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Web session

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Attendees

Please include your organization in your Zoom name.

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NameOrganizationPresent
Danielle BancroftBest Practice Software
Melva Peters (Scribe)Jenaker Consultingx
Jean DuteauDuteau Design
John Hatem(Chair)Independent Consultantx
Scott RobertsonKaiser Permanentex
Christof GessnerHL7 Germany
Corey SpearsMITREx
Dave HillMITRE
Frank McKinneyPOCPx
Isaac VetterEpic
Joe QuinnSmile CDR
Lawrence Lo
x
Margaret WeikerNCPDP
Matt SzczepankiewiczEpicx
Peter SergentHL7 New Zealand
Reed D. GelzerTrustworthy EHR
Shelly SpiroPharmacy HIT Collaborativex
Stephen ChuADHAx
Tim McNeilSurescriptsx
Kim RobertsonPharmacy HIT Collaborative
Kent BulzaWell Healthx
Phung Matthews3M
Jack BrashierEpicx
Emmanuel Obasuyi

Kim RobertsPharmacy HIT Collaborativex

Agenda Items and Notes

Outstanding Action Item List

Meeting Notes from previous meeting

Project Review

Project Proposals

Project Scope Statements

Catalog Updates (John Hatem)

  •   - I was unable to attend but no Pharmacy specific issues came up this week. Next meeting is scheduled for Friday, April 1st. 

Workflow Update (John Hatem) 

  • - Discussed Contract issues.  No Pharmacy specific issues came up this week. 

Healthcare Product Update (John Hatem)

  • - Discussed BDP trackers and Device trackers.  No Pharmacy impact. 
    • new element to device - Link attribute
      • no changes needed for our triple lumen catheter example

EHR conformant reconciled medication list (cRML)

  • a sub-project of EHR Reducing Clinician Burden
  • developing a use case/scenario of medication reconciliation between prescriber, patient, assistant, and social worker.  excludes MedRec by pharmacist.  Looking at how technology can reduce the time required by prescriber/assistant, improve the quality of the medication list, and improve patient care (reduce errors and frustrations
  • Scott, Shelly and John at attending
  •  
    • cRML group has pretty much completed the use case/scenario
    • A vendor has come forward to implement system(s) to illustrate the "improvements" expressed in the use case. 
  • - Update from March 3rd meeting - John and Scott attended the meeting.  No Pharmacy concerns at this time
  • No meeting this week.  I have provided an overview document on Medication Reconciliation to get agreement about what it is.  I will share the content in a future meeting. 
  • - no update

NCPDP Updates (NCPDP Members)

WG18 Patient Consent TG:

  • Propose submitting the updated IG for the September HL7 ballot
  • Propose submitting NCPDP DERF at the May WG Meeting
  • Meetings are scheduled for March 24th, and 31st at 11:00 am Central time

MC Consumer and Provider RTPB Standards Monitoring Sub-Task Group

WG14 Consultant Pharmacist TG

  • Continue the process of updating the current C-CDA guidance document, “Consultant Pharmacist Consult Note v1.0: Guidance on the Use of the HL7 CDA Consolidated Templates for Clinical Notes R2.1 Consult Note”, to incorporate FHIR Resources.

  • Meetings are scheduled for March 3rd, 17th and 31st at 10:00 am Central time
  •  
    • will be presenting to StrucDoc and PtCare
  • expect kick-off announcement this week
  • Discussed adding additional use cases to document.
  • March 7th - the IG will have its kick-off announcement shortly
  •  
    • had kick off meeting today
    • will be starting biweekly meetings on March 21st
    • expect to have ready for September 2022 Ballot Cycle
  • no meeting today

