecare.usEnableCare
  •  
Ben Hamlinhamlin@ncqa.orgNCQA
  •  
Julia Chanjchan@cwglobalconsult.com