PCC TC Face to Face April 31-May 3-2018
April 2018 F2F Meeting Day 1
Attendees: Steve Moore, MIR Tone Southerland, IQVIA Michael Clifton, EPIC Gila Pyke, Cognaissance Denise Downing, AORN Nemanja Mienkovic, ASIP Emma Jones, Allscripts Raffaele Giordano, Arsenal IT Celina Roth, HIMSS Yvonne, HIMSS Andrea Fourquet, eHealthsign Daniel Venton, Allscripts George Dixon, Allscripts Amit Popat, EPIC Chris Melo, Phillips Thomson Kuhn
|Discussion:
Agenda Update : Switched CDA Document Summary to start at 9:30am so that PCS Summary can be moved to the afternoon
Workflow CP Loinc Codes
• Arsenal IT submitted 4 CPs proposing that we create our own TypeCode OIDs instead of waiting on LOINC to assign them, since LOINC does not manage non-clinical OIDs
• PCC will create 4 TypeCodes and update the consolidated IHE wiki where the formatCodes are with TypeCodes
• Gila will add this to the joint meeting agenda to help us understand how to assign typeCodes
CDA Document Summary
• Emma presented CDA Document Summary volume 2, and updated the Template ID OIDs in the PCC Wiki
• Emma will work with Tone offline to work out the Notes section and how to follow the CDA IG
Dynamic Care Plan (DCP)
• FHIR based profile meant to support the care planning process
• New actor, new transactions
• Task still needs to be profiled
• Gila to add “IHE Constraint Cardinality” column to the joint meeting agenda
IHE FHIR Profiles - Conformance (presenter John Moehrke)
• Process menu item from Wiki left hand menu
• FHIR Conformance Resource Templates contain guidance for profile writers who are using FHIR. What additional things can you do when profiling FHIR? This is just the current thinking, not the ultimate way we will profile FHIR as new IGs are published
• You have to do this step for any of the publication systems so far o Process is described under “Current Guidance on ‘use’ of FHIR o A conformance resource is a way to convey metadata about datatypes, resources and API features of the FHIR spec that can be used to create derived specifications o Uses CapabilityStatement, StructureDefinition(s)(called profiles in simplifier), OperationDefinition, SearchParameter at minimum. Other Conformance module resources are still in flux. o John recommends that we use the STU3 Conformance resource as a manifest of the required elements
• A capability statement is a definition of an actor
• An implementation guide in HL7 is equivalent to a profile in IHE
• A FHIR profile is a subset of StructureDefinition that puts constraints on a (single) resource, such as limiting the cardinality, defining the value set to be used, define fixed values, etc
• Why should we publish them? o They are machine readable o There is tooling that has been built to help create the conformance resources o Conformance resources can be used by servers to test whether an app request is compliant with an IHE profile o There is also tooling for application writers to import definitions into their tooling, which will force them to fill out all the required fields
• Wiki Profiles page really needs to be up to date!!!
• Index of ftp.ihe.net/TF_Implementation_Material/fhir/CapabilityStatement/ contains machine readable capability statements where you can publish them
• We then use “Simplifier” to publish them to the registry.fhir.org registry of conformance resources, which can point to the IHE wiki for the relevant profile. Anything mature should be updated to the FHIR registry
• Publish examples of messages in the IHE domain implementation guide section of the implementation material wiki, not in the fhir directory which is limited to capability statements
• Encourage IHE to get enterprise licenses to the Simplifier tool
• TODO: All profile writers, upon completing their profile, to create a: o Capability Statement o Implementation Guide o Structure Definition(s) where you add constraints on a resource
• Guidance on how to do this is on the wiki, and John is happy to help
• Zulip, at chat.fhir.org is a group chat with an IHE stream that you can discuss any IHE topic. John can also use the announcements stream to announce public comment for FHIR IHE profiles
PCS Summary
• Replace volume 2 with a statement “no new transactions” and delete everything
• Reviewed volume 4 and vol 6 content
May 1, 2018 Meeting Day 2
Attendees:
Michael Clifton, EPIC Gila Pyke, Cognaissance Denise Downing, AORN Nemanja Mienkovic, ASIP Emma Jones, Allscripts Raffaele Giordano, Arsenal IT Celina Roth, HIMSS Yvonne, HIMSS Andrea Fourquet, eHealthsign Amit Popat, EPIC Thomson Kuhn
Discussion
Agenda Update: Switched CDA Document Summary, PCS, and DCP
CP Discussions
• CP 222 has been applied to a version of RPM that is in the current published folder, but does not match the version on the IHE.net site.
