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Administrivia

Approve Minutes

• • 2023-06-15 Main  - Motion to accept the minutes as updated.  JD Nolen, Yanick Gaudet

    • Against: 0; Abstain: 3; In Favor: 11
  • 2023-06-22 Main - Motion to accept the minutes.  Lorraine Constable, Elliot Silver
    • Against: 0; Abstain: 3; In Favor: 11

Topics for Today: 

• JIRA tickets - Topic: Families  to  be  represented  in  Resources

  • FHIR-41410 - ServiceRequest.performer should allow for family

  • FHIR-41406 - DocumentReference.author should include a group
  • FHIR-41405 - Observation.performer should allow group

  • FHIR-41414 -  Supply Delivery

  • FHIR-41395  - Transport should allow for families
  • FHIR-41394 - Task should allow actor to be a family
  • FHIR-41411  - NutritionIntake should support family based medicine
  • Suggestion to evaluate these across OO resources together and add some description to help aid the implementers when to use Group instead of RelatedPerson.
  • Also note that this same request for families was made on several other resources across multiple working groups - three are 23+ resources – all should apply the SAME way for this solution
  • Need follow-up to determine how a family is represented: group.type? relatedPerson? other?  Also, when to use CareTeam vs. Group?
  • nutritionIntake will be discussed in 2 weeks
    • only 1 person will eat the explicit food item
  • currently group.type does not include family = so would need to have vocab update
    • ask the owners of group resource (FHIR-I) on how this resource will be used to represent family
    • tag Grahame specifically
  • is this for assigning the responsibility without identifying specific person?
    • we are using practitionerRole for this type currently
  • also follow up with Grahame on what his vision was (waiting for input) – start a zulip topic = Representing Family in Group resource. 

• Proposal for patient characteristics
  • Looking for resources to staff this work - update on next week's call
    • Rob McClure put out request - brought Lorraine and Kelly Davison together
    • Lorraine will help draft proposal
    • Will work on this over the summer
    • Project team is starting to get together
• Follow up on whole report level normal / abnormal
  • From Elliot's email: Checking with some Radiology colleagues, they pointed me to the IHE Results Distribution profile: https://www.ihe.net/uploadedFiles/Documents/Radiology/IHE_RAD_Suppl_RD.pdf. On a quick scan, I don’t see primary vs. incidental findings playing into their discussion, but I do see comments about the normality/abnormality of the report as a whole is the normality/abnormality of the most abnormal finding.
  • Today's discussion:
    • Requested by pediatric docs to label a report as normal, even if some observations are abnormal
    • If report is flagged as normal all observations should be normal
    • A flag indicating some observations are abnormal vs the whole report being abnormal
    • Should this be a conclusionary observation across the whole report?
      • It is dependent on who is making this conclusion
        • The lab/performer – that should be in the DiagnosticReport
        • The physician reading the report – that should not be in the DiagnosticReport
        • This would be the performer (pediatric cardiologist) making that assessment, because the reference range does not apply to the kids tested
    • DiagnosticReport for colonoscopy may be not usable, if patient didn’t properly prepare – this is not a result status, but more reporting of the condition of the procedure (similar to specimen condition)
    • This is not a clinical note, but a discrete flag
    • Would be good to resolve for R6
  • Next step is to have a JIRA with proposal based on discussions - Daniel Rutz 
• FHIR Core
  • DeviceMetricObservationProfile in FHIR Core? - Will be addressed as part of the Device Module page to resolve both need, context, and ownership.
  • ProfileForCatalog in FHIR Core? - Catalog project team will pick this up.
• UDI Cross-Paradigm IG v1 Expiration
  • Monday HCP if we don't get to it.
  • Marti and Hans to provide a proposal on whether it needs to be kept or move into a new version.
• Micro next steps
  • For tomorrow's Lab call.

OO Project Proposal Triage

• No new Proposals or PSSs to review (reviewed 2/7/2023)

Other (Project Approvals, NIBs, etc.)

• Advanced Directives (PACIO) - July 20 
  
  

• OO on FHIR Block Vote for 7/6
  • Email sent out on 6/29/2023

• • The following may need to be pulled pending clarification:
    • FHIR-32154 (Dan) the exact resolution seems incorrect because it would say “not all results”, and the use of plural there seems nonsensical for a single observation.  After discussion pulled to resolve.
  • The following have been asked to be pulled:
    • FHIR-32154 (Hans) need clarification of scope of the observation status to be either the observation itself, or across its hasMembers as well.  Either way, language would need to be different.
    • FHIR-25552 (Dan) it appears that the requested outcome has already been accomplished but the logical chain of which trackers get us there doesn’t seem to add up
    • FHIR-41426 (Javier) needs more discussion.

• Check back in June for progress

UP-44 -no value set content defined for v2 table 963 value set 

• Leaving UP-44 open for now – so that the new tickets and this one can be linked

• V2 Dashboard 

• V2.9.1 related comments:

  • https://jira.hl7.org/browse/V2-25404

  • https://jira.hl7.org/browse/V2-25411

  • https://jira.hl7.org/browse/V2-25391
  • https://jira.hl7.org/browse/V2-25401

Discussion Topics: 

JIRA 

Block Vote of old Jira trackers set for next main call - see: https://confluence.hl7.org/pages/viewpage.action?pageId=161072874#id-20230504Main-OOonFHIRBlockVote(senton4/26/2023)

The following are draft pages to organize and author content for each of our health care product resources: 

• BiologicallyDerivedProduct
• Devices
• Nutrition Product
• VisionPrescription

OO Resource Coverage

• Need to discuss developmental roadmap for each of the OO resources for R6
• Added R6 planning to WGM agenda
• Need to discuss what needs to be done prior to WGM to prep for discussions
• Add Resource reorg comments to module pages

Notes

• Marti revised related resource for each topic area to where the resources align to current modules
• Definitional resources were in workflow (pattern is still there) but those are now in administrative – Marti and Jose to take off-line