Pharmacy
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Date

 

Chair

Melva Peters 

StatusPlanned
Comments

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    Meeting ID: 323 199 8494
    Find your local number: https://zoom.us/u/aLIcTlITh

Web session

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Attendees

Please include your organization in your Zoom name.

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NameOrganizationPresent
Danielle BancroftBest Practice Softwarex
Melva Peters (Chair)Jenaker Consultingx
Jean DuteauDuteau Designx
John Hatem Independent Consultantx
Scott Robertson Kaiser Permanentex
Christof GessnerHL7 Germanyx
Corey SpearsMITREx
Dave HillMITREx
Frank McKinneyPOCP
Isaac VetterEpic
Joe QuinnSmile CDR
Lawrence LoColumbia University HIT Student
Margaret WeikerNCPDPx
Matt SzczepankiewiczEpicx
Peter SergentHL7 New Zealand
Reed D. GelzerTrustworthy EHR
Shelly SpiroPharmacy HIT Collaborativex
Stephen ChuADHAx
Tim McNeilSurescripts
Kim RobertsPharmacy HIT Collaborativex
Kent BulzaWell Healthx
Phung Matthews3Mx
Jack BrashierEpic
Emmanuel Obasuyi

Joel MontavonPQA
Robb YoungPharmIDx

Agenda Items and Notes

Outstanding Action Item List

Meeting Notes from previous meeting

WGM Agenda

  • Pharmacy WG May 2022 Virtual WGM Agenda
    • Pharmacy Templates - prep for September Ballot
      • Discussion of CDA examples/CCDA Examples
        • Use of the templates
      • schedule 1 quarter
    • PDex Formulary Updates
    • Formulary Item Resource
    • Care Plan update to Patient Care - Thursday Q1 - Shelly will attend
    • Possible Pharmacist Care Plan update - Shelly
    • CDA compound medication examples - schedule a quarter
    • PSS-2047 - Getting issue details... STATUS - Wastage

Project Review

Project Proposals

Project Scope Statements

Catalog Updates (John Hatem)

  • - Meeting on April 8th did not have any Pharmacy specific issues.  The Catalog group is working through their materials for the next ballot; reviewing examples, text and any open issues.  Next Catalog meeting is planned for April 22
  • - No meeting held on April 15, 22 or 29.  Next Meeting is May 6th. 

Workflow Update (John Hatem) 

  • - No Pharmacy specific issues in this very brief meeting.  LM stated that he is hoping to complete the updates to the workflow patterns from various trackers by end of this month.  Expects to start the work next week. 
  • - BPMN discussion - no pharmacy specific issues. 

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.  
  • - Trackers discussed for BDP and Device.  No pharmacy specific issues discussed. 
  • - Trackers discussed for BDP and Device. No pharmacy specific issues discussed. 

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
  • - no issues relevant to Pharmacy
  • - no meeting this past week. Next meeting is scheduled for April 28th

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
  •  
  •  
  • - will be participating in the Connectathon in May
    • submitting a DERF in May for NCPDP to notify that implementation IG will be in HL7 September 2022 Ballot
      • comments received will be submitted from NCPDP to HL7 for the September cycle
  •  
    • IG updates have been made
      • Updates based on the task group’s decision to broaden “patient consents” to simply “consents”
        • Enrollment forms also request authorizations from the prescriber by removing patient this allows for other types of electronic authorizations from physician, HUB, patient or anyone who may need consent or authorization to facilitate timely access to patient care.
      • Other adjustments may be suggested after review with sponsoring HL7 WGs

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
  • next meeting is April 18th - Scott will be sending out information today
  • Scott looking for mapping of FHIR to CDA Consult Note - 
    • Scott has done a mapping, but needs to be validated
    • Will raise with Structured Documents on call this week

WG18 Specialty Requirements for ePrescribing Task Group

  • Adding Patient Consent to Specialty Medication Enrollment Guide
     http://build.fhir.org/ig/HL7/fhir-specialty-rx/index.html
  • No meetings are scheduled at this time
  • - target to ballot in September
  •  
  •  
  • no updates
  • - this is rolled into the Patient Consent 

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 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
  • - no discussion
  • - submit NIB for ballot cycle

PDex Formulary (Corey)

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.
  • - no update
  • - no further questions
    • close this item

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
  • - 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
  • will be discussing later today
  • - still some questions to be resolved
    • quantity and strength attributes
    • Scott to create a Confluence page
    • needs to be clearer in the documentation in Pharmacy Templates and also in FHIR
    • original question was how to represent how to represent in CDA

FHIR (Group)

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

  • Wastage
    • PSS-2047 - Getting issue details... STATUS
    • Looking at how to represent medication waste in FHIR
      • look at schedule for a quarter at the WGM

Any Other Business

Next meeting: May 2, 2022