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Facilitator:

Austin Kreisler

Date:


Dial-in number (US): (605) 313-6278
Access code: 311131#
International dial-in numbers: https://fccdl.in/i/strucdoc-cc3
Online meeting ID: strucdoc-cc3
Join the online meeting: https://join.freeconferencecall.com/strucdoc-cc3

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."

Attendees:


 Click here to expand...


Agenda:

  1. Call to order
  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Approve minutes from 2019-12-19 Agenda and Minutes
    3. HL7
  3. External Updates - ONC and others
  4. Project Updates
    1. Value Set Issues (@ who? )

    2. C-CDA Rubric Informative Guide (Gay Dolin, Matthew Rahn)
    3. Other Project Updates
      1. C-CDA Rubric Criteria Project Page
      2. CDA IG Quality Criteria
      3. CDA Questionnaire Form and Response
      4. Consolidated CDA (C-CDA) Project
      5. Personal Advanced Care Plan (PACP)
  5. Additional Items
    1. 2 items (Holly Miller)
      1. ..?
      2. New C-CDA templates for C-CDA Referrals
    2. Personal Advanced Care Plan (Lisa R. Nelson)
  6. FHIR Tracker Items (if time is available)

    1. IDDescriptionSubmitterNotes
      FHIR-25438Clarify scope of Composition resource




  7. Adjournment
    1. The next meeting of Structured Documents will be Thursday November 7, 2019 @ 10:00am EST.

Notes/Minutes

  1. Call to order
    1. Meeting called to order at 10:00am EST.
  2. Business Updates (10 min)
    1. Additions/modifications to the agenda
    2. Approve minutes from 2019-12-19 Agenda and Minutes
      1. Minutes approved by consensus.
    3. HL7
  3. External Updates - ONC and others
    1. No Update.
  4. Project Updates
    1. Value Set Issues (@ who? )

    2. C-CDA Rubric Informative Guide (Gay Dolin, Matthew Rahn)
      1. Left off talking about on  Comment number #207 of the Rubric. Gay Dolin discussed just removing this rubric. The clinicalDocument.code that specifies the document type is the same as the shell.
      2. Austin Kreisler These rubrics are based on schematron validation. They are not an alternative to.
        1. TypeMotion
          Motion

          Motion to dispose as Not persuasive with mod.

          By
          Second
          Date

           

          Ref ##207
          For15
          Neg00
          Abs01
          Status

          APPROVED

          Tally15-00-01
          Discussion




      3. As stated, the item is not testable. Act IDs on entries from different classes should not be the same.
        1. If the IDs are the same then the attributes, if present, must have the same values.
        2. TypeMotion
          Motion

          Motion to dispose this comment as persuasive with mod.

          By
          Second
          Date

           

          Ref ##208
          For17
          Neg00
          Abs00
          Status

          APPROVED

          Tally17-00-00
          Discussion

          The intent of this rubric was to limit the misuse of the id. It would be difficult to create a complex set of rules. A simple rule would catch 80% of the misuse.



      4. Comment #210. Problem codes should be expressed with core subset of SNOMED codes. Should we wait and discuss this when Rob can be on the phone? Do we know what the defined list of problem codes are in the SNOMED list and do we know what Core has defined? What is FHIR using? This could be looked at as part of ValueSet clean-up. We could mark this as out-of-scope. We could list this as non-persuasive. We should investigate whether this should be part of ValueSet clean-up. This is two-part. If it is wider and we want to run it as part of the Rubric, we'd have to run it as part of a subset of the current ValueSet. Is there a technical way to state a JOIN of the Problem List and the Core. Is the subset sufficient to be a rubric? Investigate need to change/expand problem ValueSet through discussions in forums such as C-CDA Implementaiton-A-Thon
        1. TypeMotion
          Motion

          Motion to dispose as Not persuasive.

          By
          Second
          Date

           

          Ref ##210
          For18
          Neg00
          Abs00
          Status

          APPROVED

          Tally18-00-00
          Discussion




    3. Other Project Updates
      1. C-CDA Rubric Criteria Project Page
      2. CDA IG Quality Criteria
      3. CDA Questionnaire Form and Response
        1. In the current ballot that opened this week. Review and submit comments. Martin thanks everyone for getting this work done.
      4. Consolidated CDA (C-CDA) Project
      5. Personal Advanced Care Plan (PACP)
        1. Lisa will have a block vote for next week.
  5. Additional Items
    1. Adding vocabulary to Consolidated CDA (Holly Miller - Med Allies)
      1. Holly Miller If we were to add this to C-CDA we could use this imminently. Gravity project, add to C-CDA project could add value almost immediately.
      2. Lisa R. Nelson There is not a PSS to work on templates for some of the FHIR work. For example, food insecurity, could be represented using social history. The codes established to use in FHIR and the ValueSets for FHIR could be used. The Social Observation template. Could provide some guidance. The code in a Social Hx could be done using many of the existing templates. We haven't done the evaluation and we don't have the charter to do the documentation of the examples. As for the dell, not sure who is building those FHIR IGs. Could ensure they are building those FHIR IGs and make sure they design them to align with existing templates.
      3. Andrew Statler - Could we have the C-CDA Examples task force take on the task of creating C-CDA Examples for these new layouts rather than creating new PSS/Charter for this work?
      4. Acute to Skilled Nursing determinations and 360x
      5. Austin Kreisler 1 approach could be to create appendices to the current approaches to identify how to do it. A 2nd approach would be to use the Examples Task Force. A 3rd approach would be more of a traditional project approach to develop a new guide for creating the relative templates in C-CDA going through the full project approach to developing a new artifact that would define this.
      6. Lisa R. Nelson If anyone were interested, they could work on this at the Connect-a-thon track to co-develop this process for C-CDA at the same time as the FHIR components.
      7. Holly Miller to reach out to Gravity project team.
    2. New C-CDA templates for extra template referrals (Holly Miller - Med Allies)
      1. Holly Miller Interest in sending via Direct to extra-clinical environments such as YMCA, weight-loss programs, smoking-cessation programs. They've created templates for very simple information for the referrals based on the limited HIPAA information they are able to share. It can't be as dense of information as what they have in existing C-CDA documents.
      2. Lisa R. Nelson In Gravity - Handling use cases such as sending to food banks and using the module from FHIRr4 release for the Referral Note that is shared out with the basic ovservation note and goal. Downscaling a Referral Note that needs to be sent out. If they did a Companion Guide, it would be gathering the information, sending for use, sending for secondary use.
      3. Austin Kreisler The caveat here is that it is more complicated and may require an additional C-CDA IG. The existing templates may not be light enough. The potential for stuff being there is still possible. We will be restricting things in these use cases and so we will need to do some deeper analysis, so we will likely need to look at this more closely.
    3. We will need to start updating the Agenda for Sydney. You can add topics to the Agenda at the bottom of the Agenda page. 2020 Feb Sydney Agenda SDWG WGM
  6. FHIR Tracker Items (if time is available)
    1. No tracker items addressed today.
  7. Adjournment
    1. Meeting adjourned at 11:40am EST

 

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