Pharm Plan Minutes 2017.10.30

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Meeting details

Location

Groupe Hospitalier Pellegrin https://www.chu-bordeaux.fr/CHU-de-Bordeaux/H%C3%B4pitaux-et-sites-du-CHU/Groupe-hospitalier-Pellegrin/

WebEx details:

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  • +43 125 302 1542 Austria toll
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Agenda

09:00 - 09:30 Welcome

  • Participants
    • Jose Costa Teixeira
    • Joao Almeida
    • Jacqueline Surugue
    • Stephane Spahni
    • Leonidas Tzimis
    • Juergen Brandstaetter
    • Michael Tan
    • Marc Robberecht
  • Joao is a new member of IHE Pharmacy. He is 27 years and works with Alert, the Portugese IT vendor.
  • Review and Approve Agenda
    • The agenda has been adjusted and approved.
  • Approval of minutes
    • approved the minutes of 15 and 16 June in Chania

10:00 -11:30 Current PHARM implementations (informational)

  • Case study form
  • Presentation from Jacqueline Surugue
    • the presentation was given for e-health in Greece
    • 1ste phase community pharmacy is connected to all pharmacies through a central repository.
    • It stores 4 months of history of a patient. The pharmacist can see where the patient has been.
    • For biological medicines this period is 3 years and 21 years for vaccins.
    • Phase 2 : connect also hospitals to the repository. These are drugs that are not sold in the community.
    • Phase 3 : View from doctors into the DP using the card from the doctor and the patient ( insurance card).
    • medical doctor can only view, but not update.
    • When there is a shortage, you can communicate this alert.
    • There is also a possibility to send alerts ( terror attack, pandemic)
    • The DP is ready for the DMP ( Medical Dossier ), but the DMP is not yet implemented.
    • The DP is created by the patient. The patient has to give consent.
    • All drugs from the pharmacy, including OTC are reported except for the drugs which the patients object to.
    • There is a signal that it is not complete.
    • The pharmacist also has to use a card. The patient also has to provide his social security card.
    • 99% of pharmacy and 400 hospitals are connected.
    • 36 million have a record.
    • can have a copy and view all the profiessionals who has viewed his DP.
    • Only governments ( ASNM and INVS) can view anonimous data.
    • 60% of medication errors occurs at transition of care and the DP is a powerful tool to show the medication at transition.
    • When there is no pharmacy management system you have no interface and you have to review manually.
    • Some smaller vendor companies do not have an interface to the DP. The larger systems provide this software.
    • They use PN13 from 2018. These are French standards.
  • Jose and Joao are thinking to set up standards of feeding a central system to facilitate European exchange of information.
    • Why would a vendor replace PN13 if it works? It could convince the smaller vendor companies to develop this interace.
  • Leonidas mentions directives from the European Parliament http://www.citizensinformation.ie/en/health/eu_healthcare/cross_border_directive.html
  • http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=celex:32011L0024
  • Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross-border healthcare
  • In Switzerland a patient cannot hide specific lines of information, but he can refuse to participate in the program.
  • The law in Switzerland each patient should have a record in 2020, but the pharmacists have already set up there own repository. There is a chance that a patient could have 2 repositories.
  • There are now 2 standards used in Switzerland. One from Stephane and the other from other group.
  • A consultation is expected from e-health Suisse on the proposed format.


  • Kounalakis Dimitris progress of project in Greece:
    • No news from Dimitris. Leonidas will send an e-mail to ask for input.

11:30 - 13:00 PHARM Strategy and Vision

  • Outlook, Visions
  • Shaping up Roadmap, Wiki, etc.
  • Schedule 2017/2018
    • Discussion on the F2F joint meeting with ITI and PCC, QERPH
    • This will be in Oslo.
    • Juergen would like to meet on Monday and Tuesday 11 and 12.
    • The joint with ITI , PCC , QRPH must move to Tuesday.
    • Michael to approach Jeremiah to propose the agenda.
  • Should IHE pharmacy have a joint session with HL7 Pharmacy in Cologne?
    • Clinicians on FHIR could give our end users an interesting introductio into FHIR.
    • HL7 Pharmacy exchange idea's about our MMA and UBP.
    • Juergen is not against the suggestion, but sees no personal issues.
    • Joint session with PC, PHarmacy and O&O.
    • For the meeting in June we are considering Portugal or Crete.
    • First investigate the location and costs.
    • If Porto it should be around the 25-26 in Porto. For Marc this week is OK.
  • Single landing page for the documentation. Action Item Jose.

