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Meeting Details

Date: July 18, 2023

Time: 2PM

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


David Barwin, Kathy Walsh, Elliot Silver, Yanick Gaudet, Rob Hausam, Dan Rutz, Marti Velezis

Chair: Marti Velezis

Scribe: Marti Velezis



Meeting Notes

  • JIRA Tickets on Families/Households:

    • Grahame indicated that there is a draft on how to update Group (not yet approved) on how to be able to reference a family:
    • We want to clarify whether "household" would be progresses as well given it could be considered a potential performer.  Hans to add to Zulip. - Marti added to Zulip 
      • Response from GG - "Yes it's on my list"

      • Also see discussion on Zulip re: changing definition of group as to the responsibility (note - this will be discussed in FHIR-I)
    • OO now needs to look at the resources to determine whether any attributes need to be expanded to include Group enabling referencing a household or family.  OO on FHIR will pick it up.
    • Plan: review all resources and then update JIRA tickets.  We should be able to complete this next time.  If we do't have quorum 
    • 7/18 - Notes

      • We need to re-evaluate based on the discussion about CareTeam and Group - which needs to be better defined between the boundaries.
        • Group - receives or is acted on
        • CareTeam - performs the action
      • We discussed that we need to apply the changes to our previous responses based on the understanding that when there is a performer the care team would be able to convey the family/household (in detail or basic terms).
      • Next time we will finalize our thoughts by applying the criteria above.

    • Note from GG/Zulip: Functional uses for group like this from the global goods community:

      • a family
      • a household
      • a set of people who work in the same place
      • a set of people who were at the same place at the same time (e.g. infection event)
    • JIRA ResourceElement(s)Response
      FHIR-41410   Service Requestperformer

      Add Group: Any member of the family could perform the ServiceRequest whether it be a one time event or recurring.

      7/18 - The CareTeam should perform the Service an it allows for Family/Household to be described in the best way possible (e.g., category, name or participants if known).

      Pick up here next time
      FHIR-41406  DocRefauthorAdd Group: Members of a family may have authored collectively, similar to the care team.
      FHIR-41405  ObservationperformerAdd Group: Members of a family may have authored collectively, similar to the care team. Note: Observation.performer is normative and this will add an option not previously available
      FHIR-41394Taskowner, requester, requestedPerformer and performer.actorAdd Group

      Add Group to .requester

      Need to evaluate performerType; owner for family 

      Add JIRA for Transport.requester to include CareTeam (Yanick added FHIR-41568)


      Add Group to InventoryItem.instance.subject 

      Need to consider other resources for InventoryItem.instance.subject such as Practitioner, CareTeam, etc.





      • Change Patient to Subject 
      • Subject should include a Reference to Patient, Group, Organization
      • Add Reference to Group to Receiver
      • DeviceUsage.informationSource 
        • Add Group for Family


      • DeviceDispense.subject
        • Add Group for Family


      • DeviceDispense.receiver
        • Add Group for Family

        • Remove Patient and RelatedPerson (may be a new JIRA)
        • We are NOT adding Group


      • OO notes that on the BDP Dispense resource there is no attribute that would indicate a reference to the family (or household) as the dispense is always to the intended patient who is to receive the BDP as a treatment/procedure.



      Nutrition is able to have a subject of group, but the reporter cannot be a family (=group) nor This seems like an oversight  

Next time:

Next Meeting: July 25, 2023

Backlog Issues

  • FHIR-38985
    • WGM Work: FHIR-38985 - What happens if the definition deviates from the Observation? TRIAGED
      • With the removal of Instantiates[x] from Observation - this issue will be moved to the extension
      • Extension definition will need to be updated: 
        • If inconsistent - an error can be thrown
        • From OO resources - the deviation can be added as a rule/constraint
        • Review of Extensions - on the stats page – GG to send this out again
        • 5/15 - will give GG a week to get back to us on this action item
  • FHIR-38833
    • This ticket was reopened after R5 publication
    • Added to the FHIR-I session at WGM on Thursday Q2
    • See if we can get FHIR-I to add another time slot for Rob to participate
    • WGM Work: FHIR-38633 - Target Awareness Element or Extension TRIAGED
      • For R5 the proposal for an extension was to get some experience with the requirement; we should reconsider the proposed disposition 
      • Should this be "Communication" instead of a separate extension that was proposed for R5
        • Actual communication with the patient should use the Communication resource.
          • user (patient/clinician) acknowledges the communication by marking the action in a system
        • Flag the awareness of the patient b/c that the information was presented to the patient but there is no systematic acknowledgment
        • Lesser fidelity communications – push the communication but receipt is unknown (e.g., "null" flavor)
        • Need to raise across resources on how to capture 
      • 5/15 - will give GG a week to get back to us on this action item

  • FHIR-19253
    • Not inclined to change .code to 1..* but need to discuss how to handle the use case of multiple imaging studies with one diagnostic report. 
    • WGM topic for PC and II joints