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Meeting Details

Date: February 6, 2023

Time: 3PM ET

Coordinates:  Join Zoom meeting: https://zoom.us/j/5100467805 | Meeting ID: 510 046 7805 | +1 929-436-2866-US (New York)

Attendees: 

Hans Buitendijk, Elliot Silver, James Allain, Ana Kostadinovska, David Barwin, Javier Espina, John Hatem, John Rhoads, Jose Costa Teixeira, Paul Ashford, Pepijn Worteboer, Raquel Belarmino, Ricardo Quintano, Marti Velezis

AGENDA

  • Status on JIRA Tickets
    • Nutrition updates (15-20 mins)
    • Devices (20 mins)
    • BDPDispense (20 mins)
  • AOB
  • Next Meeting

LINKS TO JIRA - HCP DASHBOARDS

HCP_Backlog - FOR REVIEW (includes Nutrition resources)

HCP_Ballot Related - JIRA that need to be completed by R5 (many of these are related to Normative content)

HCP_Work In Progress - Items that need to be updated in the build and/or QA for completion

Upcoming Topics/Due Dates

Date

Topics

February 12,  2023Due Date for UTG Approvals (freeze on changes)
February 13, 2023 WG Call
  • Nutrition updates (15-20 mins)
  • Devices (20 mins)
  • BDPDispense (20 mins)
February 20, 2023 WG Call
February 24, 2023Due Date for Ballot Reconciliation and Revisions to the CI Build (i.e., FHIR R5 QA begins)
Unscheduled Discussions

Action Items

Instructions: Type your task here, using "@" to assign to a user and "//" to select a due date

Action Item

  • Clarify SupplyDelivery for shipment vs reception (FHIR-39277) Jose Costa-Teixeira to draft a proposal using a single resource to address "stage" and relationship across "stages".  
  • Update Nutrition Samples James Allain  
  • QA Changes to OO Resources  

MEETING MINUTES

  • R5 JIRA Tickets
    • Nutrition
      • Follow-up from James
      • FHIR-39584 - NutritionOrder.oralDiet.instruction should be markdown? TRIAGED James Allain response: is all the information I can provide. I posted the NutritionProduct examples
        • Only enteralFormula.administrationInstructions should be markdown
        • The oralDiet.instructions and supplement.instructions are only a short text string and can say as is
        • Motion to find Non-persuasive with modification
          • Marti Velezis / James Allain : 12 - 0 - 0 
          • Assigned to Jean Duteau (if he can complete by Feb 24 deadline)
      • FHIR-32293 - Resource NutritionProduct should provide better examples
        • Check comments - any other examples suggest?    James Allain response: I'm not sure if we need to review that either.  
        • Issue with the category example sets
        • Next week to be finalized reducing the list of ingredients to have real codes, use the extension format and address the syntax comments
      • Next time: 
    •  BDP
      • FHIR-33396 - How to store the nutrients of a BiologicallyDerivedProduct?
        • Use of property.type - need to look at value set example; it may be misleading
        • For R5 - allowing text via making BDP.property.type a codeableConcept for now - no change to value set
          • Motion to find Persuasive with Modification 
            • Ricardo Quintano / David Barwin : 13 - 0 - 0
            • Assigned to JD Nolen
    • InventoryItem
      • https://build.fhir.org/inventoryitem
      • Reviewed the draft 
        • characteristics - consolidate the various characteristics to one type/value pair; e.g., storageHandling, dimensions)
        • instance - is this really needed? Need to better justify the instance elements
    •  Devices
        • Revised backbone proposal:
AttributeCardData TypeComments
.orderDetail0..*BackboneElementAdditional information about the request
>parameterFocus0..1CodeableReference (Device | DeviceDefinition | DeviceRequest | SupplyRequest | MedicationRequest | Medication | BiologicallyDerivedProduct | Substance)Indicates the context of the order details by reference
>parameter1..*Backbone Element
     >>code1..1CodeableConceptIndicates the details of the order being requested
     >>value[x]1..1Quantity | Ratio | Range | boolean | CodeableConcept | string | PeriodIndicates a value for the order detail
        • Motion to accept Persuasive 
          • Marti Velezis / Ricardo Quintano : 11-0-1
        • Assigned to Jose Costa-Teixeira 


Next meeting: February 13, 2023 - and extend to 4:30PM EDT (90 mins)

------------Adjourned at 4:03 PM EDT-----------------------------

Did not get to the following: 

  • Device Association - reference in other resources
  • Service Request: FHIR-40286 - ServiceRequest should include the product element defined with the Request pattern TRIAGED
  • Nutrition: FHIR-40094 - ingredientSummary

INVENTORY BACKLOG

SOURCE 

ISSSUE/TOPIC FOR DISCUSSION

NOTES

BiologicallyDerivedProduct
  • FHIR-37953 - BiologicallyDerivedProduct.collection.source should allow RelatedPerson SUBMITTED post WGM
  • Working in the direction of non-persuasive, while following up on more clarity from Grahame and a draft updated description for .source to clarify why RelatedPerson would not fit.
  • Check JIRA comments

