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Date:  

Quarter: 1


Agenda Topics

  • Review Agenda
  • Reps to other WGs
    • Wed Q2 - O&O - HealthcareProduct: Substance, Substance Definition, BiologicallyDerivedProduct, Supply, Medication, MedicinalProduct, MedicationKnowledge
    • Wed Q4 - Public Health - confirmed with Public Health that there are no agenda topics
    • Thurs Q3 - CDS
    • Fri Q1 - Patient Care - Care Plan report out
  • Assign Roles for Quarters
  • Approval of September 2019 WGM Minutes
  • If we have new attendees, review
    • Overview of Pharmacy material - V2, V3, FHIR, CDA
    • Overview of Template work
  • Hot Topics
  • Prep for Joint FHIR meeting

Supporting Documents

Minutes/Conclusions Reached

  • Review Agenda
  • Reps to other WGs
    • Wed Q2 - O&O - HealthcareProduct: Substance, Substance Definition, BiologicallyDerivedProduct, Supply, Medication, MedicinalProduct, MedicationKnowledge - Scott
    • Wed Q4 - Public Health - confirmed with Public Health that there are no agenda topics
    • Thurs Q3 - CDS - we will cancel Thursday Q3 as we won't have quorum
    • Fri Q1 - Patient Care - Care Plan report out - Scott will attend
  • Assign Roles for Quarters
    • See updated agenda in Confluence
  • Approval of September 2019 WGM Minutes
    • Motion to approve - Tom - Melva - 8-0-1
  • If we have new attendees, review
  • Hot Topics
  • Prep for Joint FHIR meeting

Action Items

  • Melva Peters will notify HQ about cancellation of Thursday Q3

Quarter: 2


Agenda Topics

Supporting Documents

Minutes/Conclusions Reached

  • Specialty Medication Prescribing PSS
    • reviewed PSS.  still have issues regarding definitions (what is a "specialty medication", "third party") and interactions ( what is the relationship between "third party" and "pharmacy" in the co-joined boxes)
    • comments added to the PSS
    • Melva sending message to Pooja to see if we can get feedback by the end of the week
  • FHIR Trackers
    • FHIR-20184 - Getting issue details... STATUS
    • FHIR-19913 - Getting issue details... STATUS  change binding to administration method.  fix examples in the description.  Persuasive with Mod (Tom/Julie) 8-0-0
    • FHIR-25555 - Getting issue details... STATUS  update description to include more examples.  for the exemplar value remove "discharge" 

Action Items

Quarter 3

Agenda Topics

  • FHIR Trackers

Supporting Documents

Minutes/Conclusions Reached

Action Items

Quarter 4

Agenda Topics

  • Discuss Medication List with Michelle Miller

Minutes/Conclusions Reached

  • Discussed the history of the active medication list and the issue of using MedicationRequest
  • Asked US Core to update wording related to "patient reported meds" to reflect that it is medications that are intended to be taken reported by the patient - FHIR-25035
  • Pharmacy will look at the status of MedicationUsage and move some out to attributes
  • Address overlap between intended medications that exist between medicationrequest and statement
  • Discussed whether US Core would move to using multiple resources - 

Action Items

Date:  

Quarter: 1

Agenda Topics

  • Medication List Project

Supporting Documents

Minutes/Conclusions Reached

  • Melva did a review of the existing Confluence pages on MedicationList
    • Australia has care transfer-to- care transfer work going on
    • Australia has a Pharmacist Shared Medicines List
      • curated by the pharmacist that they know the patient is taking
    • Australia also has a ePrescribing Medication List
  • Worked on the Medication List Guidance PSS (Medication List PSS)
    Motion: Approve the Medication List Guidance PSS as written: Jean/Peter: 9-0-0 - Carried
  • Medication List Guidance Project Work
  • Recorded some common contexts
    • US Meaningful Use
    • New Zealand
    • Australia ePrescribing

Action Items

  • Melva Peters will forward the Medication List Guidance PSS to the PMO and to FMG

Quarter: 2

Agenda Topics

  • Medication List Project

Supporting Documents

Minutes/Conclusions Reached

  • Continued work on the Medication List Guidance Project
  • See updated contexts page on Confluence

Action Items

Quarter: 4

Agenda Topics

  • VA Pharmacy Project - Jay Lyle (material to be provided)

