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Attendees: Bob Dieterle, Riki Merrick, Gary Bartlett, Nandini Ganguly, Zane Shott, Hans Buitendijk, Pallavi Talekar, Briana Barnes


Topic:

  • Introductions
    • Hans Buitendijk (Cerner) – OO Co-Chair
    • Riki Merrick (Vernetzt, LLC / APHL) – OO Co-Chair
    • Bob Dieterle (Enable Care) – working for CMS and HL7 for 8 – 9 years – project lead for this Project
    • Gary Bartlett (Brighttree) – Project Manager – post acute space, home-health / hospice
    • Pallavi Talekar (EMDI) - Project Manager
    • Briana Barnes (EMDI) - Project Coordinator
    • Nandini Ganguly (EMDI) - Business Analyst
    • Zane Schott (Apria/DMEhub) - Director for IT Referral Applications with Apria (a home health supplier); DMEhub is their software
  • Overview
    • Slides = https://confluence.hl7.org/download/attachments/44499186/Post%20Acute%20Fhir%20Based%20Orders%20%2020191108%20V3.0.pptx?api=v2
    • Post-acute ordering IG = still need to make an acronym (PAO or PAFO – F = FHIR) (Durable medical equipment and home health services)
      • Project page: https://confluence.hl7.org/display/OO/DME+Project
      • Ask at order Entry questions will those be covered – for example expected flowrate for oxygen?
        • Depends if that is counted as medication that may be too complex
        • PT/OT could be covered – or med administration training
        • CMS careplan DME areas should be supported, but for home health may have exceptions
      • For workflow task and subscription are needed
        • Why subscription?
    • Looking at the diagram = https://confluence.hl7.org/download/attachments/44499186/eRX%20workflow%20V1.1.vsdx?api=v2
      • Is the first is a message bundle?
        • Expected to be a POST of a transaction / message bundle
          • Will have to decide which one and document rationale (Lloyd's write up suggested not to use FHIR messaging)
        • Task resource contains "ORC-like" elements
        • Bi-directional eReferral is using FHIR messaging in order to treat the inbound queue
        • We used the same approach for prior auth
          • Using the claims profile to get the prior
          • We are using it as a request for authorization
        • In the first arrow – using the current R4 subscription resource, rather than the retrofit proposed for Argonaut to mimic topic resource
      • Assume subscription is a many to one approach
        • If using subscription the ordering system will have to go get the info about the update of the task resource – one additional transaction for each update
    • Spreadsheet review = https://confluence.hl7.org/download/attachments/44499186/Post%20Acute%20FHIR%20based%20Orders%2020191109%20V2.1.xlsx?api=v2
      • ServiceRequest
        • OrderDetail – is not separate break down, but more info on the order
        • How do we describe the type of CPAP with 2 of this = will need to make an extension, but not on orderDetail (even though that is the term used in DME)
        • RelevantReview – may need different name, but is definitely
      • DeviceRequest is for the actual thing
      • Expected timeline for this project = balloting in Feb 2020
        • NIB deadline is 11/17 – Hans and Bob will work on this offline
        • Need to check when the IG needs to be substantively complete – per calendar think it is 11/17, but will follow up
  • Next Steps
    • Have listserve set up
    • will hold weekly calls
    • Get NIB approved


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