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AGENDA

• Workflow 
  • IG Proposals
    • FHIR Orders Exchange
    • Clinical Order Workflow
  • Workflow documents
• AOB?

MEETING MINUTES

Workflow Topics -

• [DME/Acute] Orders
  • PSS: https://jira.hl7.org/browse/PSS-2158 
  • FHIR Orders Exchange
  • US Realm
  • Referrals and Orders 
    • Scope: Documentation for Prior Auth, Claims - all products and services
    • Ordering Provider and Performing Provider
    • RESTful, Messaging and Hybrid
    • Resources are profiled 
    • Value Sets need to be expanded
  • Need to identify the IGs that include orders, etc. (Bob has a list and Riki has list)
    • Review of Existing Workflow Approaches 
    • Workflow based on source (e.g., EHR, LIS, etc.)
  • Which IG is foundational
• IG work Clinical Order Workflow (COW)
  1. Jose Costa-Teixeira and Robert Hausam will work together on details over the next two weeks to get the IG formatted and moved into the HL7 repo
  2. Need for cross-walk between regulatory requirements and the IG, so "best practices" or "best behavior" is recommended to implementors. 
  3. IG needs to help define the use/boundaries between order status, task status, etc. (glossary) 
  4. How does this square with IHE profiles?
• Belgium IG Resources
  • https://build.fhir.org/ig/hl7-be/lab/guidance.html#The%20laboratory%20order
  • Lab Order Model: Workflow Diagram (BE) 
  • Generic Referral: https://build.fhir.org/ig/hl7-be/referral/
  • Lab Order Sequence Diagram: http://build.fhir.org/examplescenario-example-laborder.html
    • Order by Task diagrams reviewed
  • Lab Order (powerpoint)
    • ServiceRequest
      • ServiceRequest.requisition
    • Task
    • Grouping of Orders
      • Option: Request Group (CDS/Bryn Rhoads)
      • Option: RequestOrchestration
      • Option: CarePlan
      • Need to determine which option makes sense for the clinical workflow 

Powerpoint including the options FHIR to the LAB (5).pptx

• Group needs to discuss further the options for which resources to use for the orders - including single and grouping of orders within the workflow.

Next meeting: March 3, 2023

----------------Adjourned meeting 11:05AM EDT------------------------

For next meeting.....

• Reviewed the FHIR IG proposal:
• • [2023-02-17] Reviewed the FHIR IG Proposal
    • Action items:
      • Will follow-up on the involved parties to see if others should be included
    • Align on the R4B version, and if necessary pre-adopt R5 as extensions
    • Informational IG Ballot targeted for September 2024 (at the earliest).
    • Will work on the following offline: 
      • Long Description - TBD Jose Costa-Teixeira will draft something
• FHIR-39324 - Add example value set for Task.businessStatus for Lab TRIAGED
  1. Example codes (we'll continue in the next call)
     1. Specimen collected ← Not clear whether we need this - it's in specimen
     2. IG prepped ← TBD
• https://jira.hl7.org/browse/FHIR-32154 - Definition for preliminary
  • Please review the comment
  • Decided that we would not add partial at this time.
  • We will update the definition of Observation.status to mirror that of DiagnosticReport.