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Meeting Notes

• JIRA Tickets on Families/Households:

  • https://chat.fhir.org/#narrow/stream/179280-fhir.2Finfrastructure-wg/topic/Representing.20Family.20in.20Group.20resource
  • Grahame indicated that there is a draft on how to update Group (not yet approved) on how to be able to reference a family:https://build.fhir.org/ig/HealthIntersections/fhir-playground/StructureDefinition-public-health-group.html. 
  • 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	Resource	Element(s)	Response
    FHIR-41410	Service Request	performer	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	DocRef	author	Add Group: Members of a family may have authored collectively, similar to the care team.
    FHIR-41405	Observation	performer	Add 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-41394	Task	owner, requester, requestedPerformer and performer.actor	Add Group
    FHIR-41395	Transport	requester	Add Group to .requester Need to evaluate performerType; owner for family  Add JIRA for Transport.requester to include CareTeam (Yanick added FHIR-41568)
    FHIR-41415	InventoryItem	InventoryItem.instance.subject	Add Group to InventoryItem.instance.subject  Need to consider other resources for InventoryItem.instance.subject such as Practitioner, CareTeam, etc.
    FHIR-41414	SupplyDelivery	subject receiver	TBD Change Patient to Subject  Subject should include a Reference to Patient, Group, Organization Add Reference to Group to Receiver
    FHIR-41413	DeviceUsage	patient	DeviceUsage.informationSource  Add Group for Family
    	DeviceDispense	subject	DeviceDispense.subject Add Group for Family
    		receiver	DeviceDispense.receiver Add Group for Family
    		performer.actor	DeviceDispense.performer.actor Remove Patient and RelatedPerson (may be a new JIRA) We are NOT adding Group
    	BDPDispense	patient	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.
    FHIR-41411	NutritionIntake	reporter performer.actor	TBD Nutrition is able to have a subject of group, but the reporter cannot be a family (=group) nor performer.actor. This seems like an oversight

Next time:

• • FHIR-41448
  • Added Missing CareTeam in DeviceAssociation: 
  • FHIR-41567 to be discussed next time
  • FHIR-41568
  • FHIR-41241   
  • FHIR-41186       
  • FHIR-41002

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