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Melva Peters Scribe

Dial-in Number

Web session


Melva Peters (Chair)

HL7 Canada/Jenaker Consulting

Amy Kim

Columbia University

John HatemIndependent Consultant
Tim McNeilSureScripts
Joe QuinnOptum
Jean DuteauDuteau Design

Agenda Items and Notes

Outstanding Action Item List

Pharmacy List Topic

  • March 25, 2019 as a follow up to:
    • differentiate "infusions" from "medications" - forwarded by Christof Gessner
    • Previously there was GF #20524 that was closed on March 18, 2019.  
    • Questions are:   How would a nurse organize the medications to be given to a patient in the following manner:  ( BTW this is a very common scenario in MARs).  Or maybe I should ask, how would FHIR support organizing the "to be administered medications" in this manner?  Is this all done via extensions?  
      • Intravenous: This section of the MAR would be for Intravenous medications and would exclude IV Push and IV Bolus meds
      • One time:  This section would include all medications that were one time orders.  This would not include medications that had frequencies for more than one administration of a medication. 
      • Scheduled:  This section would include all medications that had frequencies of more than one administration of a medication. 
      • PRN:  This section is not always present, but when present it would include those medications that were ordered "as needed" based on some criteria.  When this section is not present, these items are included in the Scheduled section.  
    • Once these questions are answered, Pharmacy can respond to the Zulip chat. 
    • new tracker added to be discussed


Medication Knowledge Resource (GF #16095)

    • Status on
      • Update resource proposal and submit
      • MedicationKnowledge FHIR Resource Proposal
      • Melva Peters to update with diagram
      • Review of changes made
        • Kinetics - need a better name
        • Identifiers - how do we handle an identifier at different levels of the medication
          • Use case - scan a bar code - and want to get MedicationKnowledge for a particular identifier
          • Melva Peters to add an identifier at the top level with a cardinality of 0..*
        • Need to make sure we can handle a package of 2 different drugs - e.g. clotrimazole cream and clotrimazole ovule
        • Jean Duteau to ensure we can handle and what changes may be necessary
      • New Project - to try to gather/confirm requirements - through NCPDP - Jean will review on an upcoming agenda
    • 2/25/2019 no update 
      • review resource proposal and approve next week
      • MedicationKnowledge FHIR Resource Proposal reviewed by Melva Peters.  Motion to accept proposal by Melva P, seconded by John H.  Vote: 4-0-0
      • Jean will try to join FMG call on Wednesday. Melva will join
    •  - proposal will be discussed this week
      • Melva to email Lloyd to say can't join this week.  If reviewed and there are questions, forward them to Melva/Jean
    •  - Resource proposal may be on FMG agenda this week - Melva and/or Jean to attend

Gforge Trackers - Link to Gforge Tracker

Waiting for Input

  • #19333 - basedOn with reference on MedicationDispense 

Previously discussed, with open issue

  • #19698 - re-discuss - new use case added to tracker
    • Sent reminder email to Alexander 2019-03-18
    • Response from Alexander - discuss 2019-04-08
      • There’s a principle reason for adding/substituting PractitionerRole:

        • PractitionerRole was added late before STU3 as resource and should have replaced almost every single Pracitioner reference throughout FHIR, but Was simply did not have time to do it back in STU3. This was fixed throughout FHIR in R4 with few notable exceptions and this would be one of them. If there is no principle or semantical reason *not* to add/substitute PractitionerRole, I would expect it to be a non-issue. The 80% rule just does not seem to be the most important issue in this case, overall FHIR consistency is.

          There’s a use case for adding PractitionerRole:

          - The very reason for the existence of PractitionerRole is that it is the only way to know in what capacity someone works in an Organization. There is no useful ink between Practitioner and Organization other than PractitionerRole. *If* it is important enough to make it known that a Practitioner picked up meds, then it must be relevant in what capacity this Practitioner was acting. For that you need access to PractitionerRole.

Triaged Trackers

  • #20184 - binding for site in Dosage
  • #19913 - Valueset for Dosage.method

    • This issue is related to the Zulip chat related to "infusions".  Once we have improved the value set to support "IV Push" and "IV Bolus", it should be possible to query for all medications who have a route of Intravenous, and exclude in the query those medications who have a method of IV Push or IV Bolus.
    • See Pharmacy List Topic where this same issue is discussed.   
  • #19365 - Definition for Medication List 

  • #17222  this tracker is about the assessment of whether Medication Request resource could support anesthesia gas orders.  We did receive a document from Anesthesia and will follow up with them about their use cases.  

    • John Hatem will follow up with anesthesia regarding pharmacy feedback and to assess next steps
  • #15509 - Example Scenarios for Pharmacy
  • #15136 - Conditional Dosages
    • Reach out to CDS to see if they have done any work in this space
  • Melva Peters Create examples from Oncology, NCPDP and GF19694
  • Tim McNeil to send document that has examples from NCPDP

Catalogue Project

  • Status - nothing to report - dealing with lab related content issues

Updates from Workflow

  • Status - refining definitions - no impact to Pharmacy

Pharmacy Templates

  • ballot content was submitted - no further action until ballot reconciliation

  • Medication Order and Administration - STU - need to publish

Healthcare Product

  • Status - no meeting this week


  • Status - John is exchanging emails
    • will follow the work but not formal meetings scheduled with Claude

New Projects

  • Standardized Medication Profile - Questions about the new project
    • Can the project description be updated to include more details about this project? Looking for more specifics about the project.  I noticed this is a white paper and is informative, so I am assuming it is not a FHIR "profile", correct? 
    • Jean will report back with more information from NCPDP
    •  - still waiting on some votes at NCPDP
      • Jean will update the PSS and forward out to the list for review on our next call

WGM Agenda Topics - Montreal

  • MedicationStatement - potential IG for active medication list

Any Other Business

  • RIM mappings needed for 2 attributes

Next meeting

  • April 8, 2019 - 4pm Eastern