Pharm Tech Minutes 2010-4

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Welcome from Co-Chairs, roll call of participants.

Jaqueline Surugue, User Cochair, Hospital Pharmacist, France

Jürgen Brandstätter, Vendor, CodeWerk, Standardization, Austria On behalf of Franz Pfeifer, Vendor Cochair (excused)

Simon Letellier, Secretary, Hospital Pharmacist, France

Members

  • Michiel Sprenger, User, Nictiz, Netherlands
  • Geert Claeys, Vendor, Agfa, Belgium
  • Jose Costa Teixeira, Vendor, Agfa, Belgium
  • Isabelle Gibaud, Vendor, SIB, France
  • Charles Parisot, Vendor, GE, France

Welcomed

  • Viktor Hafner, User, Community Pharmacist, Austria
  • Francisco Machado, User, Hospital Pharmacists, Portugal
  • Orlando Rodrigues, Vendor, Glintt, Portugal

Guests

  • Fredrik Linden, Coordinator epSOS, Sweden
  • Lisa Spellman, HIMSS, USA

Lisa Spellman is asked for doing some information efforts in the United States for the existence of this group to generating non-European members to the group.


Approval of the minutes of the last TConf/meeting.

Approved!

Drafting the framework for Pharmacy:

Hospital pharmacy profiles : submission from Australia, APHP, Austria Australia Geert: No proposal received yet. We hold them in the mailing list loop. APHP

Jose: There are challenges in the logistics of drugs between hospital/hospital and hospital/community. This ist not a current use-case, but should be considered.

Jacqueline: There can be drugs, which are not available in community pharmacy (eg. in France, Portugal). For these the hospital takes the role of a community pharmacy. This use-case is already in the whitepaper.

Jose: The difference to the “real” community pharmacy use-case is small – just a change in the business rules. Austria Community pharmacy and pan hospital/community is main target. Hospital pharmacy is already covered well by HIS. Logistics is no topic. Community pharmacy profiles : submission from epSOS, Australia, Austria epSOS

Michiel: Only about unplanned care, only community pharmacy. A prescription in the home country can be dispensed in the visiting country. A dispensing event in the visiting country can sent be to the home country. Transcoding shall take place (brand-names will be resolved to substances/dose etc.) Current status: Finalizing of the specification. Life pilots shall be implemented in 2011. Extension of the use-cases: The basic use-case is a cross-border prescription/dispense event, but it’s not the most common use-case. Much more common is the prescription AND dispense in country B, but with information of the home country as support as well as communication backwards (for complete medication overview).

Fredrik: 5+3 countries do plan pilots to e-prescription/dispense. Most of the systems come from the administrational point of view, not clinical. Some of the decisions in epSOS might be not long-living. There is the expectation that IHE Pharmacy brings up new input also for epSOS evolvement.

Jacqueline: What are the next steps of epSOS / Pharmacy collaboration?

Geert: IHE Pharmacy shall official apply for getting the epSOS specifications as input. Enhancements of epSOS on existing IHE profiles should be brought in into IHE.

Fredrik: Agree to start this process. Shall be directed to him. Netherlands

Michiel: There has been a lot of development already in the Netherlands about an exchange mechanism for pharmacy. Already implemented is the overview about the dispensed medication (based on EDI and HL7 messaging and a central registry, which points to the pharmacy which holds the actual data). Attitude is changing from focusing on the own country to a more international collaboration. Experience could be brought into this group.

Discussion for decision :

Introduction: What’s our task to do? Jürgen: Gives an overview about the structure of an IHE Integration Profile

Decision 1: Create/develop 1 or 2 profiles?

Strong distinction between community and hospital: community is “document-based”, hospital is “message-based” That results in dividing at least into 2 different Integration profiles (although there are wide areas of similarity, eg. The information model)

Decision:

Integration profile 1: “CMPD: Community Medication Prescription and Dispense”

Integration profile 2: “HMW: Hospital Medication Workflow”

Integration profile must cover the whole use-case

Discussion about staying to the “pharmaceutical advice”:

Michiel: epSOS has decided not to use that, because there are member states, where this concept is not used

Viktor: It’s called “4 eyes concept” in Austria. This function is crucial for the profile being accepted in Austria.

Jose: Effort is significant. We should keep it simple in the first step and add it later.

Francisco: This concept is important. It should stay in.

Isabelle: Actor “Pharmaceutical advisor” plus transactions as option

Decision: We take it as it is and try to include it in the profile. If the editorial team can’t manage to hold the timeframe, it put this to decision again.

Discussion about “Workflow”

Decision: Dispense will be a Document and can be persisted in XDS Transactions: Submit-Prescription, Retrieve-Prescriptions Prescription will be a Document and can be persisted in XDS Submit-Dispense, Retrieve-Dispense The transient aspects of “Ordering” are excluded in the profile. This should be generally discussed together with ITI in conjunction with all other “Ordering”/Workflow topics (e.g. Lab, Referral, etc.) We leverage the outcome of ITI in the future Discussion about “Query recently dispensed drugs” Michiel: This is an essential functionality for quality assurance, which is required in many European countries. Jose, Jürgen, Viktor: This is not part of the basic workflow, it should come in a second step

Integration profile 2: “HMW: Hospital Medication Workflow”

A Volume 3 is created containing with Content Specifications.

Kept under authority of Pharmacy but according to the rules of PCC

Contains all content specifications (documents or messages)

Use case decision

Volunteers for editorial work to use-cases:

  • Coordination

Jürgen

  • Community

Jürgen Viktor epSOS Michiel for Netherlands

  • Hospital

Francisco, Orlando Jose Jacqueline Simon Isabelle (just review)


Selection of relevant standards

identify options and decision process. Based on known existing implementations and knowledge editors.

HMW : HL7v2.5 / HL7v2.6

CMPD : HL7v3/CDA, XDS

Roadmap/ schedule for the forthcoming year

Plan 2 F2F meetings°: 7-8 June (Paris) and 9-10 September (Brussels).

Tcon Thrusday 16:00-17:00 (Paris, Brussels): May 27th, June 24th, July 22th, August 26th, September 23th, October 28th, November 25th, December 23th.

  • Version for public comment°: end of September
  • First versions of the 2 profiles must be ready end of October.
  • Goal : presentation and test at the next IHE Europe Connectathon.


IHE Pharmacy input for IHE ITI Roadmap 2010 (strategic decisions)

  • Develop an Interoperability Solution for cross-enterprise ordering of a service (e.g. prescription)

Possible standards : HL7v3 messages , XDS/CDA

  • Develop an Interoperability Solution to link results (e.g. dispensed medication) to an order (e.g. prescription)

Possible standards : E-R module in CDA document, XDS metadata

  • Develop an Interoperability Solution to manage state of a document / workflow (e.g. prescription state)

Possible standards : CDA element, ebXML Lifecycle management

  • Develop an Interoperability Solution for a document oriented aggregation service (e.g. aggregate individual medication documents into a medication history document)