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Meeting Details

Date: April 28, 2023

Time: 10AM ET

Coordinates:  Join Zoom meeting: | Meeting ID: 510 046 7805 | +1 929-436-2866-US (New York)


Kathy Walsh, Annie Raval, JD Nolen, Thomas Zhou (AH), Brian Handspicker, Ralf Herzog, Gelu Comanescu (CDC), Scott Fradkin, Kayla Perkins, Andrea Pitkus, John King, Rob Hausam, Riki Merrick, Marti Velezis

Chair: Riki Merrick

Scribe: Marti Velezis

  • Quorum (CH-Chair +2) Met 


  • Deliverables (i.e., key outputs from this group)
  • Workflow Topics
  • JIRA Tickets 
  • AOB?

Meeting Resources

PSS: PSS-2101

IG Proposal: Clinical Order Workflow (COW)

JIRA Tickets: OO Workflow JIRAs

Background Materials



  • Discuss specific goals for this group and deliverables
    • This is related to the Monday call for FHIR Order Exchange in US realm
    • This should be an IG, which will give implementers better starting point
    • The IG could be a framework IG that defines the pattern on HOW to do orders
      • for each use case - lab / medical equipment / referrals then create profiles for each use case - defining the specific FHIR resources that are needed in that use case
  • IG proposal:
    • Updates made to the Clinical Order Workflow (COW) IG Proposal which is still in the "pending' state.
    • Determined that we need to have both R4B and R5 content
    • Determined in scope and out of scope scenarios (In scope: Lab, DME, Specialty* Referrals, Nutrition, Imaging, Medication, Inventory, Social Services, Procedures) - see Long description section
      • Note - specialty includes consultations, surgical, speech and language, occupational, physical therapy, post-acute care, rehabilitation, hospice, etc.)
      • Add Immunization under the Medication
      • Screenings may fall under imaging, labs or other groupings
    • Need to have Jose provide the gitHub location for the IG
    • Discussed the linkages to other IGs: Gravity, ELTSS, etc. and will need to note others.
    • Next steps:
      • Action item: Please review the IG proposal and make any comments to this page with any related IGs and/or additional use cases

Next Meeting: May 19, 2023 (week after the WGM)

Note - next week is cancelled and the following week is the working group meeting

---------Adjourned 11:01AM EDT  ----------------

Chat Messages:

ThomasZhou (AH) to Everyone (Apr 28, 2023, 7:23 AM)
May think to build the data model on R4 and the vocabulary is free

ThomasZhou (AH) to Everyone (Apr 28, 2023, 7:34 AM)
replace completion with close?
Does it cover precision medicine?

Andrea Pitkus to Everyone (Apr 28, 2023, 7:38 AM)
Yes, any order information needed for precision medicine is included
it's implied.
Precision medicine is based more on results and their values (pathology, genomics/molecular, clinical lab, biomarkers, etc.) Orders may include medication (i.e. for companion diagnostics), etc. too.

Brian Handspicker to Everyone (Apr 28, 2023, 7:42 AM)
Any desire to add into the Related IGs section the SDOH ClinicalCare IG? (Gravity Closed Loop Referrals for Socialcare Services)

Brian Handspicker to Everyone (Apr 28, 2023, 7:48 AM)

Annie Raval to Everyone (Apr 28, 2023, 7:56 AM)
Not sure if this relevant but should we include immunization orders  (vaccine, dosage etc.) or screening orders (cancer screening, infectious disease screenings) ?

Andrea Pitkus to Everyone (Apr 28, 2023, 8:00 AM)
Do we need a protocol order which involves sub orders medication and imaging for procedure w contrast
Or therapy with DME (need both) per protocol/order set

Brian Handspicker to Everyone (Apr 28, 2023, 8:00 AM)