WG18 Specialty Requirements for ePrescribing Task Group

Meeting information can be obtained at https://dms.ncpdp.org/

Projects

Pharmacy Templates

  •  - discussed how to add an extension to support Marketing Authorization Holder
    • Christof will follow up with stakeholders to discuss Jean's suggested approach
  •  - Christof presented discusses to the group and trying to convince them about the MAH - 1 org and will be either manufacturer or MAH
  •  
    • Georgio is trying to get this ready for May 2022.  Christof will be working with Georgio.  still need to get PDF from Kai.
    • CDA-2075 - Getting issue details... STATUS - non persuasive, Christof / John H 13-0-0  (Christof would have withdrawn but Jira workflow wont allow it to be withdrawn)
  • - work underway to complete the work for ballot
    • Kai has been involved in discussion
    • Final content deadline for May ballot - March 27th
      • Pharmacy needs to approve final content on March 21st!
    • Melva to followup with Giorgio to get status on the content for ballot
  •  
    • HL7_PHARM_Templates-R2-v201.pdf
    • just received content yesterday and have not had a chance to review - today is the last day we can approve content for ballot
    • Motion - Melva - Scott - to approve the delay of the content for the September 2022 Ballot Cycle given the lack of review - approved 9-0-4 
      • discussion of doing an evote

PDex Formulary (Corey)

  • continuing to work on
  • Expect some items to vote on for next week
  • PSS will need to be reviewed by Pharmacy
  •  
    • Formulary IG under general PDex PSS, adding bulk data requires a revision to PSS
    • Draft in Word, not in confluence yet
    • added bulk data, "authorized individuals and organizations", additional use cases (e.g., future care), access by non-members
    • will be creating new resource
    • question related to "individuals" should include non-individuals (parties). (not a request for change)  
    • question if there any privacy concerns (no PHI)
    • on HRex diagram - PSS work is built on top of HRex, there is more in HRex that is not used in PDex
    • Motion to accept changes to PSS:  Corey Spears / Tim McNeil  7-0-1 PASSED
    • no other updates to report
  •  
    • email to go out for a block vote on these issues

      Issue key

      Summary

      Resolution

      FHIR-36143

      Add invariant to InsurancePlanLocation requiring address or geolocation extension

      Persuasive

      FHIR-36142

      Make FormularyItem PharmacyType cardinality 1..*

      Persuasive

      FHIR-36137

      Update CapabilityStatement to make Location SHALL

      Persuasive

      FHIR-35365

      FormularyItem extensions need descriptive descriptions

      Persuasive with Modification

    • Motion to approve the Block Vote: Corey Spears / Scott Robertson: 11-0-1
  • - Corey
    • FHIR-35586 - Drug Tier CodeSystem
      • defined in formulary IG
      • question of whether it is mature enough to move in to THO or if there is an existing code system that should be used
      • expect that payers will have their own - will be extensible
      • not aware of code system that could be used
      • leaning to finding this either not persuasive or considered for future use
        • not persuasive - if need to get implementation experience before making a final decision 
        • considered for future use - will consider doing this in the future
        • Lean to "considered for future use" unless they are really guide specific
    • 13 items (including FHIR-35586)
      • Block Vote 2 - Corey will send them to the Pharmacy List and we will vote on March 21st
    • There were actually 14 in the block votes (not 13 as noted above)

Issue key

Summary

Next Step

Reporter

FHIR-34526

IG needs a definition of "must-support"

