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MEETING MINUTES

• Work through the Order Catalog IG Example 1 
  • https://build.fhir.org/ig/HL7/fhir-order-catalog/exlabservices.html

  • Blood potassium test example:

    • Single order = ServiceRequest

      • Implicit split creates more sublevel ServiceRequest resources

        • ServiceRequest for specimen draw for phlebotomist (Person based resource):

          • OPTION 1 – this may be implicit when done at the provider’s organization

          • OPTION 2 – this may be implicit when done at the lab’s organization

          • OPTION 3 - explicit for draw via intermediary

            • 3A at a collection center

            • 3B drawn at a home

          • ALL will:

            • Create a task

            • Create a specimen resource

            • Then close this sublevel ServiceRequest and task

        • ServiceRequest for lab

          • Creates a task

      • OPTION 1 = done at the provider’s organization

        • Top level ServiceRequest

          • Task at provider for specimen collection

        • Top level task is  sent to the lab along with the specimen and task

        • Provider knows

          • status of specimen collection (internal task is closed)

          • status of order (status on task until status on ServiceRequest is closed and result received)

    • How to handle error correction and order modifications? Later

    • How to handle unsatisfactory specimen – for example hemolyzed sample, or unspun sample?

      • If the provider collected would have to cancel and request re-draw from the lab

    • What if the order is a panel?

      • Could mean multiple different specimen – would that require a separate ServiceRequest / task?

        • Only if that is done at different times (and potentially also different people) – for example multiple blood sample and random urine, but if urine is 24 hour or if special procedure like biopsy / CSF

    • Seems that task is dependent on company policy (if you have 1 person responsible for all collection, then no need for multiple tasks, but could make task/specimen) also depending on how billing is set up, may need to include ServiceRequest, if that is what you need in order to bill

    • Sharing the status?

      • is via the task – it is the placer’s responsibility to update the status in their own ServiceRequest based on the businessStatus value returned in the task

        • Service Request for the top level is the summary of ALL sub-ordinate ServiceRequest.status values

        • Does that mean the vocabulary for task.businessStatus needs to change based on the domain we are in?

          • Yes, create a profile for each of the domains we are using so we can adjust the vocabulary – that should also work when translating that into the inside lab workflow

          • Do we need to create the minimum set of status concepts need to be included (not the words used, but the concept expressed – like completed – could be collected / dispensed / completed

          • Could we use table for order status as a starting point for lab = HL70038 = https://terminology.hl7.org/5.1.0/CodeSystem-v2-0038.html

            • may want to create “buckets” of:

              • in progress (scheduled, some, but not all results, specimen received (that is in a different table – result status HL70125)

              • resolved with the different permutations (canceled, completed, replaced)

              • Exceptions? (on hold, error?)

  • Powerpoint Version 9 uploaded. It is >here< 
  • Pick back up here next week
• Logistics:

  • Will have the catalog call to discuss Francois’s email and determine where we are with ballot reconciliation and decide on next steps

Adjourned 11:01 AM EDT

FROM CHAT:

• Peter Muir 10:15 AM
  • Should scenario overview consider lab test ordered as part of panel from parent?
• Riki Merrick 10:22 AM
  • we are trying to start with the easiest first
• Peter Muir 10:31 AM
  • Panel could simplify with items referencing single task vs repeating same info multiple times
  • One component of lab panel could have timing requirements (eg fasting glucose) that would affect panel timing. Example of blood draw and u/a could be one task with two components since 2 different actions required or nurse and lab tech.