20230116 Q1 PHWG WGM Minutes

Welcome and introductions 

Agenda review and plans for the week

• 2023-01 Public Health WGM Agenda - Public Health - Confluence (hl7.org)
• WQ2- CIC- CREDS, registries,
• WQ4- CIC- Cancer interop
• MOVE HELIOS TO WQ3
  • Hearing update on digital Bridge – Added to Mon Q3
  • No MQ2
  • No MQ4
  • No TQ1
  • TQ5- Helios Birds of a Feather (Down in Pavilion, tent by the pool)
  • No WQ1
  • Need to confirm CIC registries meetings on Wed Q3 and Q4
  • No THQ1 & THQ3
  • Any new agenda topics to add?

Review STUs approaching expiration

• Clinical Decision Support for Immunizations Release 1
  • HL7 FHIR® Implementation Guide: Clinical Decision Support for Immunizations, Release 1 - US Realm
  • NIST is implementing for testing purposes
  • Want to request an extension. Need to do so before June.

Update Project Roadmap with new projects

• Imm FHIR resources- maintenance project
  • Voted on all issues, one left to apply for R5
• Imm Clinical Decisions Support, - Accepting comments, will be requesting extension
• 2.8.2 Imm IG- not being promoted for adoption. Collecting comments.
  • Planning to ballot another version of the 2.5.1 guide
  • Going to start looking for volunteers to technical working group for 1.6 version of current national guide.
• VCI Smart Cards- about half states who have adopted
  • Could give update on work to test this standard international with WHO and G20, trying to resolve against competing standards
  • Not fully published. Bryant will reach out to MITER who is waiting for omnibus. This is currently hitting us on a couple of different WG metrics
• Adverse Drug events- published in Oct 2021 and collecting feedback
  • Will expire in Oct 2023
• Longitudinal Maternal and Infant Health- circulating a prepub version and will be requesting publication on the next WG call
• CREDS-
  • Continuation of ONC work on adoption of FHIR in clinical registries, one of the associated projects
  • Registry to describe their data model using FHIR Definition and build tools around that and publish their data model to comply with FHIR Igs
  • Successful Connecathon this session with ACC registry, demonstrate ability to get data into registry and now looking at registry feedback and validation
  • Expecting to go to ballot and publishing in next cycle
• Medicolegal Death Investigation – Collecting feedback, but not expecting a lot of updates, discussing workflows, and assessments with overlaps with other VR related IGS
• ODH- Lori will give update tomorrow.
  • Made comments on how its reflected in CDA and will need to make updates
  • Missing ODH DAM- In development. Expecting to try a comment only in May.
• Vital Records-
  • DAM was published in May 2022, not actively collecting updates right now. Expecting to maintain.
  • Everything else has been retired but the FHIR IGs
  • Death Reporting- active EDRS to NCHS, some internal testing of that IG and collecting feedback and expecting an update mid year, exploring other workflows from EDRS to surveillance and cancer registries  
  • Birth and fetal death- tested over the connectation, and did some FHIR GAP analysis with EPIC and CERNER to assess data, Utah and GA participated with their EDRS vendor. (ASK CINDY ABOUT VENDOR), expecting May ballot. Need to add to our table.
  • Any work on Bulk FHIR to death reports between local health jurisdictions (coroner’s offices) and EDRS at state level? Bryant to send Craig request on this for possible review in Helios and review of workflows. PH FHIR Implementation Collab, vs Helios- how does these all play?
• NHSH
  • HAI for long term care reports got published in Jan 2023, collecting feedback. Expecting to start pilot in soon
  • CDA may be part of the pilot
  • Working on transforms between CDA and FHIR
• MedMorph- just got approval the publication request for the reference arch IG.
  • Cancer Content- resolved all tickets and waiting for ref arch to be published. This is probably the same for all the other content IGS
• Cancer
  • CDA- continuing to maintain IG for now. Looking to moving to FHIR IG from MedMorph. Have a pilot project but need an update. Need to look at dashboard. Need clean up and confirm stuff has been addressed.
  • TnM codes- agreement on how to represent with AGCC and SNOMED, the text description cant be extended. Scott Cambell is handling. Still figuring out codes for IGs. Expecting to happen in FHIR MedMorph and not in the CDA. CDA is named in regulation for Cancer currently. At what point can we switch or include FHIR in leg. Need to provide feedback on ONC ISA.  
• SANER- Implementation stage. Working on a project with Tx and expecting to start pilot soon. Server built used at Helios Connectathon testing and were able to receive measure reports
  • Feedback from connectation expected to be included in final version, also expecting updates to CSV conversation
• BsER- working with gravity to harmonize referrals including clinical referrals. Would like an update later in May. No track at this connectathon, but there was a session jointly with gravity. Consensus that there are two general paradigms, messaging and query. Services requests and tasks and harmonizing discussion. Activity in OO on service request and task in a general sense and what to make sure that the PH use cases are represented. Discussion around chaining of activities (one referral sent and receiver breaks it up into several referrals). Will continue with harmonization more broadly.
• Healthcare surveys- receiving 1.2 from hospitals. Collecting feedback. Getting questions about wanting to follow updated templates (CDA) or follow 1.2. Needs further discussion. Any net new implementers for CDA they are asking for 3.0. Not a lot of activity, no open issues.
• Case reporting- FHIR published 2.1. CDA published 3.1. Both are collecting feedback. Both are active and anticipate both continuing.
• Syndormic- need to follow up with Karl.
• CDA Birth defects- no updates. Collecting comments.
• Birth Defect DAM and FHIR IG-
• CCHD- no plans to update
• Diagnostic Audiology- waiting for SNOMED, starting to trickle in.
• LOI/LRI related – no updates.
• FHIR Lab results- OO is following and talking about the FHIR lab workflows. Trying to get the parent/child relationships into R5.
• Bring up to Implementation Division- Getting a lot of resistance from hospitals to open up their API to establish FHIR communication of the results. Legal and Tech are not in agreement. Possibly the right APIs are not developed. Get link to the HITAC Public Health Data Systems Task Force recommendations and circulate to workgroup and schedule time to discuss. Will try to cover in MQ3.  What will be an output that would be helpful.

Review Mission and Charter and update the HL7 page-

reviewed and approved at Sept WG

Review outstanding JIRA tickets (workgroup health metrics) 

• CDA HCS no matching issues
• Cindy will address the backload of JIRA tickets for the Cancer CDA IG
• Impacting out workgroup metrics/health- PHWG got a warning
• JIRA tickets have to be resolved just like we do with balloting. This will impact our ability to do new projects.

PAC call for comments on CMS proposed rule-

Called for comments on CMS proposed rule Prior Authorization. RFI requesting for comments on behavioral and maternal health. May be worth looking at on a future call. May want to reinforce the need for that data. Will send the link out.

CDA Management group having a new process for publications

A quality checklist now required for publication requests.