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Melva Peters (Scribe)

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    Meeting ID: 323 199 8494
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Web session


Jean Duteau (Chair)

Duteau Design/HL7 Canada

Melva Peters (Scribe)Jenaker Consulting
Danielle BancroftFRED IT
John Hatem
Frank McKinneyPOCP
Maggie Buchinger


Pooja BabbrahPOCP
Steve SaillardEpic
Scott RobertsonKP

Agenda Items and Notes

Joint Meeting Plans

Will not be holding WGM - will be scheduling phone calls

  • Medication List Project
    • May 7 - 5-7pm Eastern
    • May 14 - 5-7pm Eastern
  • May 18 - Q3 (1:30pm - 3:00pm Eastern) - BR&R - UNICOM Project - Joint with Pharmacy (BR&R hosting)
  • May 20 - 4-5:30pm Eastern - FHIR-I (depending on topics arising from FMG email on May 6)
  • TBC - Clinical Decision Support
  • TBC - OO - need to confirm what the topic is
  • Not needed
    • Public Health Joint Meeting
  • Need to determine if we will publish a list of meetings for what would have been the WG<

Catalogue Project

  • April 20, 2020
    • Use cases - Medications 

      • This section lists the use cases for using catalogs of medications.

        • A health care organization maintains its medication formulary and shares it to the applications used by its physicians, nurses and pharmacists to support medication prescription, dispense and administration.
        • A content vendor publishes the general catalog of medications authorized to a national market. Health care organizations of the country import subsets of this general catalog so as to synchronize their local medication formularies.
        • Variant 1: In addition to the general catalog of medications, the content vendor hosts the medication formularies of each of its client organizations who interact with the server to use their own medication formulary in their medication workflows, as well as to maintain this medication formulary over time (inserting/updating/retiring items).
        • A health care organization provides medication formularies to its patients for educational purposes.
        • An organization exposes the set of standardized vocabularies needed to support full semantic interoperability for prescription, dispense and administration of medications within a jurisdiction (e.g. a country). This reference set is represented as a generic catalog of all the medications that are usable within the jurisdiction. This generic catalog is imported in whole or in parts by the applications of the prescribers, carers and dispensers of the jurisdiction.
      • Pharmacy has been asked to review and provide updates to the use cases
      • Team is working on lab use cases - likely September ballot cycle.  Pharmacy content will follow on
      • Review of Interaction Framework 
        • 3 actors - catalog owner, catalogue custodian, Catalogue consumer
      • Use Cases - review notes
        • A health care organization maintains its medication formulary and shares it to the applications used by its physicians, nurses and pharmacists to support medication prescription, dispense and administration.
          • presume this is within an institution
          • provides a list of medications that are orderable - limited scope
          • not typically based on a specific patient's coverage for the inpatient setting
          • there may be a flag on the formulary that would indicate - need pre-authorization or if high cost
        • Patient - want to see medications that I'm insured for - there could be more than 1 of these per organization - varies by conditions, employer groups
          • may include medications that are not covered
        • Consumer or provider facing drug information - 
          • provide drug information - compendium
          • catalogue of information - could construct using a FHIR construct
        • Knowledge Base Vendors - need to flesh out this and see if it is a use case to be included
          • List of list of drugs maintained by a Knowledge Base Vendor
            • Scott has reached out to 3 Knowledge Base vendors and their interest in catalogues - First Data Bank, Elsevier, Wolters Kluwer
            • Scott will summarize and add to the minutes
          • Decision Support Modules - 
            • there may be catalogues for this - give me all drug interactions for a given drug; or indications for a give drug; patient education monographs; professional monographs
        • List of National formularies
          • Health Canada has a searchable database - not FHIR, but could be
          • Australia - national terminology server - FHIR based
            • looking at how MedicationKnowledge could be used
          • Scott to reach out to NLM regarding RxNorm
      • Melva to review use cases in IG and provide updated wording for review
      • Need to have a discussion with Catalogue project with updated wording and the possibility of a separate FHIR IG
        • could try to bring vendors to the discussion for the medication work
        • will schedule after we review updated wording
  • April 13, 2020
    • reviewing current IG
    • will review use cases and then notify Francois when ready for review
  • Review Use Cases

Updates from Workflow

  • April 27, 2020
    • looked at extensions to determine if they need to be supported - no action items for Pharmacy at this point
    • Contract Resource - currently a request, but a tracker is added to change to an event - not pharmacy related

Healthcare Product

  • April 27, 2020
    • requirement for a "commercial brand" - different brand names with different manufacturers
      • this use case exists in medication
      • BR&R has modelled this in one of their resources
    • SubstanceDefinition - BR&R
      • currently don't use this - do we need to evaluate if we should point to this
      • John will add a Jira issue if needed after next weeks call

NCPDP Updates

  • Specialty Medication Prescribing PSS update - Specialty Medications
    • April 27, 2020
      • task group meeting held - reviewed some questions
      • Frank worked on creating the guide
      • Working through requirements
      • Spreadsheet being maintained in NCPDP but linked from NCPDP 
      • Schedule a review of the IG on next weeks call
  • Standardized Medication List - Standardized Medication Profile
    • April 27, 2020
      • call on Wednesday
      • Jean to provide an update after that call

V2-FHIR Mapping



Trackers - link to pharmacy unresolved Jira trackers 

  • FHIR-26901 - MedicationDispense.subject is not mandatory
    • we believe it should be - see updated FHIR issue 


Next meeting

  • May 4, 2020 at 4pm Eastern
    • Jay Lyle - VISTA mapping
    • Specialty Medication - Review of draft IG
    • Updated wording 

Action Items

  • John Hatem to add a JIRA issue for use of SpecificationDefinition
  • Melva Peters  review use cases in IG and provide updated wording for review