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Craig Newman, Nathan Bunker, Heather Patrick, Danny Wise, Brian Lee, Daryl Chertcoff, Mike Indovina, Eric Larson, Jose Costa Teixeira

Discussion items

Publication Plans
  • Update on application of ballot recon changes
    • NIST has agreed to help, scheduling time to work on ballot recon
  • Looking at code sets (do next week or as homework)
Clinical Content Expansion
  • The CDC Harmonized schedules (for childhood and adult) have very similar concepts

  • Craig created a proof of concept profile for Questionnaire and then an instance of a Questionnaire that has the basic questions from the harmonized schedule
  • There is an NLM tool at that can be used to display and interact with FHIR Questionnaires
    • It just displays Boolean questions at a check box
    • Craig could get a value set created for the CD4 count question, so he substituted v2 table 0078 just to get the idea of what a choice question looks like
    • The tools allows you to see what the QuestionnaireResponse would look like

FHIR Base Resources Discussion
  • Belgium is adopting FHIR and Jose is looking at the Immunization FHIR resources
  • Product
    • Vaccines are likely very similar to other products like medications or biological products and have similar supply chain workflows
    • Should there be an "administered product" that points to a product that could include things like the lot number, expiration date, etc?
      • The lot number and expiration date are attributes of the vaccine, not the administration event
    • The Public Health WG tries to harmonize the Immunization resource with the Medication resources
      • We should reach out to John Hatem to figure out what they are doing
      • MedicationStatement has been renamed MedicationUsage R5?
    • Jose will create a Jira ticket for this
  • Reaction - Immunization
    • Typically captured after the vaccine administration (but sometimes delayed) and can't always be tied to a specific event
    • Jose likes how it is done now
    • An Immunization can be the "suspect entity" in AdverseEvent
  • BasedOn - Immunization
    • In the US, the "order" isn't often documented explicitly
    • Elsewhere, prescriptions are more common
    • The Event pattern has basedOn although there is also an extension that can be used
    • Jose will create a Jira ticket for this
  • Instantiates - ImmunizationRecommendation
    • .authority (as a reference to an Organization) already exists
    • There are potentially 3 levels - the organization producing the schedule, the overall schedule and then the more discrete series
    • At least in the US, the way the schedule is published doesn't lend itself to creating discrete "plan" references
    • Could be implemented as a codeable reference to allow pointing to either a Resource (eg PlanDefinition) or a "code" that gives a display name
    • Jose will create a Jira ticket and will mock up a PlanDefinition for a recommendation

Action items