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Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
Management Minutes ApprovalApproved minutes of Atlanta WGM by consensus
BusinessReview of US Core Decision from Atlanta WGM

Based on discussions in Atlanta at the WGM, US Core will transition from Structured Documents after publication of the current Update cycle. The US Core Update reconciliation is continuing in Structured Documents during the second half of their weekly call (11-12 Thursdays Eastern Time). The final package is expected to be published at the end of October after which the project will transition to this WG.

BusinessCMS Data Element Library project discussion

PSS: CMS Data Element Library (DEL) - presented by Dave Hill (Mitre) from the project team

Data Element Library Content:

Plan is to create a FHIR API - based on the Impact Act, facilities are expected to provide information for transfer to extended care facilities (e.g., MDS, OASIS, etc.) using an API.  Facilities are required to complete these assessments and submit them through the QUIES system (Quality Improvement Evaluation System). The process is currently cumbersome with a web app that requires viewing a duplicate screen to choose the required responses and paste them into the screen containing the answers to the questions.  The form could be built in a data-driven way.  An EHR could incorporate this function as part of the standard clinical workflow but that effort is expected from the implementers.  The hope is to get comments and review from this FHIR implementation guide.  A goal is to determine how items are represented in other profiles.  The current questions are LOINC questions - more of a model of use design while other IGs are referencing a model of meaning design.  Gay Dolin asked how the project would reconcile these issues. Previous work in CDA had similar issues. Dave Hill responded the near-term intent is to get information flowing quickly. 

Jean indicated the IG is complete. Dave Hill noted there is still some fine tuning but that the IG is pretty close to complete.

Floyd asked what FHIR resources are being used. Response - each Dell standard form is represented as a questionnaire.  The current resources include Questionnaire and may consider adding QuestionnaireResponse but responses will not be sent back as FHIR resources.

Reference implementation builds the form from the data element library.  It references a snap shot of the DEL (I.e., a pseudo-DEL).  This is part of a larger general use case such that information shared by care settings is communicated to the patient/provider. 

The project participated in the HL7 Atlanta Connectathon (post acute care track). Presentation: Data Element Library - Read-Only.pptx

Jean Duteau discussed the HL7 process - Patient Care was the first WG approached and referred to this WG.  Dave Hill suggested that the data included are not part of Patient Care resources. The project has a different project for Cognitive Status and for Functional Status that are sponsored by CBCC, Patient Administration and Patient Care but this DEL PSS does not have a sponsor at present. This project does not seem to be a good fit for this WG - it does not cross multiple WGs and it may have a natural home. The Questionnaire resource is owned by FHIR Infrastructure, but the PSS is using the resource and the appropriate WG needs to be determined.

Another item to consider is the fact that all content has been developed outside of HL7; this is a completed project. Architectural Review Board will need to review since it is external content. 

Another issue is the hope to ballot in February but the PSS has not completed the usual process for approval.

Craig asked if there is an expected HL7 deliverable - I.e., an HL7 IG. Dave Hill responded that Is an option if reconciliation is successful. The current expectation is for a Comment Only ballot.

Jean will work with TSC and other chairs to consider a recommendation to move forward with HL7 processes. 

Management Next agenda

Next meeting in two weeks - October 17, 2019

Structured Documents Call Thursdays 11-12 ET to review US Core Update reconciliation.

 Adjourned at 13:55