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Meeting Details

Date:  February 13, 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: 

JD Nolen, Rob Hausam, Elliot Silver, Javier Espina, Jose Costa Teixeira, Paul Ashford, James Allain, John Hatem, John Rhoads, Karen Moniz, Raquel Belamino, Yanyan Hu, Marti Velezis

Chair: JD Nolen

Scribe: Marti Velezis

AGENDA

  • Status on JIRA Tickets
  • 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 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-39277Jose Costa-Teixeira to draft a proposal using a single resource to address "stage" and relationship across "stages".  
  • QA Changes to OO Resources  

MEETING MINUTES

Device

  • FHIR-38976 - gatewayDevice description missing 
    • Need to discuss - pulled from Feb9 Block vote
    • A device acting as a communication/data collector, translator or controller; This is useful when there is more than one gateway device, for example, where there are apps on a phone and each are a device, and more than one app is used to pass on the data to a FHIR Server. In that case you need to be able to say from the  observation which specific app was used to act as gateway.  
    • Persuasive with modification to add a description as above with editor discretion
      • Elliot Silver / Javier Espina : 11-0-0 
  • FHIR-38917 - Add example of and/or guidance on how to associate device settings with clinical observations
    • Link to FHIR-40288 - the Device Module page (TBC after R5 Publication)
    • Consider for Future Use/ Defer Request
      • Elliot Silver / Marti Velezis : 10-0-0
  • Technical Correction
    • FHIR-38951 - SaMD & DTx Resource?
      • Should we move this to a CR?
      • It should be "Considered for Future Use" and Deferred to after R5 publication.  DTx is emerging and we need time to separate the issues between SAMD and other Digital Therapeutics and the boundaries between devices and medications.
      • Needs consensus vote
      • Motion to make a change request and defer request
      • Marti Velezis / Elliot Silver : 9-0-0

BDP

  • Update on status of BDPDispense resource
  • https://build.fhir.org/biologicallyderivedproductdispense
    • Definitions were sent to Hans/Jose that need to still be applied to the resource (Paul to send forward)
    • Value set for the status 
      • If product is returned – to lab for use on another patient or returned for destruction 
      • Need to look at InventoryReport 
    • BDP Module 
      • Marti to create JIRA ticket to describe the BDP workflow

Nutrition

  • Nutrition: FHIR-40094 - ingredientSummary
    • Discussed to leave the constraints to IGs
    • If summary and specific items are individually listed
    • Jose Costa Teixeira / James Allain : 12-0-0
    • Assign to Jean Duteau
  • FHIR-32293 - Resource NutritionProduct should provide better examples
    • Updates made to examples 
    • Motion - and to include adding ingredient summary in at least one of the examples
      • Jose Costa Teixeria / James Allain : 12-0-0

Next meeting:  February 20, 2023

--------end of call at 4:00 PM EDT--------


  • FHIR-38637 -Add period to Device.association
    • Administrative - Not Persuasive as this was overcome by the creation of the Device Association resource. 
    • Need update to DeviceAssociation.operation
  • Did not get to the following last time: 
    • Device Association - reference in other resources
    • Service Request: FHIR-40286 - ServiceRequest should include the product element defined with the Request pattern TRIAGED
  • FHIR-39049 - DeviceDispense should allow dispensing devices to Practitioners and RelatedPerson
  • FHIR-38818 - Clarify SupplyDelivery for shipment vs reception
    • Duplicate FHIR-39277 - Clarify SupplyDelivery for shipment vs reception
    • Do we need to address the ticket for R5

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 from 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