Date

 

ChairScott M. Robertson
StatusComplete
Comments

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    Meeting ID: 323 199 8494
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Web session

Attendees

NameOrganization
Scott Robertson (Chair)

Kaiser Permanente

Jean Duteau


Tim McNeil
Christof Gessner
Corey SpearsMITRE
Danielle
David Hill
Peter Sergent

Agenda Items and Notes

Meeting Notes from previous meeting

Administrative

  • vote on WG representatives to TSC - vote for 3;
    • Jean will send an email to the pharmacy list

Gora Datta profile 

Anthony Julian FHL7 profile

Ulrike Merrick profile

David Pyke profile

AbdulMalik Shakir profile

  • Reminder to vote on HL7 Leadership ballots

    Position

    Who Can Vote

    Link to submit Votes

    HL7 Treasurer

    All current individual members and the designated voting representatives of organizational and Affiliate members.

    http://www.hl7.org/permalink/?BODOfficersElection

     

    HL7 Director
    (2 positions)

    All current individual members and the designated voting representatives of current organizational members.

    http://www.hl7.org/permalink/?BODDirectorsElection

    TSC Implementer Representative (1 position)

    Current individual members and the designated voting representatives of current organizational members.

    http://www.hl7.org/memonly/vote/vote.cfm?electionCode=TSCImplementer


    Work Group Co-Chairs

    Current individual members and the designated voting representatives of current organizational members who were subscribed to the relevant listserv by June 24, 2021. Non-voting organizational members and Affiliate members subscribed to the relevant listserv by June 24

    Elections shall be conducted via Election Runner. Watch you email box on July 1 for your invitation to vote. Check your junk or clutter box if have not received an invite to vote by mid-day on July 1.

    This is an automated process and to be recognized as an eligible voter by Election Runner, you must be subscribed to the list with the default email address associated with your membership.  If you have subscribed to the lists using another email address, Election Runner will not have recognized you as an eligible voter. If you feel you are eligible to vote in an WG co-chair election but have not received an invite, please contact Linda Jenkins at  Linda@HL7.org.

    Co-chair candidate’s statements are available at: https://www.hl7.org/intranet/2021-Co-Chair-Statements.pdf


Project Review

Project Proposals

Project Scope Statements

NHSN Inpatient Medication Administration Reports (FHIR IG) - Sarah Gaunt

  •  
    • Review ballot comments - discuss and vote: 5 issues
    • Reviews all 5 tracker items - Motion by Sarah G and Seconded by Tim M, to accept all resolutions for the 5 items passed by a vote of 7-0-2
  •  - not reviewed

Discussion of MedicationKnowledge and possible issues for CDS

  • proposed changes for MedicationKnowledge
  • ongoing discussion/concern about the scope of MedKnowledge and MedicinalProductDefinition
  • Jean completed an analysis
  • there are some attributes in MedKnowledge that are not part of the definition, but there are attributes that overlap
    • cost isn't definitional
    • guidelines may not be definitional
  • proposal was to pull out content that are definitional and are in MedicinalProductDefinition
    • improve the link to the definition
    • Knowledge would provide jurisdictional specific information about the drug
  • Is the modelling different in the definition
    • in many cases, it is structured differently because there is more information in the definition - more detail
    • in almost all cases, MedicationKnowledge is a subset of the information that is in MedicinalProductDefinition
    • do we need to put guidance in our resource about
    • will have to explain as part of scope where there may be duplicate information
  • Is there ever a circumstance where you would have a code (e.g. hospital specific code) but also need to reference MedicinalProductDefinition
    • need to discuss this
  • Comments from Bryn
    • need to know ingredients and relative strengths of ingredients
    • in MedicationKnowledge - was straight forward and clear
    • in MedicinalProductDefinition - can't answer the same questions
      • can see ingredients, but don't know the relative strengths
        • have to look inside the ingredients to find strengths
      • can answer the question, but need to consider that ingredient is specific to a product
      • there are some ballot comments - may be changes that make this harder to determine
    • problem with the proposal - what was easy before, is now harder to find
      • at least one level of indirection
      • names are not the same
      • 3 level of hierarchy to look for ingredients and then dig information out
      • disservice to those that have been well served by the existing MedicationKnowledge
  • Options
    • could include a backbone of the definitional items
      • reference to definition and/or attributes that were previously included
      • there could be push back - could just contain the definitional items - need to justify this
    • maybe clearly defining the scope would be a better option - scope and boundaries
  • Next steps
    • reach out to Francois about use by Catalog Project - Jean to reach out
    • take to FMG and describe the problem
      • hearing from implementers that the approach adds complexity
      • can we include definitional information?
    • need to push back to BR&R on the level of complexity - Bryn to submit trackers
    • Is there another project that is using MedKnowledge?
    • Input - have a proposed solution -  Jean to create a new build
      • duplication of definitional information - apply to a local build - Jean to apply
    • Rxnorm is a good use case!  look at international models that are not regulatory
    • reach out to Patrick Werner - project in Chile - Melva to reach out on Zulip - done
  •  - outstanding action items
    • leave until new information
  •  - no discussions
  •  - Jean 
    • overlap between MedicationKnowledge and MedicinalProductDefinition
    • proposal to remove the "definitional" elements from MedicationKnowledge
    • new MedicationKnowledge
      • not in the current build yet
      • adds .definitional backbone element for those (fewer) elements to retain in MedicationKnowledge
      • simplified .ingredient
      • .amount is still strange.  Needed in Canada.  may become a Canadian extention.
    • Jean will check with BR&R and then move the new MedicationKnowledge into the current build

