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https://confluence.hl7.org/download/attachments/40739984/HealthCareProduct%20Landscape.pptx?api=v2

Tues Q4

Wed Q1

  • CIMI update:
    • Susan Matney presents a powerpoint slide about modelling, the process and Simpel.
    • Mark: the logical part from CIMI was too difficult for them. The step between modelling, IG and FHIR resources was not easy. They are using FHIR shorthand, which does not start from modelling.
    • Skin wound risk assessment (2010) is using LOINC and SNOMED coding. FMG would like verification of the model in a FHIR connectathon.
    • Discussion:
      • CIMI issues: Because of the use of SNOMED it has to be labelled as US realm. This does not make sense in the eyes of CIMI. Would make more sense to call it the SNOMED realm. Topic to be discussed with the FMG.
      • Reference sets are created and included in the extension, because there is no central repository available. This will be an important issue to solve, because the amount of valuesets to be mainained will be great. More agility is required.
      • Wound Gradation: Different wounds are staged differently.
      • Wound qualitative amount special terms introduced.
      • How do you want to model? Qualifiers are currently now in extensions.
      • Stephen suggests to move them into Observations.
      • Conditions differ from observations in the sense that it does not have components.
    • Stan wants Observation to be contained within the Condition so that you do not have to step over to Observation. Mark notes that the backbone element in Observations should allow recursiveness.       That would mean qualifier in qualifier.We do not want a reference. We want to be recursive.
    • Motion: Stephen Chu: Submit a Change Request to add a qualifier back bone element in Condition resource using a structure similar to Observation.component.   Susan seconds the motion.
    • Vote: 7 in favor of the motion. 0 abstentions, 0 against.
    • Action item: Stephen submits the change request in Jira and notify Michelle.
  • Vital Signs is being expanded. Vital Signs are observations
  • DisPrecondition; Temporal period something has happened before a certain event and could affect the measurement of the vital signs.
  • Action Item: Susan Matney to ask Michelle Miller to put the topic of Precondition in a conference call.


Wed Q2

Agenda Items

  • Patient Care Resource Review
    • Maturity levels of resources that could go normative
      • AllergyIntolerance 3
        • Implementations in 
          • Germany - Stefan
          • Netherlands - Alexander Henket - STU3
          • UK - David Barnet - STU 3, moving to R4
      • Condition 3 - Normative
        • UK
        • Germany
        • Netherlands
        • Noted by Stephen Chu - Trackers will be entered by CIMI for qualifier backbone elements
      • Procedure 3 - - Normative
        • Germany
        • Netherlands
      • CareTeam 3- Normative
        • UK - being implemented as part of Child Health
        • Noted by Stephen Chu - Care team DAM may solicit some feedback
    • Per Grahame
      • Have the following procedural options
        •  can still take the resources and update with the changes.
        • can take the resource and hold off taking the added part normative.  
    • FamilyMemberHistory 2 → 3

Genomics groups using this resource - Michelle will reach out to them


CarePlan 2 → 3
Goal 2 → 3
Communication 2 → 3
CommunicationRequest 2 → 3
AdverseEvent 0 → 1?
ClinicalImpression 0 → 1
Linkage 0 → 1
Flag 1 → 3


R5 Timeline

May push for a draft ballot in the May cycle

Reasons for getting R5 moving forward

  • Subscription work by the EHR vendors
  • Work around care guidelines, planDefinition, activityDefinitions from Patient Care
  • Medication knowledge

International Patient Access - Grahame

Patient using an App can access information about the patient from a clinical record systems

In the US - US Core regulations

A lot of countries are approaching companies to bring this capability to their countries. 

Plan is to take US Core and take away all the US specific parts. Will be left with the International parts. Log in and can get to the same resources and search for the same information. 

Each country can sign up and use their own variances. 

The platform remains international. Each country can have their own set of rules. 

Affiliates can do their own or can ban together - e.g. Australia and New Zealand. 

IPA will be consistent with US core. If implemented US Core will automatically be conformant to IPA. 

On the other hand have learned 

  1. accessing data for a patient and find that the patient record have been merged with another patient record - what happens? Have added rules on how to handle this. This is specific to IPA.
  2. What about IPS? A set of content agreements on how to share data. IPA does not have many content agreements. IPA content accessed thru IPA is bestt

Wed Q3

Wed Q4

Thurs Q1

Thurs Q2

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