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Dial-in Number

Web session


Melva Peters (Chair)

HL7 Canada/Jenaker Consulting

Peter Sergent

HL7 New Zealand

Frank MckinneyPOCP
Tim McNeilSurescripts
Margaret WeikerNCPDP
Pooja BabbrahPOCP
John Hatem
Maggie BuchingerSurescripts
Steve SaillardEpic
Jean DuteauDuteau Design
Brett MarquardWaveOneAssociates
Amy BensonCarradora
Mike FlaniganCarradora

Agenda Items and Notes


  • will move over for calls starting next Monday
  • RTPBC team will notify CARIN Team 

US Meds Update Discussion (Brett Marquard)

  • April 6, 2020
    • US Meds 
      • discussion of proposed language for PSS
      • HL7 published the original version of the US Medications implementation guide based on FHIR R3 in 2017 to provide guidance for patient and provider access to patient medications. A future release improved the guidance, and added a section mapping FHIR to NCPDP and PMIX to support PDMP exchange. The PDMP FHIR mappings are FHIR 3 based, and based on prior industry standards.

      • Broad industry adoption of FHIR R3 in the US did not occur, and the latest US regulation requires certified HIT systems support FHIR R4, and US Core.

        • Fetching All Medications, Active Medications, and All Medications for an Encounter

        • Get All Medications

        • Get All Active Medications

        • Get All Medications for an Encounter

      • Fortunately, many of the lessons from the US Meds guide were included in the US Core upgrade to FHIR R4. For example, the following guidance is now included in US Core:

      • The MedicationDispense and MedicationAdministration profiles are not included in US Core due to minimal adoption.

      • This project will upgrade the PDMP mappings to FHIR R4, add ASAP mappings, upgrade the MedicationDispense/MedicationAdministration profiles, and remove any Medication List guidance from the guide that is superseded by US Core.

      • This project will not enhance US Core profiles, nor provide additional guidance on profiles that belong in US Core. Any relevant lessons for US Core will be logged as trackers for a future US Core release.

      • Melva will reach out to Lynn/Dave to see if we should update one of the existing PSS or create a new one.  How do we track against 3 PSS for 1 IG?
    • MedicationRequest in US Core
      • US Core needs to re-word the use of intent
      • Pharmacy is going to look at statuses in MedicationUsage and pull them out to attributes
      • For patient reported meds - pharmacy would support the publication of an errata
      • Future - Pharmacy will be also looking at the overlap between intended medications between medicationrequest and medicationusage
      • Changes to US Core - Brett will come back to work on proposed wording on a future call - there may be some additional edits that need to be made
  • Melva Peters to reach out to Lynn/Dave to ask about updating 1 of the existing PSS or creating a new one and how to track a single IG to multiple PSS
  • Melva Peters to add Brett to agenda for call on April 13th - changes to US Core
  • March 30, 2020
    • The FHIR US Meds implementation guide based on FHIR R3 published in 7/2019 with a new section for PDMP. The project ran under two different PSSs: Project #1291 and Project #1393.
    • This past week we received a request to upgrade to R4, and update the PDMP mappings to latest standards and scripts.
    • There are a few questions floating around for me:
      • US Core published in 11/2020 and now includes medication list guidance. Should the guidance in US Meds be deprecated in favor of US Core? (which I also know you requested changes to in Sydney!)
        • Active medicines list
      • The github repo is named ‘FHIR-ONC-Meds’, should we rename to match current intent, which seems to be primarily a PDMP interaction guide?
      • What is the preferred HL7 process for an upgrade to R4 and deprecation of content: STU update, ballot, other? My initial thinking is ballot, but I am curious to your input.
        • Asking pharmacy working group?
          • Update medication and dispense to R4
          • Update PDMP to R4
          • Remove anything that is currently in US Core
        • Discussion
          • Could consider pointing US core and US meds at each other
          • Needs additional thinking, as PDMP mapping is still used
          • Upgrade driven by PDMP, re-brand guide to PDMP version and continue to test IG update
          • Retain Med Admin and Dispense but leave the rest in US Core
          • Recommend new project scope statement to cover, Brett to draft proposal and come back to pharmacy to discuss next week

Catalogue Project

Updates from Workflow

  • Business process management - mappings from BPM to FHIR

Healthcare Product

  • device definition - trying to get a sense of if they can create guidance for device lists
  • John to provide link to Confluence pages, PSS and FHIR IG Proposals
  • no specific issues with Pharmacy

NCPDP Updates

V2-FHIR Mapping


  • Real Time Pharmacy Benefit Check -
    • Block Vote 3
      • Eric has asked that FHIR-25659, FHIR-25660, FHIR-25661 and FHIR-25665 be pulled from the block vote.  Comments added to issues.
      • Frank has not been able to talk to Eric - has requested multiple meetings but have been cancelled
        • Eric responded to first email with a date to meet - Tuesday - cancelled
        • rescheduled for Wednesday - Eric didn't attend
      • Will give Eric some additional time 
      • Motion - to approve the block vote minus  FHIR-25659, FHIR-25660, FHIR-25661 and FHIR-25665- Jean Duteau - seconded by Pooja Babbrah - 8-0-1 Carried

Change Request
FHIR-25659TRIAGEDNot Persuasive with Modification

use single namespace

Eric Haas2020-01-272020-03-30
Change Request
FHIR-25661TRIAGEDNot Persuasive with Modification

example request narratives

Eric Haas2020-01-272020-03-30
Change Request
FHIR-25665TRIAGEDConsidered for Future Use

use GraphDefinition

Eric Haas2020-01-272020-03-30
Change Request

table unreadable

Eric Haas2020-01-272020-03-30
Change Request
FHIR-25662TRIAGEDNot Persuasive with Modification

remove page contents

Eric Haas2020-01-272020-03-26
Change Request
FHIR-25660TRIAGEDNot Persuasive with Modification

use standard profile views

Eric Haas2020-01-272020-03-26
Change Request

redo menu

Eric Haas2020-01-272020-03-26

  • Medication List Guidance
    • Confluence Pages: Patient Medication List Guidance
      • Melva reviewed the context page
      • will be starting to put some words around the content
      • Danielle will help with content
      • Melva to start FHIR IG Proposal
    • Universal need for doing e-prescribing over FHIR
    • focus on use cases for e-prescribing IG - have an plan to create an IG
      • there are some AU requirements from e-prescribing - that can feed in to next project
    • FHIR IG Proposal has been approved
    • Medication list FHIR IG approved
      • Space created in Github 
      • Structure an outline available, no current content 
      • Group to discuss how to get content into the guide, potentially confluence 
      • Enter suggestions for IG sections within confluence IG Sections
      • Info will be migrated over to Github into the build for group to view

VA Vista - Jay Lyle

  • John met with Jay Lyle - trying to map DSTU2 to current systems
    • looking at about 100 elements in outpatient space 
    • John reviewed and met with Jay to review - closed off some
    • identified some extensions - if the attribute existed in R4 suggested he used this to model the extension
    • Jay will followup with Jean with some specific issue
    • Will continue the discussions with Jay
    • Jay will come back to Pharmacy and send updated spreadsheet


Trackers - link to pharmacy unresolved Jira trackers 

  • FHIR-26563
    • in principle, agree that we could add a reference, but need to do more analysis on how we would handle the requirements
      • bigger picture of relationships
      • continue to discuss


Next meeting

  • April 13, 2020 at 4pm Eastern
    • Brett - US Core and US Meds PSS
    • Catalogue Use Cases