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Meeting Details
Date: March 17, 2023
Time: 10AM ET
Coordinates: Join Zoom meeting: https://zoom.us/j/5100467805 | Meeting ID: 510 046 7805 | +1 929-436-2866-US (New York)
Attendees: Ralf Herzog (Roche), Marti Velezis (Sonrisa / FDA), Rob Hausam (Hausam Consulting), Scott Fradkin (Flexion), Ana Szarfman (FDA), Kathy Walsh (Labcorp), Kayla Perkins, Michael Lingenfelder (CDC), Gelu Comanescu (CDC), Annie Raval (CDC), Dan Rutz (Epic), Brian Handspiker, Riki Merrick (Vernetzt, LLC / APHL)
Chair: Ralf Herzog
Scribe: Riki Merrick
- Quorum (Co-chair +2) Met
AGENDA
- Workflow Topics
- JIRA Tickets
- AOB?
Meeting Resources
PSS: PSS-2101
IG Proposal: Clinical Order Workflow (COW)
JIRA Tickets: OO Workflow JIRAs
Background Materials
- Review of Existing Workflow Approaches
- Generic Referral: https://build.fhir.org/ig/hl7-be/referral/
- Lab Order Sequence Diagram: http://build.fhir.org/examplescenario-example-laborder.html
- Lab Order slides: Powerpoint (please version this in OO documents)
- Belgium
MEETING MINUTES
JIRA Backlog
- FHIR-38971 - observation-precondition should be a modifier extension
- Issue was returned to us by FHIR-I
- Need to draft text for isModifier
- this is an R5 comment
- Motion to apply Lloyd’s changes as proposed in the comment from 2/20
- Persuasive with mod / clarification / non-substantive / for R5 . assign to Rob
- Rob Hausam, Marti Velezis, no further discussion, against: 0, abstain: 0, in favor: 12
- Issue was returned to us by FHIR-I
- FHIR-37975
- We discussed and dispositioned here: https://confluence.hl7.org/pages/viewpage.action?pageId=161056766
- FHIR-40540
- We have to update the diagram up top – need to add GenomicStudy to the diagram similar to ImagingStudy – one arrow from observation to genomicStudy
- If we have ServiceRequest on LIS that creates tasks, then do we need to add?
- Not now
- Marti will make that change – will have to re-create, since we cannot find the original
- Added the diagrams, but is missing text?
- Original considerations: https://confluence.hl7.org/pages/viewpage.action?pageId=79504418
- Actual final version: https://confluence.hl7.org/display/OO/Draft+Parent+Child+Explanation+in+DiagnosticReport+Examples
- Rob will apply the final version and might bring back for review on the Lab call
- FHIR-38633 - Target Awareness
- Need to discuss adding this extension in R5 STU (i.e., after R5 publication) - for next agenda
Clinical Order Workflow
- IG
- Continue Workflow discussion (i.e., Lab order slides)
- What is the level of this project – could or should?
- Standard guidance for dealing with orders = implementation orders
- NICTIZ is trying to move lab integrations to FHIR by 2025 – this project needs to be should, else it will be mute, if we don’t come ut with something folks should use
- ServiceRequest may need a FillerOrderNumber, but internally they may not need to persist it on their end, but need to be able to communicate that ID, if we cannot do that in the task
- FHIR is just the communication layer, it does not prescribe the internal data structure
- There is a need for businessIdentifer, do we also need a businessStatus on ServiceRequest?
- We should make sure we have a clear description of the relationship between the business statuses of the order and the results – until the order is completed
- Placer Service Request – communicate the request to the filler and then the filler creates their Service Request linked via task – how is the update exchange
- Do we need to support the messaging paradigm
- Where is the authorization to perform?
- It is carried in the ServiceRequest
- Result of the initial serviceRequest may result in additional referrals to other services- but we need to track that those ServiceRequests are linked to that original ServiceRequest
- Task is the mechanism to identify who is going to track the mechanical deals of the fulfillment of the action authorized in the ServiceRequest
- It is carried in the ServiceRequest
- What is the level of this project – could or should?
FROM CHAT:
SZARFMAN 10:02 AM
Good morning!
Riki Merrick to Everyone 10:16 AM
Riki Merrick to Everyone 10:27 AM
SZARFMAN to Everyone 10:30 AM
Is the image kept as originally generated?
Marti Velezis to Everyone 10:30 AM
Marti Velezis to Everyone 10:47 AM
https://confluence.hl7.org/download/attachments/4489770/DiagnosticModule_FHIR.pptx?api=v2
This is the updated image for the diagnostic module page — @rob the JPG is also here: https://confluence.hl7.org/download/attachments/4489770/DiagnosticModule_FHIR.jpg?api=v2
SZARFMAN 10:56 AM
what happens when the payer does not approve it and the patient decides to pay out of his/her pocket
Andrea Pitkus 10:57 AM
I have a different understanding. have to run.
service request includes both original request and add on that are not from the provider, but a lab and not tasks
CALL ADJOURNED AT 11:02 AM ET