  • Propose updating collection.source Description & Constraint from
    The patient or entity providing the product

    to:
    The patient who underwent the medical procedure to collect the product or the organization that facilitated the collection

  • Need Jose Costa-Teixeira and Carl Leitner on the call.
  • Is there a benefit to have definition for BDP, in blood bank with ordering is one (and maybe only example).
NutritionProduct
  • FHIR-33396 - How to store the nutrients of a BiologicallyDerivedProduct?
  • Added after 9/12/22 call (missing in previous listing)
  • FHIR-32293 - Resource NutritionProduct should provide better examples
  • Added after 9/12/22 call (missing in previous listing)
  • FHIR-32756 - request-insurance extension needs more context given in the description
  • Waiting for Jose Costa-Teixeira  to respond to comments; this should be included in a future call (August 8 or 15)
  • FHIR-19516 - Substantive workflow changes for OO resources
  • Needs to be assigned (Status = Resolved Change Required)
NutritionOrder
  • Added after 9/12/22 call (missing in previous listing)
NutritionIntake
  • FHIR-32294 - Does NutritionIntake resource exist?
  • Added after 9/12/22 call (missing in previous listing)
  • Note - this is in the listing under resources, but when doing a search in JIRA, it does not show up.  It must be missing somewhere.

Device

  • Pending additional review
Note - moved up parent FHIR 38904 for discussion.
  • Specialization
    • Need to discuss with DEV group on Wednesday and schedule a time to discuss in HCP
    • FHIR-38057 - DeviceDefinition and Device should use same "specialization" modelMeeting adjourned early - due to lack of participates for the topics on hand.
    • FHIR-38058  - Device specialization assumes a particular model of standards compliance
    • FHIR-39084 - Change .specialization to .conformsTo
      • FHIR-39242 - Change .specialization to .conformsTo. See ticket FHIR-39084FHIR-39053 - Ambiguity when to use .specialization and when .property element
    • FHIR-38902 - Consistency between Device and DeviceDefintion resources

Device Dispense
  • FHIR-39046  - Critical use cases for Device(Dispense)
    • Need a flow of the devices across these use cases to get a better handle on how to address this request
    • Also need to pull some of the uses cases into the DEV on FHIR group for discussion (e.g., Representation of a web based application as a source of information (i.e. is the browser instance or the server the source, I expect the server).; Devices representing CDS algorithms; Imaging equipment.
  • FHIR-39049 - DeviceDispense should allow dispensing devices to Practitioners and RelatedPerson

DeviceDefinition
  • FHIR-32271 - DeviceDefinition.parentDevice and DeviceDefinition.hasPart allow same concept to be modeled in two ways 

  • FHIR-31750 - Complement Valueset-identifier-type for Device identifiers 

  • Approved; Updating UP-232
  • Need to complete work on Device Definition to make it consistent with or address variations from Device resource
  • E.g., Parent, hasMember – need to address this across Device and DeviceDefinition
    • parentDevice (change to parent if kept in resource)
  • Mappings (TBD)
DeviceDispense
  • FHIR-39046  - Critical use cases for Device(Dispense)
    • Need a flow of the devices across these use cases to get a better handle on how to address this request
    • Also need to pull some of the uses cases into the DEV on FHIR group for discussion (e.g., Representation of a web based application as a source of information (i.e. is the browser instance or the server the source, I expect the server).; Devices representing CDS algorithms; Imaging equipment.
  • FHIR-39049 - DeviceDispense should allow dispensing devices to Practitioners and RelatedPerson

DeviceRequest

  • FHIR-26429  - Consider adding extension to allow fuzzy timing for DeviceRequest.occurrence

  • Note - Robert Hausam there is an outstanding question in comments for you - also see under Service Request.

  • Need update form OO on FHIR

  • FHIR-26953 - Apply performerOrder (standard extension) to DeviceRequest or add in core.  Checking with Bob Dieterle on PAO impact of changing to CodeableReference.

  • FHIR-26948 - Create examples for prosthetics (e.g. glasses, lenses) in DeviceRequest; Comment added for Jose - Pending
  • See topic below (Device Request and VisionPrescription)
  • Device Request and VisionPrescription
  • FHIR-26429 -  Will be discussed at OO on FHIR on August 2 (note - Robert Hausam there is an outstanding question in comments for you)

DeviceUse
  • Will be kept open until UDI IG has addressed these and can confirm it covers it.
ServiceRequest
  • FHIR-15922 -  Include DeviceRequest for SupplyDelivery.basedOn
  • Added comment for Rick Geimer to weigh in on this issue.
  • FHIR-26429 -  Will be discussed at OO on FHIR on August 2 (note - Robert Hausam there is an outstanding question in comments for you)

  • Multi-Level Parameters 
  • On Hold
Product Pattern
  • FHIR-14766 - Discuss a pattern or parent resource for Products, to avoid implementation questions, and ensure that the use of resources does not create obstacles to traceability and safety. - 2018-Jan Core #105