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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 StueweDirectTrust
  •  
HealthLX
  •  
Hans Anderson
  •  
Jonas
  •  

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


Implementation Guide Update

Alerts/Notifications Draft Implementation Guide: http://build.fhir.org/ig/HL7/davinci-alerts/branches/master/index.html

  • Please review the narrative included in the draft IG and provide feedback to Eric HaasLinda Michaelsenor Ulrike Merrick
  • Looking for volunteers to work on a workflow diagram - focus is on admission and discharge scenarios
  • Viet Nguyen Chat Comment: w.r.t. the discharge trigger. We should recognize that there's a discharge order event that kicks off the process and an discharge disposition event (when the patient physically leaves the unit). The opportunity to notify and intervene is greater after an ordering event than at disposition.  There's probably some terminology differences in usage of my terms above



Mapping Review
  • communication.category refers to the message conveyed - event type = topic is different
  • communication.encounter
  • Need extension for type? No, use communication.topic for that and create a valueset that includes:
    • ED visits
    • ED visit, discharge to home
    • Hospital admission
    • Hospital discharge to home
    • Hospital discharge to other than home
    • and then we also support others - binding as extensible, so we can
      do we need a hierarchy for topics
  • For the use cases in first phase we are using encounter.status change to trigger the alert

  • In encounter you can refernce a conditition, do we also need to include condition in communication.about

  • Are we creating an extension of encounter?

  • Pushing bundle that includes the communication and other references that need to be included

  • If you need to include all the information, then need to package, else just send the communication with what is already included there

    • option 1: send only the ID

    • option 2: send ALL information in the bundle

  • Send Communication with a set of content that pertains to the type of alert you're sending, for example:
    • Admission notification would need to include Communication, Patient, Encounter and Condition in the bundle
  • Joseph Quinn Chat Comment: how about the first cut is a Minimum Viable Product Alert where the Alert contains "sufficient information" to identify the patient/member, what event, and where the event takes place?  We can discuss what "sufficient information" includes.

    • Payers receive condition in today's ADT messages
    • Group agrees Condition should be included in minimum
    • All the actors we've included in scope would require a diagnosis (i.e., condition)
  • Discharge scenario - Ulrike Merrickwill determine half a dozen codes we can include in IG as a 'starter set'
  • Legal ramifications of chemical dependency alerts, etc.?
    • Chemical dependency admissions are masked in ADT messages
    • Security aspect of dealing with sensitive information
    • Need to figure this out, but will include a statement in IG
    • Michael Gould and Jennifer Curry (jennifer.curry@regence.com) will work on a paragraph to describe the considerations re: handling sensitive data
      • Need to discuss different mechanisms for governing sensitive data - for example, certain institutions might not send any alerts because the institution/location of treatment indicates the type of treatment
    • Condition should be optional resource (it's optional in ADT messages
  • Team will create a Zulip channel for Alerts/Notifications


Homework

ManagementNext Agenda

Adjournment
Adjourned at 1pm ET

Supporting Documents

Outline Reference

Supporting Document

Minute Approval
Alerts/Notifications Draft Implementation Guidehttp://build.fhir.org/ig/HL7/davinci-alerts/branches/master/index.html
Presentation Material for today's meeting (7/3)Da Vinci Presentation 20190703Alerts-Notification.pptx
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


Create Decision from template