PCC TC Face to Face Nov 12-13 2014

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Attendees (in person): Keith Boone, Denise Downing, George Cole, Emma Jones, Tone Southerland, Tom Kuhns, Angelique Cortez, Nagesh Bashyam (Dragon), Chris Lindop, Paul Shurman (PCD), Alex Lippett, On Phone: Charles Rica, Brian Reinhold, Glenn Marshall

CPs - updates

  • CP 0098 sdtc Ext – received email from Lisa stating that HL7 approved the scdt extensions, CP needs to be updated once the HL7 webpage has been updated, going back to Lisa, Denise and Emma will then update CP0200
  • CP 0163 – missed voting, went through ballot, received ballot comments stating the CP needs to be changed, 1 comment from Allscripts and 1 from Lisa, CP updated by Keith to include “Racecode”, send to Lisa for review, vote on it during our next CP call, notify Nancy that the next CP call is a voting call
  • Content Creator/Content Consumer is bound to CDA, digital signature wanted to reference our Content Consumer actor, take RECON & MCV and look at how the options are currently being used, Tone will complete the review

RECON on FHIR

  • Led by George Cole, Emma Jones
    • The profile will use the same Use Cases from RECON recognizing Care Providers using FHIR Resources.
    • HL7 Recon is part of the domain work CCS has done for modeling Care Planning, interoperability concern is that the work is missing the ability to communicate that the items have been reconciled.
    • The goal of the profile is to provide the user with as much reconciliation as possible and notification that reconciliation has occurred.
    • This profile may be doing tweaks to an already existing FHIR Resource, content submission deadline for new resources to HL7 is Dec 1, and discussion around this deadline was about not having time for that process to occur to meet IHE profile deadlines.
    • Suggestion to leverage use of List Resources for this year. A List Resource comparison was done by Keith Boone and he felt it had everything we needed for this profile. IHE Tech Framework vol 1 actors and transaction don’t completely need to be CDA specific, CDA on FHIR should be able to provide reconciliation for CDA documents. The FHIR List may need profiling and possible extensions, IHE group in HL7 can work together (HL7 group identified Recon was lacking). George doesn’t think using the List Resource is the right list to use, He discussed that the List has a source, date, items to be reconciled, but in RECON we talk about the entire list as a whole not just a list of separate items. Suggestions to create another entry in RECON or an attribute to add to the list was recommended.
    • Discussion around trying to get the HL7 FHIR group to work together with IHE or delegate it off to an existing group. This is a good example for defining the HL7 and IHE workgroup and what they can do. A conversation with Lloyd and Graham (FHIR people) needs to occur.
    • IHE will need to provide a FHIR version of our IHE RECON profile and subsequently provide update to PCC TF vol 2.

DAF

  • led by Nagesh Bashyam (Dragon)
    • Implement the various IHE profiles for DAF, no new metadata using the XDS metadata, limiting the document to CCDA. Discussion occurred around what is the process for an Implementation Guide. The profile will warrant PCC feedback about each sections, how will this profile work integrate into the IHE process - review and check-in looking at specific performance requirements for an extension in the US, develop a high-level (generic) cookbook that can be international, does this fit into an IHE national extension today? There are some that exist already, do this as an IHE USA extension – create a process, this would be a new construct for IHE International it’s between a Whitepaper and IHE International Profile, this is a new item for IHE International that hasn’t been done before. Vocabulary will need to be reviewed so that those aren’t constrained, technical content can evolve and the process needs to be defined and understood by IHE International or IHE USA. We envision this as a national extension that crosses multiple domains. Because of this we suspect the need for a more robust national extension model than the IHE Technical Framework templates currently provide. Our thoughts are to create some sort of national extension guide (i.e. cookbook) in addition to the actual DAF extensions to IHE profiles. We believe this should be a joint effort between IHE International and IHE USA if it is to be effective in its goals. PCC will host the efforts for this profile. This profile work should be discussed during our 4pm joint meeting with ITI.