Supporting Documents

Minutes/Conclusions Reached

  • support a new pharmacy application working from VistA data via FHIR
  • Trying to stay close to the FHIR design
  • Jean Duteau question: VA has a concept of an "IV limitation".  this can limit either the maximum time or volume for the order
    • max dose, e.g., no more than 1L:  dosageInstrutionMaxDosePerPeriod with numerator=1 L, denomiator=1 ea
    • max time, e.g., no longer than 24 hours:   timing.boundsPeriod or timing.boundsDuration
  • reviewed the VistA logical model
  • began review with File 52 fields, mostly focusing on those assigned for extensions
  • Notes on specific fields here

Action Items

  • Melva Peters add dedicated time on weekly calls to discuss VA mappings project

Date:  

Quarter: 1

Agenda Topics

  • Project Management
    • Schedule for Conference calls
    • DMP - 2018
    • M&C - 2018
    • SWOT - 2018
    • Reaffirmation/Withdrawal of 5 year items
    • Forward Planning
    • Project Review
      • 3 year plan review
    • Action Item list review
    • Addition of another chair

Supporting Documents

Minutes/Conclusions Reached

  • Project Management
    • Schedule for Conference calls
      • Monday 4pm Eastern
      • first meeting will be February 17th
    • DMP - 2018
      • no discussion
    • M&C - 2018
      • no discussion
    • SWOT - 2018
      • no discussion
    • Reaffirmation/Withdrawal of 5 year items
      • no standards to withdraw or reaffirm
    • Forward Planning
      • MedicationKnowlege - guidance on representing catalogues in FHIR
        • interest from Australia 
        • maybe others - Singapore, UK, RxNorm and others
        • will add as a 3 year plan item
        • Discuss with Dion McMurtrie to see if we should move forward - reach out in May 2020
      • e-Prescribing
        • how to get an electronic prescription transferred from prescriber to dispenser using FHIR
        • Implementation guidance document on considerations for e-prescribing 
        • MedicationRequest as the resource and then add in the underlying subscription/provenance
        • trying to get consistency across countries
        • add as a 3 year plan item and discuss in May 2020
    • Project Review
      • 3 year plan review
      • Project 856 - motion to close Scott - Dion - 4-0-0 Carried
    • Action Item list review
    • Addition of another chair
      • Discussion of why we would like a new co-chair 
      • Kate will discuss with Danielle

Action Items

  • Melva Peters  will close Project 856
  • Melva Peters will talk to Grahame about MAR project he mentioned and also other types of projects that should be considered
  • Melva Peterswill add MAR to the contexts for the Medication List project
  • Melva Peters will followup with Danielle about co-chair position
  • Melva Peters will add new 3 year plan items for e-prescribing and MedicationKnowledge

Quarter: 2

Agenda Topics

  • Joint Meeting with FHIR-I - Pharmacy Hosting

Supporting Documents

Minutes/Conclusions Reached

  • MedList project
    • can be a FHIR IG and can be informative track
    • update PSS to remove White Paper
    • Submit to FMG
  • not taken attribute on MedStatement/Usage
    • discussion of whether we can move back to the not taken attribute rather than as a status
    • could use "on hold" as the status if patient says they intend to continue taking, but not taking right now.
    • 2 ways to say "intend to take" - MedRequest with intent of plan or proposal or MedUsage
    • should we fix this or just provide guidance
      • MedRequest of plan with patient as the source
      • MedUsage - active with no end date
      • Lloyd - Plan - has a period of time of which expected to be effective.  It is forward looking
        • MedStatement - more a statement of what is happening now - has an effective period
        • expect them to show up in slightly different places
      • Statement is a patient statement, but plan is more curated
        • patients don't specifically assert a plan to be on a med
      • Status on MedStatement is not about what are you supposed to do
    • US Core - will use MedicationRequest.intent=plan and MedicationRequest.intent = order
      • will look at R5 to see what Pharmacy does to MedicationStatement resource
      • still won't be able to say "aren't taken"
      • Cerner - looking for compliance attributes on MedUsage for future
        • will look for guidance with intents and status
    • need to clarify the interaction between status code and effective dates on MedUsage
  • Adherence 0..* 
    • include recommendation (by reference - MedRequest, CarePlan or PlanDefinition) and then the statement of alignment with that recommendation
  • status of the record - entered in error
  • Not planning to go to ballot with R5 in May
    • waiting for US regulation to be announced
    • will be asking implementer community after rule has dropped
    • will not publish R5 in Jan/Feb 2021 - will likely be early summer 2021 - will seek advice from implementers
  • WGs are asked to identify urgent needs for content to be included in an earlier release

Action Items