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Quarter: Q3 2-4pm eastern

Chair: Craig Newman

Scribe: Erin Holt Coyne

Minutes Approved as Presented 

This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."


Set goals, objectives or some context for this meeting.

Discussion items

60 minMedMorph updateMaria Michaels
  • MedMorphSlides_for sept 2020 HL7 WG Meeting_PH v4 _FINAL.pdf
  • Preparing to ballot in January
  • Background
    • Lifecycle
      • Deliver actionable knowledge that drives
      • Health impacts and outcomes generate data that resides in EHRs and Registries to allow for the
      • Analysis data to advance evidence then we can
      • Update scientific evidence and knowledge needs to be updated
    • Project timeline 3 years
    • Patient -Centered Outcomes Research Trust Fund via HHS Assistant Secretary for Planning and Evaluation
    • Stood up a multi-stakeholder technical expert panel (TEP)
    • Workgroups
      • Made up of: Technical experts, and subject matter experts
      • 3 use case workgroups (Hep C, Cancer, Healthcare Surveys)
      • Technical requirement workgroups
        • Data flows and clinical workflows
        • Data standards
        • Reference Arch/authorities, policies
        • Evaluation planning and execution
      • Deliverables:
        • Reference Arch, Reference Implementation (open source software), Balloted IGs, road map for scalability
        • IGs:
          • Reference Arch
          • Each Use Case (profiling)
        • Testing one of the use cases in agile fashion
        • National Test Collaborative including variety of clinical orgs and EHR platforms and other testing partners, like PH
      • Reference Arch
        • Aim to minimize burden of both senders and receivers by providing common method for obtaining data for research and public health for multiple conditions or uses
        • Must pilot and test to ensure implementability
        • Defines abstract model actors and systems for building the various workflows to accommodate
          • 5 workflows supported (provisioning, notification, data collection and report creation, data submission, and receiving response/ack)
        • See the confluence page for more details
      • Activities
        • Use Cases:
          • Health Care Surveys- 2 use case (ambulatory and inpatient/ED)
          • Hep C Reporting-2 use cases (care cascade, uncomplicated male and pregnant mom with exposed infant)
          • Cancer Reporting- 1 use case (reporting based on specific criteria with an alternate flow on every encounter)
          • Research- 2 use cases
        • For each include
          • Work-flow tables
          • activity and sequence diagrams
          • abstract models
          • data elements
            • common
            • those not already supported on the USCDI
          • Evaluation:
            • Short term goals:
              • Within 3 years evaluate: Acceptability, feasibility, and adaptability
              • Logic models
              • Results from this eval will be incorporated into longer term plan
            • Longer term goals
              • Greater than 3 years: adoption, sustainability, scalability, adaptability and improved health outcomes
              • Logic models
              • Results of this will be incorporated into road map
            • Decisions and Considerations
              • Provisioning workflow- need help from members
              • Data collection and submission report creation
                • Need to decide security mechanism solution
                • TTP certification
              • Receiving response/ack
                • In security mechanism solution, TTP certificate options
              • Handling Create update delete transactions in the API
            • Discussion with PH
              • GitHub link available in slides
              • Expect info re the reference arch on confluence
              • RE Handling create update delete transactions, will we consider just APIs or also consider messages
                • For content possibly use bundle for message header, similar to FHIR eCR
              • What is the driver for using FHIR messaging as opposed to subscriptions?
                • Use regular FHIR APIs (post, put, get, and delete)
                • The FHIR messaging part is just to specify the meta data for routing and use of intermediaries for research and PH use cases
                  • Adding those intermediaries shouldn’t necessarily require this, may consider whether or not intermediaries matter
                  • Folks are welcome to review the documentation, participate in implementation/connect-a-thon, and provide feedback
                • Initial IG will include:
                  • Less than 10 profiles (message header bundle, plan definition,…)
                  • Start from US Core for framework
                  • APIs on resources that are expected
                  • Subscription
                  • Not including the use case specific content; that will be in the use case IGs
                • What are the plans for the content use case IGs?
                  • Examples of the use cases will be in the initial IG,
                  • don’t know the timeline for the content IGs as of yet
                  • getting close on the data elements, possibly ballot next year
10 minUSCDI-ONDECCraig Newman
    • Inclusion of Travel History and Travel Plan
    • See list serve
    • Travel History
      • Travel History location
      • Travel History Dates
    • Travel Plans
      • Travel Plan Locations
      • Travel Plan Dates

Motion to approve- John Loonsk

Second- Danny

12,0,0 unanimous

5 minDiscussion/reminderswork group
  • Are all the FHIR-I sessions the same this week?
    • M, Tues, Thursday
    • Core content is the same
    • Some work groups may have had specific topics for the FHIR-I folks to discuss
    • Ph didn’t have anything specific to ask them about, so we included all sessions on our agenda
  • Reminder- Tuesday we are only meeting as a work group once at 2-4 eastern to get a SANER update

Action items