CDS for Radiology

  • Led by Chris Lindop
    • creates a workflow issue, but IHE RAD agrees this needs to be done. The work needs to be looked at for the appropriate route (workflow) for interaction with the CDS to occur. This profile can be looked at as an RFD Profile, Discussion occurred to whether S&I Framework is solving the problem. Discussion with S&I needs to occur to see what their group is doing to solve this issue. Outside the US this will be important criteria. Current work is missing the CDS engine, CDS is off to the side – it’s a big actor. CDS Service model is correct to use not something new, packaging all the clinical data needed for the CDS service and sending it to the CDS service for a value for claims and sending the approved form back. Discussion around getting a form back could be an issue with security and displaying the form. The profile should describe how the content is sent and how we are going to send it and what you get back. Communication with the order placer occurs in HL7 2.1 don’t have the standards within CDA, need to look at the capabilities organizations can use with, Next Steps: talk with S&I & HL7 Ken Calamota regarding data to be sent and format to receive it back in.

Device Clinical Bridge

  • Led by Alex Lippet and Paul Shurman
    • We have a well-established PCD profile, but this profile will allow profiles that haven’t been used as much to become used. The profile will put the device data in a form/structure the system can use. In 2015 VHA and NLM have done work on prosthetic devices and put the data for those devices into SNOMED (671 terms). This profile has been submitted to PCC because PCD thinks they have what they need, but they need guidance with the content. Devices that contain VS data will be the main focus of the profile. Discussion around how to internationalize this if a country isn’t using SNOMED-CT. IEEE nomenclature isn’t part of MU so it’s not understood by the VHA because it’s not SNOMED or LOINC. Harmonize clinical nomenclature for devices and clinical use, device manufacturer and HC settings motivations for use will be different. Discussed when LOINC and SNOMED are updated. There is a need to harmonize device info and reference terminologies (i.e., SNOMED-CT) when dealing with the EHR they want the granularity. The profile will have 1 supplement that will involve 2 profiles integration/conversion and content piece. The content creator (already there), but the content profile should talk about how to convert from IEEE to SNOMED & LOINC and how the CDA document is created in the HEHR. The integration/conversion profile should define the interaction to do the mapping-integration. The VHA is contracting with NLM for mapping, VSAC for the semantic conversion but don’t have a terminology service.

Remote Patient Monitoring

  • Led by Brian Reinhold
    • We’ve already sent data from XDS to repositories. Need to add this into IHE PCD so they can officially participate in IHE Connect-a-thons. Discussion occurred about how to move (send) data from pts personal devices (home monitoring) into the EHR. Not included within the profile will be how HPD data transactions move into an IHE data transaction. PHMR CDA documents built on IHE PCC and HL7 Implementation Guide, but it is different dealing with the need to have a detailed IEEE observation component which is not present in PMHR (don’t have SNOMED use MDC (med device codes)). In Feb or June-July when some more work has been done we will look and see the similarities/differences. Reference Alex’s profile, this is quick to implement (HRN IF and WAN IF), CP in PCD to update WAN IF to PCD 01, Alex’s project to use Continua stuff. PCC Tech will keep an eye on both projects for similarities/differences. CTSU piece focusing on different areas in the same space, mappings & translations and the other is dealing with transactions

Remote Read

  • Led by Chris Lindop
    • Presented to IHE PCC & IHE RAD. Discussion occurred that you can have multiple schedulers, a dispatcher/router, reader, workflow monitor, read requestor. Credential lists and clinician qualifications will need to occur prior to initiating remote read. Out-of-scope for the profile is the risk for double scheduling the same read.

