| Time | Item | Who | Notes |
|---|
| 15 min. | Exchange of Data for Breakthrough Cases | Heather Patrick | - FDA was asking about collecting data for breakthrough cases (positive COVID-19 cases for fully vaccinated individuals)
- Nathan: AIRA hasn't heard anything from the IIS community about wanting to collect COVID-19 lab test results, etc. directly
- Some payers do query IIS to capture immunization data and consolidate it with other clinical data
- Erin: Tennessee DOH queries their IIS (using HL7 V2) from their ELR surveillance system to identify breakthrough cases
- On a separate ELR thread, there was some discussion about adding AOE questions about vaccination status to COVID-19 lab test orders, but the ELR community was concerned about the feasibility of widely adopting this
- AMS: the Los Angeles County HIE (LANES) queries CAIR to store immunization data with the patient's record and include it in CCDs
|
| 5 min. | Expanding Value Sets in V2.5.1 IG | Lori Reed-Fourquet | - Discussions within IIP about expanding SNOMED value set for adverse reactions
- Other value sets are expected to change regularly, e.g., CVX, MVX
- Since the V2.5.1 IG is owned by CDC and not balloted through HL7, it's probably better to discuss this within AIRA's Standards and Interoperability Steering Committee (SISC)
|
| 10 min. | Recommendations Based on Additional Clinical Data | Lori Reed-Fourquet | - Currently CDSi recommendations are only based on a patient's age, gender, and previous immunization history
- Better recommendations could be made based on other clinical details, e.g. lab results, social determinants, occupation, travel history, etc.
- Some preliminary discussions previously occurred about this in the context of the Immunization CDS FHIR IG
- Would be a good topic to discuss further during the Fri. Immunization Discussion Group calls (which were just updated to a biweekly cadence)
|
| 5 min. | SMART Health Cards Question | Nathan Bunker / Max Masnick | - What happens if a patient gets multiple cards from different sources? How to determine which one to verify?
- Max: next steps for the SMART Health Cards IG are to expand on the verification implementation experience
- including verification of other diseases beyond COVID-19
|
| 10 min. | AIRA Updates | Nathan Bunker | - SISC Small Groups being convened:
- Guidance for printing VCI barcodes on IIS-generated PDFs
- including full immunization history (not just COVID-19 vaccines)
- Querying IIS for PDF ("Certificate of Immunizations")
- develop a standardized methodology (e.g., a possible FHIR use case?)
- Querying IIS via FHIR
- New, non-traditional partners may not want to develop V2 QBP / RSP interfaces
- Inter-program (e.g., ELR to IIS) / inter-jurisdictional data sharing
- ERR-5 error codes – waiting on IIS vendor implementations to re-engage and finish previous work
- Let Nathan know if you're interested in participating in any of these
- AIRA is also working on a technology improvement plan, including standards advancement (e.g., FHIR)
|
| 5 min. | NIST Update | Rob Snelick | - NIST has added a new "IZ COVID-19 Test Plan" (separate from the "ONC 2015 Test Plan") in the Context-Based section of the Immunization Test Suite
- Similar to existing ONC 2015 certification test cases but with a few differences:
- COVID-19-specific codes
- EUA fact sheets instead of VIS
- dose number in series
- status in series
|
| 10 min. | Process / Need for Updating V2.5.1 IG | Rob Snelick | - Latest guidance for HL7 v.2.5.1 is spread across multiple documents
- AIRA published consolidated guide including original IG and Addendum
- Would be nice to also incorporate the other supplemental guidance
- CDC attendees (Chrissy, Heather, Stuart) to take action item to review and discuss within the AIRA community
|
| 20 min. | https://chat.fhir.org/#narrow/stream/179166-implementers/topic/Immunization.20and.20Medication | Craig Newman |
FHIR-27018
-
Getting issue details...
STATUS
- Historically, we've tried to harmonize the Immunization resource with MedicationAdministered (for newly administered immunizations) and MedicationUsage (for hsitorical records)
- For R5, the Pharmacy WG updated the "medication" element in MedicationAdministered and MedicationUsage to be a CodeableReference that can point to a Medication resource
- Should we similarly update the "vaccineCode" element in the Immunzation resource to be a CodeableReference that can point to a Medication resource?
- Issue: both Medication and Immunization have simliar elements that could be duplicated (or worse, different values between 2 linked resources):
- lotNumber
- expirationDate
- manufacturer / marketingAuthorizationHolder
- If we remove these elements from Immunization to avoid any discrepancy, that would require that a Medication resource always be included (even as a contained resource) to convey these data elements
- Previous suggestion from FHIR-I was to leave vaccineCode as-is but provide appropriate narrative explaining proper usage
- Group was amenable to changing vaccineCode to CodeableReference to allow flexibility, but felt it was best to leave lotNumber, expirationDate, and manufacturer in the base Immunization resource
- further constraints can be added by profiling (e.g., US Core)
|
| 5 min. | Immunization Resource FMM values | Craig Newman | - FHIR-I is pushing to advance the maturity of the Immunization Resource to normative
- Group felt advancing to FMM-5 was reasonable in the timeframe of R5 but not normative
- Nathan: would like to see adoption of FHIR by IIS before being OK with normative
|
