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Chair:  @Jean Duteau

Scribe: @Floyd Eisenberg 

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Meeting ID: 915 0605 8769

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Meeting ID: 915 0605 8769

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    Health Data
    Duteau Designjean@duteaudesign.comyes
    Iris Health
    Wave One Associatesbrett@waveoneassociates.comyes
    Piper RanalloAmerican Academy of NursingPRanallo@aan.comyes


    Minutes Approved as Presented 

    This is to approve minutes via general consent. "You have received the minutes. Are there any corrections to the minutes? (pause) Hearing none, if there are no objections, the minutes are approved as printed."

    Previous Meeting: 2020-05-28 Meeting Minutes/Agenda

    Agenda Topics

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    Agenda Outline

    Agenda Item

    Meeting Minutes from Discussion

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    Minutes Approval

    Migration to Zoom:

    Co-chair elections - nominations open until June 15, 2020

    Reminder: Notices for Intent to Ballot (NIB) for September ballot are required by July 5

    Minutes approved as amended by consensus (corrected spelling of Brett Marquard's name).

    Marketplace Product Packaging Project

    Status on Marketplace Product Packaging Project

    Awaiting further feedback from Preston Lee regarding next steps, updates, and when specific group meetings will be held. Currently delayed due to Logica activities for COVID-19

    No activity due to COVID-19 activities.

    Military History Project

    Report from Military History Project team 

    Confluence page: Military Service History and Status FHIR Profiles Project Page  Document

    Confluence page updated. ODH and Military History will have a set of common components to allow multiple episodes for an individual, each with a distinct observation resource. FDA is working on some terminology issues for ODH.  Military History is moving to a later version of industry than ODH. The team will work with a terminologist regarding the terminology/code system. Defining concepts, value sets and gaps. I profile example using employment (episode), military service (episode) and combat (episode). Some existing profile require refactoring and may need new profiles.

    DaVinci needs to map a small set of codes to this information (e.g., Veteran Vs not-Veteran) - that is the current Lighthouse VA use case. X12 has information about how the person left military service (e.g., honorable Vs dishonorable discharge - affects eligibility for disability benefits).  

    Plans to go to the September Connectathon for HL7 FHIR. Consider whether the API can be used for veteran status for DaVinci use cases.

    US Core Methodology

    Road to US Core Discussion

    For consideration on the May 28, 2020: Additional US Core FHIR Trackers (Frank McKinney) regarding Real-Time Pharmacy Benefit Check (RTPBC) Implementation Guide - variance for profiles regarding Patient and MedicationRequest (see Tracker links bullet below). 

    Follow up errata for US Core:

    1. Potentially relaxing "must support" for some items such as race and ethnicity. By requiring race and ethnicity, we might be be requiring unnecessary information in all transmissions. Relaxing the "must support" will allow more flexibility. USCDI requires ability to support race and ethnicity. US Core purpose is broader than USCDI.

    Current expectations: Expecting errata package for US Core toward the end of June 2020 for a 2-week comment period followed by a vote for approval and publication in early July 2020.

    New errata for US Core:

    FHIR-27082 - Smoking status - remove the value set restriction from only 8 concepts and update to align with the requirements of the 21st Century Cures update rule.

    Approved. Brett Marquard/Floyd Eisenberg: 7-0-1

    FHIR-27733 US Core MedicationRequest variance – dosageInstruction

    The group had considerable discussion about the potential patient safety issue, or the potential additional burden to a patient who may have to re-justify authorization if the medication dosage and duration changes during its course.

    Motion: Not Persuasive with mod: Must support with clarification that the client should use the information in determining the days supply and the responder may use the information when determining a response.

    Approved: Frank McKinney/Brett Marquard: 5-0-0

    Not discussed by reviewed with the US Realm Steering Committee June 9 which identified no concerns for the following requests:

    FHIR-27732 US Core MedicationRequest variance – encounter

    FHIR-27731 US Core Patient variance – Patient.telecom

    FHIR-27730 US Core Patient variance – Patient.communication.language

    FHIR-27729 US Core Patient variance - us-core-birthsex

    FHIR-27728 US Core Patient variance – us-core-ethnicity

    FHIR-27727 US Core Patient variance – us-core-race

    Briefly discussed and will require additional work:

    FHIR-27770 - Need to work with Vocabulary and HTA since the current publication indicates reference to only one license year (2014) and CPT has a new license every year.  Need a reasonable way to manage the code system version. The version is based on the date of service. The OID, code and reference does not change but the version changes with every year of service.


    Adjourned at 2:07 PM ET

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