Pharm Plan Minutes 2017.10.30

Meeting details

Location

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

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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.

15:00 Strategy and Vision

• The workplan is here http://wiki.ihe.net/index.php/PHARM_Roadmap
• Juergen will work a proposal for the work items for 2017, 2018.
  • to be discussed on Tuesday 31 October after lunch

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).

16:15 - 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