• Current published TI is FHIR DSTU1, and Brian said that we cannot publish the DSTU2/STU3 version until HL7 has finished the device debate
• 4 things need to happen
o Apply the CP to the old version of RPM, IF it is worth updating o We need to reach out to Brian about updating RPM. If he can do it this year, we skip updating the old one. o Warn Mary that RPM will be republished this year. o The updated CP needs to be approved Amit moved to approve the CP Gila seconded No objections
• Denise to move CP 222 to the Approved folder
• CP 228 – Emma is making the changes to DCP now as part of the Plan Definition updates to DCP
o Need to talk to Chris Melo about this one and then agree on this committee-wide going forward. o Gila added the question of pointing to base FHIR for base FHIR operations or to FHIR STU to the joint meeting agenda
FHIRPlanDefinition: DCP
• Discussed DCP and XDW interactions • John Moerhke joined us to discuss what to do about FHIR and testability
CPs Work continued
• Moved Andrea/PCS topics to Wednesday due to computer issues
• Discussed CP 228 with Chris Melo, will discuss it again at the joint meeting
o Will approve CP 228 after joint meeting discussions are complete, since everyone who had a stake in the ballot was present for resolution o Needs to be moved into the approved folder once approved
• CP 227 approved without changes. o To be moved to approved
• CP 267 assigned to Lori, needs to be moved to assigned
• CP 272 assigned to Gila o Gila to update with volume 2 content o Denise to warn Mary that volume 2 will be republished this year o Move to ready for ballot
• CP 224 has been incorporated into BED by Emma, Emma will send to Denise to put in CommitteeSubmitted and notify Mary that it will be republished
• We will do a May 2018 CP Ballot, with CPs 223, 224, 263, 266, 272 o Last ballot for this publication cycle o Ask Lori about 267
• Schedule 2 CP calls to get updates and do ballot resolution on May 25 and June 8 12-1:30pm CT
• Process for updating documents discussed
CDA Document Summary Section discussion
• Emma reviewed CDA Document Summary changes. The group discussed user/developer expectations and came to resolution with no changes.
• Gila moved to approve CDA Document Summary Section for public comment. Michael Clifton seconded. No objections, no abstentions, no further discussion. SO MOVED. PPOC, eNS, GAO deprecation discussion
• Notes taken direction on the PCC Deprecation page: http://wiki.ihe.net/index.php/PCC_Profile_Deprecation#Profiles.2FNational_Extensions_in_Intent_to_Deprecate.2FDeprecated_Status
• eNS post-mortem, why did this seem like a good idea to write the profile but didn’t get implemented? o Nurses were not EHR customers, so they weren’t buying o The nurses at the time who were writing the use cases in the nursing sub group were united in their belief that this was needed to solve their documentation problems and their care coordination problems, but nobody went through the vendors to see if they would implement something like this. There was no vendor interest at all because vendors were not listening to nurses at the time. And then meaningful use happened and anything not MU related stopped (so bad timing was part of it). o Exchanging the new care plans may help with the problem too. o 2 lessons for the planning committee: Make sure the vendors are committed or there is no point going forward (we already started this last year) No more surprised from the federal government! Prioritize (US) federal priorities during planning. Bring this to the board as well.
• Tone and Amit to talk to DCC about the idea of a notice of intent to deprecate status on the wiki. Need to update the wiki, including creating a status/category page.