12:00 - 13:00 Other SDO relationships and doings

  • IHE European Connectathon (16 -20th ) april 2018 Den Haag
    • The testing tools for Connectathon are out of date. Need Eric Poiseau to update the tests.
    • Investigate vendors who are interested. These vendors have to register for the connectathon. The vendors are not necessarily IHE members, but they have to pay an amount to participated.
    • AGFA is willing to participate in the Connectathon with PML, CMPD.
    • Testing scenario's have to be set up for MMA and UBP.
    • Bas van Vliet and Evert Sanders are involved in setting up the contract between IHE Netherlands and IHE Europe.
    • IHE Europe want a permanent task force to organize the European Connectathons.
  • HL7 Joint meeting in 2018 in Koeln, FHIR
    • This topic has been discussed in strategy and vision.
  • ISO Projects
    • ISO 19293 Dispense record: This document is now finalized.
    • This document describes the act and event of dispense, as well as the contents that should be contained in a report of dispense.
    • ISO 19256. Medicinal Product Dictionaries provides core requirements for systems implementing pharmacy formularies.
    • IDMP. The EMA and the FDA have made a set of standards to allow Universal identification of medicinal products:
  • substances: GSRS ( extracted from GINAS).
  • Pharmaceutical products.
  • Medicinal products.
  • Also look at standardterms.edqm.eu for translations of different codes to the different European languages.
    • The mapping between GSRS and ATC is not 1 on 1.
    • DTR20831 Medication management concepts & definitions is now published. The document is available at ISO.

13:00 - 15:00 --- Lunch ---

15:00 Strategy and Vision


15:15 - 16:00 Presentation of the MTP in Geneva

  • e-Medication implementation in Geneva.
  • History is kept forever.
  • After death the history is removed.
    • Issue is the several islands of information.
    • The treatment plan is always update.
      • the admission
      • the discharge
      • links are from the ID of the action.
  • Phase 1 standalone in production in 2012
  • Phase 2 Connected with primary systems in 2018. (hospital systems, GP systems, Pharmacy and Home Care systems).

16:00 - 16:15 --- Coffee break ---

16:15 - 17:00 Medication Documentation

  • Initial work was done by Jose and Stephane.
  • Medication lists are taken in a certain context.
  • The medication can be constitued by 4 building blocks:
    • Order ( medication order)
    • Dispense
    • Administration
    • Statement
  • Discussion on the granularity of the building blocks
  • In Netherlands we split the building block in a therapeutical and logistical component.
  • For the time being the group agrees on the concept of building blocks.
  • Action item: IHE pharmacy group should review the 20 page document.
  • Comments are collected by Joao. Please send the documents to Joao.
  • The concept is to describe all possible data which could be used in the building block.
  • It reflects the maximum of posssible fields, but since it is optional, the context could decide which attributes are to be used.

17:00 - 17:30 Formulary

  • Work on work-item
  • Medication knowledge model FHIR resource
  • Presentation of Jose on the concept of the catalogue.
  • How is this related to the HL7 project on the Medication Knowledge Query.
  • Francois Marcary is also involved in the project.
  • Medication knowledge is on top of a catalogue.
  • Jacqueline notifies that the word substance is outdated. API should be used.
  • In IDMP they distinquish active ingredients.
  • Leonidas supplies one example where the active ingredient depend on the context ( Lidocain).
  • IHE Pharmacy should focus on medication catalogue.
  • A generic FHIR resource called catalogue ( from O&O) will be used in a FHIR Connectathon in New Orleans.
    • There will be 3 projects in HL7
      • A Catalogue project
      • A BR&R project on Biomedical medication
      • A medication knowledge project ( SPL in FHIR flavour)
  • A white paper would be the next step.
  • Later on we could write a IHE Profile.


  • Medication Data collection (Jose)

17:35 - Adjourn

Pharmacy Planning Committee