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Chair:  Ulrike Merrick

Scribe: Dana Marcelonis
 

Attendees


Present

Name

Affiliation

  •  
Enablecare
  •  
Viet NguyenStratametrics
  •  
Ulrike MerrickVernetzt, LLC 
  •  
Anupam ThakurBCBSFL
  •  
Corey SpearsInfor
  •  
BCBSAL
  •  
Casenet
  •  
Holly WeeksRegence
  •  
Jeffrey DanfordAllscripts
  •  
Joseph QuinnOptum
  •  
Laurie BurckhardtWPS Health Solutions
  •  
Lindee ChinEdifecs
  •  
Lisa R. NelsonMaxMD
  •  
Linda MichaelsenOptum
  •  
Mark TaylorReady Computing
  •  
Peter Muir
  •  
Rajesh GodavarthiMCG Health
  •  
Samir JainReady Computing
  •  
Sreenivas MallipeddiMCG Health
  •  
Susan BellileAvaility
  •  
Susan LangfordBCBST
  •  
Tony BensonBCBSAL
  •  
Yan WangMaxMD
  •  
Jeanie SmithBCBSFL
  •  
Rachel E. FoersterCAQH Core
  •  
Mary Kay McDanielCognosante
  •  
Greg LindenLinden Tech Advisors
  •  
Eric Haas
  •  
Anthem
  •  
Dawn PerreaultBCBSM
  •  
Jennell Stewart
  •  
Kat RuizUNC Health
  •  
Michael GouldIBC
  •  
Tony Laurie
  •  
Karen L. ZapataAnthem
  •  
Ann GallagherOptum
  •  
eClinical Works
  •  
Frank HoneVeradigm
  •  
BCBS AL
  •  
Lynn PerrineLantana
  •  
Nancy BeavinHumana
  •  

  •  
Ralph Saint-PhardHealow
  •  
Serafina Versaggi
  •  
Seth ParadisHealow
  •  
Sheryl TurneyAnthem
  •  
Todd Johnson
  •  
Julie MaasEMR Direct
  •  
Duane WalkerBCBSM
  •  
Epic
  •  
Jennifer CurryRegence
  •  
Regence
  •  
David DeGandiCambia
  •  
Cigna
  •  
Kate ReesCambia
  •  
TIBCO
  •  
UHC
  •  
Ric LIghtHumana
  •  
TorQuailla AultmanNC.gov
  •  
Chris JohnsonBCBS AL
  •  
Cigna
  •  
Anna MeisheidCMS
  •  
Gino Canessa
  •  

  •  
Scott Stuewe
  •  
HealthLX

Minutes Approved as Presented 


This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."


Agenda Topics

Agenda Outline

Agenda Item

Meeting Minutes from Discussion

Decision Link(if not child)
ManagementReview ANSI Anti-Trust Policy



Ballot and Connectathon Schedule
  • STU ballot in September
    • Jun 30th -- NIB
    • Jul  14rd – Initial content
    • Jul 21st - Ballot QA Period Starts
    • Aug 4th – Final content
    • July 8th - Ballot sign up starts
    • Aug 9th – ballot voting starts
    • Sept 9th – ballot voting ends
  • HL7 Connectathon (Atlanta) - September 14-15


Argonaut project - FHIR Subscriptions presentation (Gino Canessa)
  • Da Vinci Alerts use case is working in conjunction with Argonaut and their work re: subscription
  • Argonaut not focused on unsolicted events, which is one area that's different from Da Vinci use case
  • Similar to CDS Hooks concept?
    • Similar pattern that outside system can receive a notification
    • Difference is that triggers are based on data events as opposed to CDS Hooks focus on user events
    • CDS Hooks not focused on lab results, for example - we'd use subscription for that
  • Topics are things the EHR would implement, and user could subscribe to those topics
  • Consumer access case is first that Argonaut is focused on
  • Payload options
    • Ping only - no PHI involved, clients will need to ask for additional info, may require multiple roundtrips
    • Identifiers only - identifiers for which events occurred, but no full resources for those events
    • Full content
  • Implicit Subscriptions - if server knows of an interested party a subscription can be implicitly created
    • EHR already knows payer endpoint
    • If endpoint changes, someone would have to manually update
    • Security beyond scope of this project
  • Intermediary/Clearinghouse use case - intermediaries can propagate notifications between facilities with no knowledge of each other
  • Security
    • Clients are assumed to be able to authenticate
    • If not authorized, then use notifications without PHI
  • Sending the resource on which the trigger occurred?
    • For example, discharge of patient from hospital - what I want is discharge medication list, but I get the encounter
    • Graph definition out of scope for v1 
    • Found that having well-defined topics are related to a specific resource
      • In case of admission, it's represented by the encounter
      • Open to discussing use cases where that's not the case
    • An encounter is not necessarily an admission
      • Topic - well-defined event ('admission', 'discharge', etc.)
        • Can be canonical or locally defined
        • Can specify an operation on a resource (create, update, delete)
        • Can be computably defined
  • If a server doesn't support 'admission' then you can't subscribe to admissions
  • If you subscribe to all the encounters, you could filter on your side, but don't want PHI you don't have a right to view
  • resourceTrigger - criteria for including a resource update in the topic
  • Da Vinci and Argonaut staying in touch to stay aligned on ongoing basis
  • Link to slides: http://bit.ly/DaVinci-Subscription
  • CDS workgroup call today has Alerts/Notifications NIB on agenda for approval

ManagementNext Agenda
  • Unsolicited model

Adjournment
Adjourned at 12:35pm ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval
FHIR Subscription Presentationhttps://docs.google.com/presentation/d/1FyX_6Nx1_NStXwJkgQ_ujSo_qf0ELQ9LNtrtpbb5Kpg/edit?usp=sharing
Draft Alert Data Mapping - Communication & Detected IssueAlerts/Notifications Mapping
Page to collect Data Element RequirementsAdmit / Discharge Alert Requirements
Page to collect Glossary TermsAlerts/Notifications Glossary Terms


Action items


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