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Chair
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Scribe: Melva Peters

Dial-in Number

Web session

Attendees

NameOrganization
Melva Peters (Chair)

HL7 Canada/Jenaker Consulting

John Hatem

Independent Consultant

Peter SergentHL7 New Zealand
Andrew GrothenUSP
Tim McNeilSurescripts
Scott RobertsonKaiser Permanente
Pooja BabbrahPOCP
Jean DuteauDuteau Design

Agenda Items and Notes

Outstanding Action Item List

Catalogue Project

  • no updates

Updates from Workflow

  • no updates

Healthcare Product

  • no updates

NCPDP Updates

  • Pharmacist Care Plan - being ballot - CDA and FHIR IG
    • will be undergoing ballot at NCPDP in August
  • Formulary and Benefit - da Vinci
    • Ballot has closed
  • Joint project - Standardized Medication Profile
    • Task Group at NCPDP working on it
    • Scott will find out more information this week
    • Melva is interested in finding out how we are working together on this project with NCPDP
    • NCPDP has completed their analysis - 
      • will send to NCPDP and HL7 Pharmacy list
  • Jean will schedule a call to do our analysis

WGM Planning

  • FHIR trackers
  • Medication List IG - 2 quarters
  • John will not be available Monday Q3 and Q4
  • Work on QA for our resources with intent to move to Normative
  • Melva Petersto send out request for agenda topics to pharmacy list and Zulip

Projects

  • Dennis Tribble's Project
    • will not move forward with project
  • Real Time Benefit Check - Pooja
    • mapping of data elements
    • NCPDP is working on the B2B transaction
    • trying to mirror on patient facing side as closely as possible to those fields
    • Have started to do the mapping between NCPDP transaction and FHIR resources
    • Meeting with FM to make sure have what is needed on response side
      • Request from EHR from their system to payer PBM - payer id, BIN #, date, etc
      • There are some elements that are part of the MedicationRequest or Dispense 
    • Working on this over next couple of weeks
    • Looking to see if they can get a track at Connectathon - have reached out to a mobile app vendor
    • Balloting - target is January
  • Melva Peters to confirm PSS has been approved and forward to the TSC

Pharmacy Templates

  • July 8, 2019: Melva to reach out to Kai - complete
    • Forwarded Kai the ballot reconciliation spreadsheet - he will work on the updates
  • August 4, 2019
    • Kai to produce final version

Outstanding Action Item List

Active Medication List

  • Discussion/Collaboration page - Active Medication List
  • US Meds needs to be updated for R4  
    • June 24, 2019 - not discussed 
  • Do we need multiple Ids - US Realm vs others?  
    • June 24, 2019 - not discussed
  • Will join in a few weeks to discuss
  • August 5, 2019 - IG Planning and Contexts for Medication Lists
    • Contexts for Medication List
      • Medications that the patient says they are taking (NZ) - statements - includes OTCs and herbal remedies
      • Meds reconciliation on admission - matching on what national system says they are on vs what the patient says they are on
        • National system includes everything that has been dispensed in the country
        • Dispensed and prescribed (not dispensed)
          • do not include OTCs and herbals
          • if an OTC is on a script, then it is on a dispense
      • Discharge medications - from inpatient setting
        • would write new orders for all medications they want the patients to stay on
      • Status specific contexts for Medication Lists
        • Orders that are active for a patient
        • Orders that have been discontinued, stopped or on hold
      • All dispensed medications for a patient - included all status
      • Medication Profile
        • Orders with associated dispenses
        • Over the counter meds 
        • Statements about medication use
      • Query for use of a particular medication use by a patient - would potentially look at all types of records
      • Query based on drug classification
    • May need to consider confidentiality codes
    • IG
      • section on use cases
      • For each use case - types of use cases and query parameters
      • General guidance section
      • Context/uses
        • explain how to use existing resources
        • not likely terminology
      • Query parameters
    • Jean to start a draft an IG
      • we may have to create some draft profiles to include 
    • Will use Confluence to start capturing material
      • John Hatem will start to capture material that can be used

FHIR

Gforge Trackers - Link to Gforge Tracker

Triaged Trackers

  • #22828 - Medication should have an image
    • includes the ability to add an image in drugCharacteristic.valueBase64Binary
    • Propose adding Attachment in drugCharacteristic to support photo/image
    • Add new value of attachment
    • Update definitions
    • See Gforge for decision
  • #22148 - MedicationDispense.performer.actor
    • CareTeam doesn't fit (80/20) into the current actor roles
    • but does point out that the person counseling the patient should be able to be recorded
    • will wait until John H is available as this originates from Workflow
    •  waiting for a response from Lloyd
  • #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 

  • #16095 - Medication Knowledge Resource 
  • #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

Waiting for Input

  • #22933 - Make MedicationStatement Status extensible

    • Melva to reach out to requester for more information
    • Status now Waiting for Input
  • #20184 - binding for site in Dosage
  • #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
  • #20673 MedAdmin category CodeableConcept
    • reach out to John Silva with a time limit for response - otherwise we will close
    • Status now Waiting for Input

Any Other Business

Next meeting

  • August 11, 2019 - 4pm Eastern
    • Agenda Items