2021-03-24 CDex Meeting

• CDex Implementation Guide: http://build.fhir.org/ig/HL7/davinci-ecdx/ 

• Source Code in GitHub:

  • CDex Communication Response App

  • CDex Communication Request App

• HRex Sept Ballot IG: http://hl7.org/fhir/us/davinci-hrex/2020Sep/index.htm
• Note: 34 affirmatives of 35 approval threshold.

FHIR-28885 and FHIR-28886 - Lloyd reached out with no response. marking not-persuasive. 

FHIR-26855 - Getting issue details... STATUS

Continues discussion from last week:  Signatures and Provenance - Lloyd reached out to John M. to show how to use Provenance for an assigned resource.  if you are not using a digital signature, you can't without a custom extension.  

Next Step: 

• What does it mean when the Payer wants a signature? 
• What is the Provider able to do? 

Provenance references signature data type. Signature data type doesn't require a digital signature. but the only place you can define what you attest to is inside the digitual signature.  

Element for who, when all say "go look inside the digital signature for trust" but no element for "what" you are signing. 

Still unclear about how to see the "what" is being signed. 

• discussion about use for audits and claims attachments - e.g. why did you need an additional surgeon for a surgery
• Robert Dieterleto ask on Architecture call, did not get to it last week.  

Pick up with FHIR-30870 

From 2/17:

• Review  FHIR-12656 - Getting issue details... STATUS  as part of CDex Eric Haas
• Review FHIR-30868 and FHIR-30869 (see above) Eric Haas

https://jira.hl7.org/browse/FHIR-30867 - Lloyd proposed wording agreed to on call 2/17

https://jira.hl7.org/browse/FHIR-30868 - review Kathleen proposed wording based on 30867.

https://jira.hl7.org/browse/FHIR-30869 - review Kathleen proposed wording based on 30867.

• On 2/24 - Left off with FHIR-30489 - Getting issue details... STATUS  - Eric to Draft resolution.

HREX related CDEX Comments:

FHIR-26855 CDex documents require signature, but don't explain how used
FHIR-30490 TRIAGED clinician burden reduction
FHIR-30858 TRIAGED Perhaps just call for current published version?
FHIR-30863 TRIAGED Is it purely a workflow decision whether a request is required to release patient data?

FHIR-30870 TRIAGED  Clarifications

FHIR-30148 In which IG is it more appropriate to apply this one?

AMA Comments:

FHIR-30815  Not Persuasive Provider to Provider use case should be out of scope as it has not been tested.
FHIR-30816  Unresolved Please clarify whether any human involvement is required, and an example, as well as define the term fulfillment as it relates to attestation.
FHIR-30820  Unresolved When a task is complete what triggers the termination of a payer's ability to fetch data?
FHIR-30821  Unresolved When and how do data servers terminate a client's set of requests?
FHIR-30822  Unresolved What method is used to determine the end of a client's access to a data server?

Block 1 pulls:

FHIR-30831 TRIAGED Not Persuasive More missing content.
FHIR-30832 TRIAGED Not Persuasive The content of this IG wasn't quite ready for ballot. What HL7 process improvement is needed to prevent this in the future?