V2

Vocabulary

UP-44 -no value set content defined for v2 table 963 value set

• We had discussed and taken a vote on this back on 2022-06-10, but I'm not sure at this point if that is still what we actually still will want to do.  If we discuss it again together hopefully we can decide if that is what we want or we can figure out a good alternative plan.

2/9 Note: Rob indicated this could wait.

------February 9, 2023----Jump to FHIR below (please)-------

eSignature

• Decide in January if we want to use a PAC comment on this
  • Rule includes CDA Attachment of Lab Order with electronic signatures
  • Need to decide if we still want to submit comments
  • Need to follow up with Hans and Dan
  • (Note this is Frieda's last OO Main call)
• PAC deadline??? Hans Buitendijk 
• Comments due March 21, 2023

V2-Jira Review (time permitting)

• V2 Dashboard 

JIRA R5 Ballot Ticket Backlog

• Today's Block Vote  - Time requested for today's call

Request to pull FHIR-38976 - gatewayDevice description missing  - to be discussed at the HCP meeting on 2/13/2023.

Motion to accept the JIRAs as proposed minus the one pull. 

• JD Nolen, Marti Velezis.
• In Favor: 12; Against: 0; Abstain: 1

R5 Ballot JIRA Tickets

• Overall Count
  • https://jira.hl7.org/secure/Dashboard.jspa?selectPageId=12300

• Specimen

  • FHIR-39269 - Remove Specimen from Group member types

    • Bryn Rhodes would you like to chat about this on next week's OO Specimen call 2/6/2023 @ 2PM ET?  Need response from Bryn.

    • Reassigned to FHIR-I as they own the Group resource with a proposed disposition for the issue.

• Observation
  • Comment:
    • FHIR-38956 - Unclear statement
      • Hans to work on potential clarifying language.
  • Change Requests
    • FHIR-38976 -gatewayDevice description missing
      • The proposed disposition was not accepted - need to pull 2/9 for discussion, but can we determine a response to comments
    • FHIR-39113 - relatedArtifact Extension should be allowed on Observation.component
      • Still not resolved by the responses in comments
      • Motion to find Persuasive
        • Rob Hausam / Jose Costa Teixeira : 12-0-1
        • Assigned to Rob Hausam

• • • FHIR-38971 - observation-precondition should be a modifier extension
      • Explanation added by Rob
      • Reassigned to FHIR-I

• InventoryItem
  • FHIR-39161 -Product resource for inventory, catalog, supply
  • Can this be linked to the InventoryItem resource draft
    • Motion to find Persuasive with Modification 
      • Jose Costa Teixeira / Marti Velezis : 13-0-0
      • Assigned to Jose Costa Teixeira

• Nutrition
  • FHIR-33400 - How to store a nutrition administration?
    • The examples are about "feeding" which should be the Procedure.code
      • Note that "enteral feeding" and "bottle feeding" which is coded under "384760004 | Feeding and dietary regime (regime/therapy) |" under the SNOMED CT Procedure codes
    • Should this be dispositioned as "Not persuasive"  The request for routes of administration should be 417985001 | Enteral route (qualifier value) | or 26643006 | Oral route (qualifier value) |, which are included in the 284009009 (Route of administration values) and are about "administration" that are handled by other resources - e.g., Observation.
    • Motion to find Not Persuasive
      • Marti Velezis / Jose Costa Teixeira : 11-0-0
      • No changes required at this time.

• DiagnosticReport Examples / Parent-Child
  • https://jira.hl7.org/browse/FHIR-39168  - Proposed draft language to implement the disposition:
  • Critical JIRAs to resolve as well:
    • https://jira.hl7.org/browse/FHIR-34205

    • https://jira.hl7.org/browse/FHIR-34206

    • https://jira.hl7.org/browse/FHIR-34207

  • To discuss Friday (agendas permitting) and/or at OO on FHIR next Tuesday.

---------------------------Adjourned at 4:05PM EDT--------------------------------------

• Backlog JIRA issues
  • FHIR-37964 = AOE implementation in ServiceRequest
    • Proposed Motion to convert ServiceRequest.supportingInfo
      • to backbone for supportingInfo similar to DiagnosticReport, but with type attribute as 0..1, example binding to V2 Observation type
      • reference to any
      • discussion: will need to update to newer version of IG will have to review the updates to the underlying standard and how that will work
      • separate attribute (to be able to match 1:1 to DataInputObservationDefinition in catalog) or supportingInfo - discussion from Friday's calls (2022-08-19 Order Logical Model Application to FHIR and 2022-08-19 Lab)
        1. Option 1: Use the same structure but add an invariant to restrict the reference to Observation if type equals AOE and make the same invariant for supportingInfo in DiagnosticReport with an alias for AOE
        2. Option 2: Make another structure that only for AOEs (InputObservationResponse) with an alias for AOE and also add a similar structure to DiagnosticReport
      • Zullip chat https://chat.fhir.org/#narrow/stream/179256-Orders-and-Observation-WG/topic/AOEs.20in.20ServiceRequest.20and.20DiagnosticReport - so far no answers
      • Also to be included in the discussion - supportingInfo in DiagnosticReport FHIR-36858 - Provide a mechanism to reference "prior studies" WAITING FOR INPUT
        • Waiting on example codes from Daniel Rutz 
      • Some examples of AOEs:
        • Examples Last Menstrual period
        • Urine volume and duration of collection, etc. when used in the calculation of results being reported
        • Specimen source
          • Often included as AOE in the panel (may be important to have the clinical information) – but that does not need to be represented in the data exchange paradigm
          • How does this work with CLIA requirements – might restructure LIS
          • We need to support regulatory behavior in the standard to support the regulatory requirements, but not define the regulation
      • Out of the 3 options listed:
        • Hans did not like to add a new element specific for AOEs
      • We can currently do this with existing structure, but we would like to have a better way to provide guidance how specifically handle AOEs
        • If we use observation as the reference from supportingInfo – then we can still have “free text” in observation.value, but do we need to make an invariant for this to allow only observation as reference – could potentially also have questionnaire and questionarieResponse
    • FHIR-19362 -  Incorrect reference direction Procedure -> DiagnosticReport
      
      • FROM OO on FHIR call on November 8, 2022 added the disposition "Persuasive with Modification"
        • OO will add .partOf to DiagnosticReport and DocumentReference, per the Event pattern. 
        • OO will ask Structured Documents WG to also add .partOf to Composition, per the Event pattern.
        • OO will ask Patient Care WG to consider removing the Procedure.report 0..*    Reference(DiagnosticReport | DocumentReference | Composition) in light of the changes to the referenced resources
      • FROM Main call December 1, 2022: 
        • If change is made to Diagnostic Report – the other changes (to resources not owned by OO) would need to be changed
        • The change would be better now while Resources are not normative
        • IGs are affected (e.g., US Core - and specifically US Core Lab results)
        • Procedure.report changes to 
      • Update from WORKFLOW call December2:
        • NEED TO ADD!!!!