2020-09 Patient Care Virtual WGM Attendance



Added to Doodle Poll

Mon, Sept 21

2pm-4pm Eastern

1pm-3pm Central

PA hosting PC to discuss encounter/condition with FloydPA Hosting

4pm Eastern

3pm Central

AdverseEvent - PC/BRR Yes

Tues, Sept 22

10am Eastern

9am Central

2pm Eastern

1pm Central

Pharmacy FYI - medicationUsage - taken/not taken attribute and compliance attributePharmacy

4pm Eastern

3pm Central

  1. CarePlan report out
    1. MCC
    2. Gravity
    3. PACIO
    4. CP DAM
    5. etc.

All HL7-Virtual-WGM-all-things-CarePlan_2020-09_final3.pdf slide deck

  1. LHS - CareTeam (LHS has agreed to this time-7/28)
Yes added to doodle poll- confirmed and reconfirmed...
Wed, Sept 2310am Eastern

9am Central

CIC will host both CIMI and PC

  • cancer
  • mcode
  • pain assessment


need to cross reference this with CIC.  They are also expecting CIMI on Weds at 10 ET.  Combine them all?

2-4pm EasternPA/PC Joint session

4-6 pm EasternGeneral Session

Thurs, Sept 24

10am Eastern

9am Central

4pm Eastern

3pm Central

PC/SD (SDWG has agreed to this time - 7/30) (FHIR-I has agreed to send rep - 8/9)

Please Scroll down to Mapping C-CDA Participations to FHIR US Core, C-CDA on FHIR and Provenance

Mapping Author and Informant Information to FHIR US Core Profiles for FHIR Resources Derived from C-CDA Documents

Fri, Sept 2510am Eastern

9am Central

PC with Vocabulary - agenda belowYes
12 - 2pm EasternFM / Vocab / PC - Encounter/Claim Diagnosis rank/priority with FloydFM


Attendance:  2020-09 Patient Care Virtual WGM Attendance

Monday (4pm Eastern) BRR/PC AdverseEvent

Virtual Guidance

Recap last BRR/PC joint discussion

Patient Care FHIR Backlog - specific to AdverseEvent

Will reschedule monthly BRR/PC conference calls on Thurs at 5pm Eastern

Adjourned at 5:40pm Eastern

Thursday (4pm Eastern) PC + SDWG


David Riddle (presenter)

Reasons why PC did not feel condition recorder

Friday (10am Eastern) PC + Vocab



Pain project

Nathan presented the Pain deck.

Pain is the most commonly documented symptom. The Nursing Knowledge Big Data conference has been a key driver to standardizing this data element. The project (sponsored by CIC, co-sponsored by CIMI & PC) has produced a mature LOINC panel to represent the state of the art information model for pain.
Lisa: Gravity has followed a similar trajectory: 1. assemble the experts, 2. review existing documentation and practice; 3. engage Regenstrief to help harmonize and iron out issues with putting the model into a Questionnaire context.
Next step: putting the Questionnaire into a FHIR IG, with guidance on inferring other resources (Observation, etc.) from the QuestionnaireResponse.
Looking for connectathon partners, since they must conduct a connectathon prior to ballot.
a. we need to clarify connectathon requirement. It clearly should not apply to informative specifications. And can it be fulfilled outside of HL7-sponsored connectathons? Question for Clinical Steering Division.

b. Once this is clear, the project team will need to decide whether to ballot an informative specification sooner or a FHIR STU later, and how much later.

c. MaxMD offered to assist with testing & possible "connectathon."
CIC as the sponsoring WG will lead these efforts.Russ suggested Anesthesia should be involved. Others: PACIO, Patient Empowerment.

Absence of Allergy
Russ points out that an allergy is a clinical entity in the world that is expected to persist. "No known allergies" is not. AllergyIntolerance should not be where we record "NKA."
Is this a patient safety issue? If an application were to assess a patient record and found "no allergy to X," it might misread "X" as a risk and cause the provider to choose another, less appropriate medication.
Michelle will check to see if this issue has been voted on in the past. If so, there may be a process to resurrect it.
Michelle further points out that NKA is in the US Core, so there is some momentum. Change is unlikely for purely semantic reasons.
Lisa has an idea for how to profile this.

CDA & FHIR condition/allergy status
Condition clinical status seems to align.

Action item: post list somewhere. Jay to put on confluence; if there's a better place, we'll discuss.
Action item: We need a concept map. Jay or Rob H
CDA has changed their binding to dynamic, so if the selected SNOMED codes are deemed incorrect, they can be updated. Rob thinks this is unlikley.

Verification status
This is not in CCDA, but Giorgio Cangioli has proposed a problem template that consolidates CCDA and IPS which does incorporate a verification observation using the FHIR values.
Action item: STU comments in support of this
Action item: IAT topic on the element for implementers (no takers yet)
Action item: We need a concept map. Jay or Rob H

Verification may be condition-specific. Entered-in-error may result from an administrative rather than clinical process. It's not clear that either issue affects the element.

Concern status
Lisa suggests a new template for Problems that elides the Concern act might be taken up enthusiastically by implementers. If so, the mapping problem goes away, for future data anyway.

We will re-start meetings to finalize edits for publication. Watch for announcements. (Jay)

Status of Term Info
Expired DSTU. Team debating whether to publish or retire. CDA quality criteria require conformance, but it's not clear that it's followed.
Action item: request removal of quality criterion (Lisa)

FHIR publication includes "maps," which include SNOMED maps. These seem immature. We'd like to understand expectations around these maps.