FHIR Resources - Normative Candidates

These resources have been endorsed by their respective work groups as target normative candidates for R5:

  • MedicationRequest
  • Medication

Catalog Updates (John Hatem)

  •  - no updates
  •  - not reviewed

Workflow Update (John Hatem)

  •  - no updates
  •  - not reviewed

Healthcare Product Update (John Hatem)

  •  - no updates
  •  - not reviewed

NCPDP Updates (NCPDP Members)

  • NCPDP Task Group working on Patient Consent - for specialty prescribing -  Frank McKinney
    •  - starting up again this week with bi-weekly calls
      • will be focusing on coming to an approach to informing the clinic process on drugs that need consent and the type of consent needed and representing the type of consents
    •  - no update
    •  - meeting on Thursdays - looking at the way to convey the consent needed (with attachment)
      • looking at a means to inform prescriber about a patient program being available that would require consent from patient to be involved
    •  - no update
  • Specialty Medication Enrolment PSS update - Specialty Medications
    •   - Publication request approved by FMG, now going to TSC
    •  -  Publication request was approved by TSC
    •  - has been published!
    •  - no update
  • Standardized Medication Profile - Standardized Medication Profile Jean Duteau
    • - pending minor editing from NCPDP, then can send publication request
      • there are some links that needed to be fixed
      • Scott will draft publication request to come back to Pharmacy
    •  - content sent by Shelly
      • need to draft publication request - Scott and Margaret
    •  - at NCPDP Standardization Committee for review - looking at word smithing 
      • will bring back to HL7 - to see if they can be incorporated or if held for Version 2
    •  - no update
  • MTM - create FHIR IG Scott M. Robertson
    • on hold waiting for MCC eCare Plan Summary to be completed
    •  -  on hold
    •  - on hold
    •  - on hold 
    •  - no update
    •  - not reviewed
  • RealTime Pharmacy Benefit Check for Consumers (Tim McNeil/Frank McKinney)
    •  - analyzing on payer side for implementation
      • looking at timing
    •  - no update
    •  - no update - Task Group still looking at NCPDP requirements
    •  - no update
    •  - not reviewed
  • Consultant Pharmacist Task Force - will be creating a guidance document for consultant note on the FHIR IG - Scott/Shelly
    • jointly published 
    • would need a project proposal 
    •  - reviewing guidance document, want to update with FHIR
      • not ready yet for proposal
    •  - Scott reviewing requirements for next step
      • may just be an update to NCPDP material
      • if it needs to come to HL7 - needs a Project Proposal
    •  - no update
    •  - not reviewed

Global Supply Chain Project (Scott)

  •  - no meeting since before WGM
  •  - no updates
  •  - no updates
  •  - no updates
  •  - not reviewed

Medication List guidance project

  •  - John has created trackers related to updated wording
    • need additional work on other areas
  •  - to be discussed during next call July 12, 2021. 
  •  - not reviewed