Persuasive

Cooper Thompson

FHIR-34527

Remove most must-support flags on profiles

Persuasive with Mod

Cooper Thompson

FHIR-32618

mustSupport elements aren't complete

Persuasive

Lloyd McKenzie

FHIR-35587

Defining URL should be anchored in THO not hl7.org - InsuranceItemTypeVS

Not Persuasive

Joan Harper

FHIR-35588

Defining URL should be anchored in THO not hl7.org - InsuranceItemTypeCS

Not Persuasive

Joan Harper

FHIR-35589

Defining URL should be anchored in THO not hl7.org - PharmacyTypeVS

Considered For Future Use

Joan Harper

FHIR-35591

Defining URL should be anchored in THO not hl7.org - PharmacyTypeCS

Considered For Future Use

Joan Harper

FHIR-35592

Defining URL should be anchored in THO not hl7.org - PlanContactTypeVS

Considered For Future Use

Joan Harper

FHIR-35597

Defining URL should be anchored in THO not hl7.org - PlanContactTypeCS

Considered For Future Use

Joan Harper

FHIR-35586

Defining URL should be anchored in THO not hl7.org - DrugTierVS

Considered For Future Use

Joan Harper

FHIR-35596

Defining URL should be anchored in THO not hl7.org - DrugTierCS

Considered For Future Use

Joan Harper

FHIR-35598

Defining URL should be anchored in THO not hl7.org - SemanticDrugFormGroupVS

Not Persuasive

Joan Harper

FHIR-35599

Defining URL should be anchored in THO not hl7.org - SemanticDrugVS

Not Persuasive

Joan Harper

FHIR-36264

Create Conformance Expectations section

Persuasive

Corey Spears

    • Motion to accept 14 tickets as proposed - Corey Spears - Dave Hill - 11-0-2
      • Corey will update the Jira issues with vote

Ongoing Questions

Representing FHIR Compound Medications

  • Aaron Berdofe and Brendan Keeler will be joining to discuss how to represent compound medications
  •  
    • a particular question of Aaron's group: contrasting a product (manufactured) with expressed ingredients vs a compound to be made from multiple specific ingredients
    • also questions of how to express strength of the compounded product
  • action item Scott to reach out to Aaron and Brendan
  • - Scott to reach out
  • - Scott has not reached out yet

Compound Medication CDA Examples

  • review of proposed examples using CDA for recording compounded medications
  • <!-- Example mixture:             diphenhydrAMINE hydrochloride 3 mg/mL ELIX 1.6667 mL, lidocaine 3 % SOLN 1.6667 mL,             aluminum & magnesium hydroxide-simethicone 400-400-40 mg/5mL SUSP 1.6667 mL →
  • https://github.com/mjszczep/C-CDA-Examples/blob/Drug-Mixture/Medications/Drug%20Mixture/Drug%20Mixture%20(C-CDAR2.1).xml
  • Scott and Melva will work on this and provide example
  •  
    • Scott is getting closer on updating the examples ... revising Matt's and creating one or two "more normal" compounds
  •  
  • - Scott has not been able to work on examples
    • hope to get them to Matt by tomorrow
  • - Scott provided examples last week
    • Scott to reach out to Kai about example in Art Decor
    • discussion of what denominator means - it is the concentration in the final product

FHIR (Group)

R5 Normative Resources

QA freeze is midnight Eastern Sunday Mar. 6

    • Is it still our plans to Medication and MedicationRequest Normative?
      • no issues for Medication, but we have some issues triaged for MedRequest
      • still our plan to take Medication and MedicationRequest normative - Jean will respond to Lloyd
  •  - Jean has informed Lloyd of Pharmacy plans to take Medication and MedicationRequest Normative
  •   - R5 balloting has been cancelled.  FMG is asking for feedback on future plans for R5.
  • - will be balloted as STU in September - may not see normative ballot for 3 years
    • option 3 - R5 will have all content but no promotion of content to R5
  • - Do we need to keep this in the agenda?
    • this agenda item can be removed

Trackers - link to pharmacy unresolved Jira trackers (see trackers for details / resolutions)

Any Other Business

  • Do we have any issues with BDP here is the link:  BiologicallyDerivedProduct - FHIR v4.6.0 - no discussion on  
  •  
    • scope of medication - John to put it out the list to see if the scope makes sense.
    • make make sense that we add Biologically Derived product to our resources
  • FHIR-33991 - MedicationUsage - need to have multiple usage instances if you have different patterns of adherence
    • Scott to report back to Emma

Next meeting

  •  

Tasks

  • Melva Peters to reach out to CARIN about who is working on the RTPBC project
  • Melva Peters - check with STU expires for RTPBC IG
  • Melva Peters  to reach out to Kai and Giorgio to thank them the work and letting them know about the delay - due to the inability to review the final content in time for the vote to approve going to ballot
  • Scott M. Robertson to reach out to Kai about example in Art Decor