Workflow Resources/Framework

  • Led by Keith Boone
    • Reviewed his work, the work will be presented on the HL7 webpage, not a profile for this year, but will have a standard workflow document for IHE. Need to develop this guidance and try it out on XBeR or Remote Read and produce the artifact and instructions for creating technical artifact. Plug it into a workflow engine (BPMN), and tie it into Remote Read work

PCC Planning

  • Roadmap
    • Review rating criteria and discuss changes/additions needed
    • High level review of road map items, add additional road map items to list
    • Fill in rating for each of the roadmap items
  • Outreach opportunities
      • Nursing Sub-Committee
      • Remain under PCC or become its own domain?
      • Suggest reaching out to HIMSS nursing for sponsorship
  • Review slide outline for PCC domain presentation next week

Joint Meetings

  • PCC, QRPH
    • EDHI-WD profile co-created work done in PCC the request is move it over to the QRPH domain. Both PCC and QRPH committees decide jointly it can be moved to QRPH to become part of the family of EHDI profiles. It should be referenced in both places (PCC and QRPH). Need to figure out how to cross-link the profile. Talk with Mary about moving the profile. Move to QRPH registry, confirm if it has people signed up to test it at Connect-a-thon. Any CPs would have to be maintained by QRPH. EDHI profile is a Use Case in ROL (referral order linking) need to review that profile to ensure any references where to find the profile are changed to QRPH from PCC. Develop an action item list about the process. A motion from Lisa was proposed - move the EHDI-WD profile from PCC to QRPH, Tone seconded, Abstain - 0, Opposed - 0, For - 14
      • Process for Changing Profile Domains:
        • 1.Update PCC Vocabulary Registry and Data Dictionary on IHE.net
        • 2.Update QRPH Registry
        • 3.Move document to QRPH on IHE.net (contact Mary Jungers)
        • 4.Gazelle Testing (contact Lynn copy Steve about this change)
        • 5.IHE wiki update the elevator speech (short summary)about the profile
        • 6.IHE registry – search by profile or domain
        • 7.Publish a new cover page and check the document for reference to PCC
          • Put this process on the IHE wiki and email Amit with the process
  • PCC, ITI, QRPH
    • Refer to ITI minutes [[1]]

Rating, discussion and voting on projects

  • Refer to | Proposals Evaluation Matrix for ratings and assigned reviewers
  • Discussion: how many profiles/supplements are we going to create this cycle, we have a lot of relationships with other domains RAD, ITI, PCD, workload based on F2F meetings, calls, how are we able to deal with all the stuff, we have 8 proposals, but one is incomplete and without presentation and discussion at this meeting, the committee decided to remove Basic Study Requesting from the workload, each profile has sufficient resources to get their work done, Device Semantic Bridge would remain with PCC and Remote Pt Monitoring we can give to PCD after PCC has completed the work up to Trial Implementation then have a discussion with PCD to give it to them for maintenance (for product marketing), CDS is a PCC profile with interaction with RAD involvement & Remote Read will be completed within RAD and their cycle and PCC will support the development of Remote Read, in conclusion we have 6 profiles, discussed the need for authors to be present at the F2F meeting in February.
  • Voting: Keith moved we vote, Thom seconded, vote called Abstains- 0, Opposed -0, All For – 8

T-Cons

  • DAF - Monday morning 9am Central (10 Eastern) 1 hour call weekly starting November 24, 2014
  • Remote Pt Monitoring - send email to Brian about days/times for calls
  • Clinical Decision Support for Radiology - start Monday, December 8, 2014 10am Central, every other week
  • Remote Read for Radiology – start November 19, 2014 monthly at 10am Central
  • Workflow Resources Framework - start December 5, 2014, every other week at 2pm Central (3pm Eastern)
  • Device Observation Semantic Bridge – Alex will get back to us with time
  • RECON on FHIR – start December 2, 2014, every other Tuesday at 10am Central (11am Eastern)


General Action Items

  • Announcements
    • A evening event Wed Nov 12 at WildFire from 7-9pm. Shuttles start at 6:50pm from the Residence in,
    • Booking travel for Feb is on the wiki page and sent via email google groups, hotels are asking a guarantee form be faxed or emailed, the room blocks close in Jan 2015, the Villa hotel where the meetings are the other hotel will require you to walk to the meeting place.
    • A new HL7 IHE Workgroup has been developed, the information is on the IHE.net webpage or you can contact Alex Lippett or Chris Carr for details.
    • Connect-a-thon registration has opened up $195 for conference + networking event, badge registration is open until Nov 21st.
  • Meeting adjourned at 12pm Central