2022-07-21 Public Health Work Group Call Minutes

1. No new agenda items
2. Meeting minutes from last week approved as posted by consensus

Danny assumed Chair role. 

Discussion of FHIR Immunization JIRA tickets

1. FHIR-37722 - Imunization.primarySource is misrepresenting intention TRIAGED
   1. Indicate the context in which the information about the Imm event was captured. Whether the record was captured as an original primary source of truth record or a secondary or reported (historical in V2)
   2. Added a value of true that this is a primary record, collected by the person who administered it.
   3. IN base resource, cardinality is 0..1
   4. US Core has a profile on Immunization, must support 1..1
   5. Suggest renaming the element to Immunization.patientCaregiverReported, anything else is believed to be provenance, though there doesn’t seem to be consensus on this.
   6. There is also Immunization.informationSource. This is used to indicate who provided the info when not from who administered the vax directly.
   7. The IIS community doesn’t really use informationSource. They usually only use primarySource in data reported to the IIS, and will usually document everything as historical in IIS to IIS communications.
   8. IN R4, it’s a codable concept, in R5 it will be a codable reference
   9. Complexity around the longitudinal nature of provenance as information is passed from system to system.
   10. Possibly need to extend the primarySource description of the true value, and the description of the informationSource
   11. The V2 IIS spec is used primarily in the US to communicate from the EHR to the IIS and this concept is used to indicate whether the administration information is from the person administering vs someone else like patient or parent reported.
   12. Seems like there may be two or three different definitions that folks are using for this and this needs to be clarified.
   13. Proposal- will discuss on the Imm Friday call tomorrow to confirm use of primarySource and will try to come up with updated wording and will circulate with Gay (commenter) and the workgroup.
2. FHIR-32396 - documentType data type doesn't match definition TRIAGED
   1. In R4, add ability to document education material presented to the patient. Added in backbone element including documentType
   2. How we documented what was given was unclear.
   3. Documenting education as a part of the Immunizaiton resource may not have been the best idea in the first place.
   4. There is a Communication Resource is more appropriate.
   5. Would remove education backbone and then add content to boundaries and relationships narrative indicating that Communication can be used to document issuance of educational materials.
   6. Within Immunization resource you could have a contained Communication resource
   7. So you wouldn’t needed to have a standard alone Communication resource, rather imbed it the Imm resource. This was reviewed and supported by Lloyd.
   8. Similar conversations in V2 space regarding the continuation of pushing VIS i
   9. Motion- Craig moves to approve as not persuasive with mod as documented.
      1. Second- Mead
      2. Abstain- 1
      3. Opposed- 0
      4. Vote- 23,0,1

Retiring the v2.6 VRDR IG

1. STU period as expired
2. NCHS is focusing on FHIR
3. Implementers are being encouraged to implement FHIR not V2.
4. Need vote of the workgroup before it can proceed.
5. Withdraw Vital Records Death Report V2.6 IG - Public Health - Confluence (hl7.org)
6. Motion- Meads moves to approve withdraw of IG
   1. Second- Craig
   2. Abstain-0
   3. Opposed-0
   4. Vote 24,0,0
7. Craig will put on agenda for V2 management group.

• ballot pool open
• Is there a way to capture ordering provider in the imm C-CDA template? Performer isn’t quite appropriate. Reach out to Danny if you have comments.
• IF you are doing a FHIR IG in the ballot you have to attend the meeting on 7/25. If you can’t attend, you need to let the FHIR meeting organizers know.