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Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)

Management

Minutes Approval

Migration to Zoom:

Reminder: Notices for Intent to Ballot (NIB) for September ballot are required by July 5

Minutes approved as written by acclimation.


Marketplace Product Packaging Project

Status on Marketplace Product Packaging Project

Awaiting further feedback from Preston Lee regarding next steps, updates, and when specific group meetings will be held. Currently delayed due to Logica activities for COVID-19

Deferred


Military History Project

Report from Military History Project team 

Confluence page: Military Service History and Status FHIR Profiles Project Page  Document

Plans to go to the September Connectathon for HL7 FHIR. Consider whether the API can be used for veteran status for DaVinci use cases.


Deferred to address the US Core trackers for upcoming errata.


US Core Methodology

Road to US Core Discussion

For consideration on the May 28, 2020: Additional US Core FHIR Trackers (Frank McKinney) regarding Real-Time Pharmacy Benefit Check (RTPBC) Implementation Guide - variance for profiles regarding Patient and MedicationRequest (see Tracker links bullet below). 

Follow up errata for US Core:

  1. Potentially relaxing "must support" for some items such as race and ethnicity. By requiring race and ethnicity, we might be be requiring unnecessary information in all transmissions. Relaxing the "must support" will allow more flexibility. USCDI requires ability to support race and ethnicity. US Core purpose is broader than USCDI.

Current expectations: Expecting errata package for US Core toward the end of June 2020 for a 2-week comment period followed by a vote for approval and publication in early July 2020.

Remaining trackers from last meeting (reviewed with the US Realm Steering Committee June 9 which identified no concerns for the following requests):

  1. FHIR-27732 US Core MedicationRequest variance – encounter
  2. FHIR-27731 US Core Patient variance – Patient.telecom
  3. FHIR-27730 US Core Patient variance – Patient.communication.language
  4. FHIR-27729 US Core Patient variance - us-core-birthsex
  5. FHIR-27728 US Core Patient variance – us-core-ethnicity
  6. FHIR-27727 US Core Patient variance – us-core-race
  7. Briefly discussed on last call and will require additional work:
  8. FHIR-27770 - Need to work with Vocabulary and HTA since the current publication indicates reference to only one license year (2014) and CPT has a new license every year.  Need a reasonable way to manage the code system version. The version is based on the date of service. The OID, code and reference does not change but the version changes with every year of service.
  9. Reopen J#25035 

Proposal is make this a SHOULD instead of SHALL. (When recording “self-prescribed” medications-orders-, SHALL use the requester to indicate the Patient or RelatedPerson as the prescriber.)

Plus new tracker to vote on  (unfortunately too little notice to put in a block vote):

Jira Issue Summary (Reporter) Resolution

  1. J#27867 add reaction to allergies (ehaas) Persuasive
  2. J#27857 Add Reference to US Core Patient in Vitals Signs Profiles (Brett.Marquard) Persuasive
  3. J#27846 US Core Pulse Oximetry Profile: observation.value and component.value constraints are different (emmanurse) Persuasive with Modification
  4. J#27836 Expand Procedure Codes Value Set to include ICD-10 PCS codes (ekivemark) Persuasive
  5. J#27117 ICD-10-PCS: Note ownership and availability for Use. Include Codes. (saul_kravitz) Persuasive with Modification
  6. J#27116 Change Description of ICD-10-PCS Value Set (saul_kravitz) Persuasive
  7.  J#27876 - Remove Must Support References to non US Core Profiles (Brett.Marquard) Persuasive

FHIR Tracker Grouping: project = FHIR AND issuetype in ("Change Request", Comment, Question, "Technical Correction") AND Specification = "US Core (FHIR) [FHIR-us-core]" AND status in (Triaged, Submitted, "Waiting for Input", Deferred) AND Grouping = USCore-errata-2020

J#27876 - Remove Must Support References to non US Core Profiles (Brett.Marquard) 

Discussion: Tooling doesn't allow constraint to one option for Must Support (e.g., "Patient") without excluding other options (e.g., "Group").  The intent was to support the profile - If a Device is an author, it is not allowed for DocumentReference. The issue is whether all options for author must be supported for testing rather than only some.

A profile could allow splicing - must support for what must be supported and not must support for those that aren't necessary.  However a reference with cardinality of 0..1 cannot be spliced.

Resolution - Remove the reference and include text where-ever it occurs if the data element is a reference that points to a non-US Core profile.

Motion to approve the motion as detailed in the tracker:

Brett Marquard/ Mary Kay McDaniel: 10-0-0

J#27867 add reaction to allergies (ehaas) Persuasive

Motion to approve resolution as detailed in the tracker

Eric Haas/Floyd Eisenberg: 10-0-0

J#27846 US Core Pulse Oximetry Profile: observation.value and component.value constraints are different (emmanurse) Persuasive with Modification

Motion to approve resolution as detailed n the tracker

Eric Haas/Floyd Eisenberg: 10-0-0

J#27836 Expand Procedure Codes Value Set to include ICD-10 PCS codes (ekivemark) Persuasive

Motion to approve resolution as detailed in the tracker:

Eric Haas/Floyd Eisenberg: 10-0-0

J#27116 Change Description of ICD-10-PCS Value Set (saul_kravitz) Not Persuasive with Mod

Motion to approve resolution as detailed in the tracker (Value set is all ICD-10-PCS - the source code system indicates intent is for inpatient procedures. However, this is a US Core value set and the reference expects the user to know how to apply the codes based on code system guidance.)

Eric Haas/Rob McClure: 10-0-0

Reopen J#25035 - change a SHALL to a SHOULD of the requester on self-reported medication.

Motion to reopen

Eric Haas/Floyd Eisenberg: 10-0-0

Resolution J#25035 - change a SHALL to a SHOULD for the requester on self-reported medication.

Motion to approve resolution as detailed in the tracker:

Eric Haas/Floyd Eisenberg: 9-0-0


Deferred:

J#27857 Add Reference to US Core Patient in Vitals Signs Profiles (Brett.Marquard) Persuasive

Deferred for clarification

J#27117 ICD-10-PCS: Note ownership and availability for Use. Include Codes. (saul_kravitz) Persuasive with Modification

Deferred - the copyright for the value set is owned by US Realm Steering Committee - request clarification from commenter.

Also deferred:

FHIR-27732 US Core MedicationRequest variance – encounter

FHIR-27731 US Core Patient variance – Patient.telecom

FHIR-27730 US Core Patient variance – Patient.communication.language

FHIR-27729 US Core Patient variance - us-core-birthsex

FHIR-27728 US Core Patient variance – us-core-ethnicity

FHIR-27727 US Core Patient variance – us-core-race

Briefly discussed on last call and will require additional work:

FHIR-27770 - Need to work with Vocabulary and HTA since the current publication indicates reference to only one license year (2014) and CPT has a new license every year.  Need a reasonable way to manage the code system version. The version is based on the date of service. The OID, code and reference does not change but the version changes with every year of service.


Next Steps for US Core Errata

Brett indicates all trackers will be applied next week and follow with a publication version of the errata. Details to follow.


 Adjournment

Adjourned at 2:02 PM ET.


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