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Facilitator: Austin Kreisler


Date:






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Agenda:


2:00 PM ET

  1. Call to order 
    1. Call for Attendance


  2. Agenda

    Joint with FHIR-I

    • C-CDA on FHIR
    • Review C-CDA Web Publishing Project
    • CDA/FHIR mappings
    • CDA/FHIR vocabulary
    • FHIR Trackers
    • Some of the details:
    • Status of the Profile on Composition that was/is intended to constrain the Composition Resource to fit the CDA R2.0 Schema
    • Open issues related to representing CDA profiles in StructureDefinition
    • Vocabulary binding alignment between CDA and FHIR syntax and common vocabulary binding principles
    • Alignment expectations for Value Sets across CDA and FHIR Implementation Guides server the same Use Cases

Notes/Minutes:


  1. Agenda  SDWG Joint with FHIR-I (Rick is representing FHIR-I)
    • C-CDA on FHIR was approved for publication for by committee.
      • Notice to Anne will allow the TSC to take it on an E-Vote.
      • Status of the Profile on Composition that was/is intended to constrain the Composition Resource to fit the CDA R2.0 Schema - Does the C-CDA on FHIR build upon the Clinical Document profile? yes  however, there are some tracker items that are to move some items to the Universal realm extensions. 
      • For sections it does not define new entries, it indicates that if there are US Core profiles it utilizes those entries.  For sections where there are no existing profiles in US Core profiles, it will refer to the base FHIR resources.   New profiles can be submitted if they are needed. 
      • How does an implementer get guidance on context conduction in FHIR where a C-CDA document is mapped to FHIR resource or profile does not have a role defined.
        • Graham indicated that there is a 5 W pattern, that should be used (who, what, why, where and when).  Then is should be used to model these concepts in the FHIR resources. The domain committee need to determine which of the 5W features need to be de-normalized into the resources when they are more then providence, and need to be added to the resource.  Graham suggested that there may be a need to create a focus to the issue, as it spans a number of domain committees.  Zulip might be the location for the topic.  
    • Review C-CDA Web Publishing Project - Sean
      • Lantana has been working on the project for a few months. Utilizing FHIR publishing to represent CDA Implementation Guides.  The Trifolia workbench has been exported and transformed into FHIR StructureDefinitions to convert C-CDA sections (Allergies, Medications, Problems ...) a subset 1/3 of the subsections.
      • Sean shared a view of what has been accomplished so far in the conversion. There is a request to support rich text in the narrative . 
        • Sean indicated that the listing of sections and templates is getting long, so that there may be an issue to be considered with the FHIR I.
        • We should have a all conformance statements in the C-CDA 2.1 in when the project C-CDA 2.2 when it is completed.
        • There is no examples possible for some of the data types in the current solution.  Sean sent these to Graham in Chat.org. Need to look for funding from HL7 to make the samples work for data types to ensure that we can validate instances of CDA documents.
        • A question about how workflow on editing CDA profiles would take place in Trifolia.  You can edit in Trifolia today and publish it today. The source of truth is moving to Trifolio on file.  The whole goal is to move to the StructureDefinition.
        • Does Lantana have any projects that are planning to use the framework for CDA IGs. Once the FHIR tooling from Lantata can handle the job, they want to migrate.
        • If structured document wanted to do a release C-CDA R3.0 2021 we might want to consider having a dependency hierarchy it might be possible to break the C-CDA into smaller pieces and more manageable.
        • 2 to 3 week timelines for infrastructure work. There is a whole class of needs similar to C-CDA world wide that is wanting these capabilities.
        • Sean was thinking that we might want to hire a UI expert to help with the usability / accessibility.
    • CDA/FHIR mappings
    • FHIR Trackers
    • Some of the details:
      • Vocabulary binding alignment between CDA and FHIR syntax and common vocabulary binding principles. 
        • SHALL, SHOULD, MAY - and the NOT forms. There is a different set that should be used.  This is a joint topic with vocabulary.
          • Sean - used a table to map between the set. He provided a copy to Lisa.
      • Alignment expectations for Value Sets across CDA and FHIR Implementation Guides server the same Use Cases
        • There are still differences between Core concepts in C-CDA and FHIR.  Differences in negation between C-CDA and FHIR. 




 


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