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  • Or Procedure
  • Or Observation
  • <resource>UseStatement is meant more from a consumer/patient, could be the clinician, but then not the prescriber/requester/administer.
  • For CQI it is important that it is "applied/administered", as reported by clinician.  Sounds like more the Procedure (when implanted/attached).  Still tbd for DME.


  • Or Observation
  • Reflects the state of the device.  Not to be mixed with observation which is the output of the device for a particular subject.
  • Observation.device(Device) is clear.
  • Observation.device(DeviceMetric) references the DeviceMetric that yielded the observation, which in turn points to the Device.
  • If you want to know the state of the Device (collection of all DeviceMetrics) at the time of the observation then that has to be resolved elsewhere.
  • Will create clarifying language in both DeviceMetric and Observation on what aspect of DeviceMetric is used by Observation.

gForges (Devices)

Tuesday Q2

  • Observation.valueAttachment?
    • Options
      • Observation.derivedFrom => Use case would not have Observation.value
      • Observation.valueAttachment => was in DSTU 2 and it is an actual result value.
      • DiagnosticReportFrom => Inconsistent placement of an observation.
      • Observation.extension-valueAttachment =>
    • Motion to propose in Q4:
      • Define Observation.extension-valueAttachment so it can be used with FHIR R4.
        • Requires determining where to post it. 
      • Include Observation.valueAttachment into FHIR R5 build as an STU item.
      • Document clearly when to use Observation.valueAttachment vs. Observation.derivedFrom vs. DiagnosticReport.presentedForm in
        • Observation introduction
        • Element definitions
      • Kathy Pickering, John Moehrke
        • Against: 0
        • Abstain: 1
        • In Favor: 10
  • Nutrition Connectahon Update
    • Unfortunately partners did not show, but will be in Sydney
    • Worked primarily on documentation and examples.

Wednesday Q1

  • AMA - Referral PSS
    • CDS, CQI, FHIR-I, Vocab, Pt Care, Public Health
    • Overall good interest. 
    • Lot of work has already done (360X, eReferral), but mostly focused on mechanism, not content.
    • Would like to proceed.  Perhaps start with whitepaper to identify needs, gaps, etc. and then recruit.  Perhaps start with DAM.
    • Suggestions to start with whitepaper.
  • Device.status

Active - Remove "Note: For *implanted devices* this means that the device is implanted in the patient."

Inactive - Remove "Note: For *implanted devices* this means that the device has been removed from the patient."


  • [operational]Status 0..* with active, inactive, implanted, explanted, dissolved/absorbed


  • [operational]Status 0..* with active, inactive.
  • implantStatus 0..1 with implanted, explanted, dissolved/absorbed


  • [operational]Status 0..1 with active, inactive.
  • association 0..1
    • association.patient (reference) 1..1
    • assocaition.level/status 0..1 with implanted, explanted, dissolved/absorbed
  • statusReason value set: malfunction, partially function

Wednesday Q2 <supplement with Riki's notes>

Chair: Lorraine Constable

Scribe: Riki Merrick / Lorraine Constable

  • Healthcare Product Recap
  • Cancer specifications for Genetics (M-codes, v2 IG, and FHIR)

  • Clinical Genomics
    • close to publishing Genomics reporting Implementation guide
    •  will replace current extensions in 
    • R5 deprecations 
    • technical correction on examples
    • questions about searching and computational observations

  • II
    • Specifics around DocumentReference and Media for tomorrow
    • co-sponsor updates

  • BR&R

Wednesday Q4

  • v2-to-FHIR
  • No labels