PDex Formulary

  •  - will have content to review on next weeks call - 3 issues and discussion of next steps for STU update
  •  
    • FHIR-30924 - Cost Sharing description
      • not a technical correction
      • See update in Jira
    • FHIR-31672
      • proposing clarification on what should be done - use "NA" -don't believe this is a technical correction
      • come back to this
    • proposed schedule
      • STU update - starting April 26
        • Melva to look at the process for an STU update and let Dave know what needs to be done for approvals
  •  - no discussion
  •  
    • FHIR-28293 - Improve description of PlanID TRIAGED
      • new field description in tracker.  not specific to HIOS-generated.
      • Motion to accept disposition in tracker  David Hill/Margaret Weiker (10-0-1) passes
  •  
    • Qualifier of copay amount - FHIR-32178
      • Dave Hill/Tim McNeil - to accept proposed disposition - 8-0-1 - Accepted
    • may be some changes coming
    • Will add discussion for next week
    • May be able to discuss next steps for specification at WGM
  •  
    • 5 new issues have been added
    • no decision made about STU update vs ballot as new issues are being identified - likely a few weeks out
    • FHIR-31591 - wrong code included for drug
      • agree technical correction
    • FHIR-32723 - valueset tables not being displayed correctly - definition field is blank
      • agree technical correction
    • FHIR-32622 - change request
      • uses list, but shouldn't
      • short-term fix - examples will be updated and add guidance
      • will address more comprehensively in a subsequent release
      • may change to insurancePlan, but need to assess if this is the correct resource to use - low maturity
    • FHIR-32627 - search parameter codes should be lower case
      • this will be a breaking change - will add guidance to say being contemplated
      • need a "-" between names
    • FHIR-32625 - menu doesn't allow navigation
      • changing menu bar
    • Motion to approve proposed resolutions for the above issues - Dave Hill - Corey Spears - 10-0-0 Carried
  •  - no updates
  •  
    • FHIR-32718 - provide distinction between non-formulary, not covered and not found when searching drugs - Not Persuasive - there are other ways to get this information
      • separate tracker about adding guidance for queries to include a real drug
      • Motion to accept disposition - Scott Robertson - seconded by Corey Spears - 10-0-0 Carried
    • FHIR-32724 - add formulary ID field to coverageplan and MedicationKnowledge to differentiate formularies when more than one is available - Not persuasive
      • Motion to accept disposition - Scott Robertson - seconded by Corey Spears - 10-0-0 Carried
    • FHIR-31037 - CoveragePlan PlanIDType extension not defined for non-HIOS plans - Persuasive With Mod
      • Add guidance - for non HIOS plans, should be "other-plan-id"
      • Motion to accept disposition - Scott Robertson - seconded by Corey Spears - 10-0-0 Carried
  •  - Corey and Dave H, discussed two tracker items.  Both of these items should be reviewed by Jean Duteau
    • Tracker items discussed were: 
      • 31683 - again we need a technical point of view on this issue.  
        • we also provided some feedback and discussion about formulary approach using the new catalog approach.  we did not specify whether the new approach could solve this tracker issue.  
      • 31684 - the specific issues being discussed may be one for FMG and not specifially Pharmay.  Need Jean Dutean input
  •  - Corey
    • working from email from Corey to Jean
    • query for resources related in PDex (e.g., Lists, MedicationKnowledge) uses _profile. 
      • Not a preferred method. 
      • retooled to use List.code.
      • MedicationKnowledge?PlanID:missing=false (assuming the serversupports it)
      • Retrieve all PlanIDs by querying the CoveragePlan (List profile) then query MedicationKnowledgee with the retrieved PlanIDs
      • FHIR-31683 - Getting issue details... STATUS
        • motion to accept (Jean/Corey) 6-0-0 passes
      • FHIR-31684 - Getting issue details... STATUS
        • motion to accept (David/Corey) 6-0-0 passes (get Corey's email)
    • RxNorm search concerns
      • current recommendation focuses on SCD
      • difficult to find specific product, dose form, etc
      • need to expand the guidance on RxNorm, but need a pharmacist with RxNorm knowedge
        • Scott will send a query to list, will assist until someone is available
    • this will wrap up the STU update. 
      • Will not be voting next week on the STU update
      • Expect to projected date completion (for WG vote) at next call
    •   


FHIR (Group)

Trackers - link to pharmacy unresolved Jira trackers 

See updates in Jira for the following

AOB

Next meeting

  • July 19, 2021 - 4pm Eastern