ChairJohn Hatem 

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Danielle BancroftBest Practice Softwarex
Melva PetersJenaker Consulting
Jean DuteauDuteau Design
John Hatem (Chair)Independent Consultantx
Scott Robertson (Scribe)Kaiser Permanentex
Christof GessnerHL7 Germany
Corey SpearsMITREx
Dave HillMITREx
Frank McKinneyPOCP
Isaac VetterEpic
Joe QuinnSmile CDR
Lawrence Lo

Margaret WeikerNCPDPx
Matt SzczepankiewiczEpicx
Peter SergentHL7 New Zealandx
Reed D. GelzerTrustworthy EHR
Shelly SpiroPharmacy HIT Collaborativex
Stephen ChuADHAx
Tim McNeilSurescriptsx
Kim RobertsPharmacy HIT Collaborative
Kent BulzaWell Health
Phung Matthews3Mx
Jack BrashierEpic
Emmanuel Obasuyi

Kim RobertsPharmacy HIT Collaborativex
Joel MontavonPQAx

Agenda Items and Notes

Outstanding Action Item List

Meeting Notes from previous meeting

Project Review

Project Proposals

Project Scope Statements

Catalog Updates (John Hatem)

  • - No Pharmacy specific issues came up on the call. 

Workflow Update (John Hatem) 

  • - No pharmacy specific issues came up on the call.  Discussed Workflow trackers. 
    • No updates to the existing patterns but it is next on LM list of to-dos.  He will notify all folks when these updates are completed.

Healthcare Product Update (John Hatem)

  • - Trackers discussed and a review of Biologically Derived Products resource
    • Are the following products typically carried by Pharmacy systems:  Lantus, Humira, Remicade, Rituxan, Enbrel, Herceptin, Avastin, Botox ?
    • Note that in BDP the item being ordered is only available via the "identifier" element.  

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
  • - no updates - still coordinating with new pilot vendor
  • - no update

NCPDP Updates (NCPDP Members)

WG18 Patient Consent TG:

  • Propose submitting the updated IG for the September HL7 ballot
  • NCPDP DERF has been submitted for the May WG Meeting
    • Connectathon participation/testing is a requirement for going to ballot at HL7. If you want this to be available as a standard, we need your participation!
  • A meeting is scheduled for April 14 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.

  • A meeting is scheduled for March 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
  • - next meeting is April 4
  • HL7 review calls have started with little participation.  Will be pivoting to work via email to the known participants, with progress reviewed on the calls.  next meeting is April 18

WG18 Specialty Requirements for ePrescribing Task Group

Meeting information can be obtained at


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 follow-up 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
  • - will need NIB for September ballot

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




      Add invariant to InsurancePlanLocation requiring address or geolocation extension



      Make FormularyItem PharmacyType cardinality 1..*



      Update CapabilityStatement to make Location SHALL



      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


Next Step



IG needs a definition of "must-support"


Cooper Thompson


Remove most must-support flags on profiles

Persuasive with Mod

Cooper Thompson


mustSupport elements aren't complete


Lloyd McKenzie


Defining URL should be anchored in THO not - InsuranceItemTypeVS

Not Persuasive

Joan Harper


Defining URL should be anchored in THO not - InsuranceItemTypeCS

Not Persuasive

Joan Harper


Defining URL should be anchored in THO not - PharmacyTypeVS

Considered For Future Use

Joan Harper


Defining URL should be anchored in THO not - PharmacyTypeCS

Considered For Future Use

Joan Harper


Defining URL should be anchored in THO not - PlanContactTypeVS

Considered For Future Use

Joan Harper


Defining URL should be anchored in THO not - PlanContactTypeCS

Considered For Future Use

Joan Harper


Defining URL should be anchored in THO not - DrugTierVS

Considered For Future Use

Joan Harper


Defining URL should be anchored in THO not - DrugTierCS

Considered For Future Use

Joan Harper


Defining URL should be anchored in THO not - SemanticDrugFormGroupVS

Not Persuasive

Joan Harper


Defining URL should be anchored in THO not - SemanticDrugVS

Not Persuasive

Joan Harper


Create Conformance Expectations section


Corey Spears

    • Motion to accept 14 tickets as proposed - Corey Spears - Dave Hill - 11-0-2
      • Corey will update the Jira issues with vote
  • upcoming block vote - will be voted on next Monday - Corey will send to Pharmacy List

Issue key





Issue with Presenting Drug Alternatives description

Persuasive with Mod.



Add Drug Covered Under Different Benefit

Considered for Future Use



Simplify FormularyItem by inlining drug codes

Not Persuasive with Modification


And a notice on the following Technical Correction

Issue key





Update Formulary Structure Diagram to use correct profile names



  • Motion to accept the dispositions was made by Corey Spears seconded by Dave Hill.  Vote was:  12-0-1
    • Corey raised a new question about when to bring bulk data export to Pharmacy for review. Corey could wait until we are seeking a vote or we could discuss earlier to bubble up any issues or concerns before we get too far. He has the overall design done. 

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
  • - Scott sent response to Aaron and Brendan

    • no response yet
  • - neither Aaron or Brendan attended today's meeting.

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 →
  • 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
  • - outstanding question on what to do with quantity
    • wording different between CDA ingredient and FHIR ingredient
      • CDA - ingredient.quantity - believe it represents the strength
      • FHIR has strength attribute
    • assume that the unit of measure for each ingredient will be the same as the doseQuantity
  • Matt has a few questions but will take more time than appropriate on this call.  Matt will send an invite for a discussion call tomorrow, April 5

FHIR (Group)

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

Any Other Business

  • FHIR-33991 - MedicationUsage - need to have multiple usage instances if you have different patterns of adherence
    • Scott to report back to Emma
    • Emma responded and seems satisfied.  Emma asked for the answer to be posted in Jira (FHIR-33991)and Zulip, and MedicationUsage narrative updated with this information  FHIR-36701 - Getting issue details... STATUS

Next meeting