Pharm Tech Minutes 2017.06.16

Meeting details

Friday, 16th June 2017, 8:00-16:00 CET 9:00-17:00 EEST (Eastern European Summer Time)

Attendees:

• Juergen Brandstaetter
• Marc Robberecht
• Jacqueline Surugue
• Leonidas Tzimis
• Stephane Spahni
• Jose Costa Texeira
• Michael Tan
• Oliver Egger

Location

Chania General Hospital 4th floor, Room 300.B2.17

(Google maps: https://goo.gl/UMPwGd https://goo.gl/CpQXIk )

WebEx details:

https://phastinternational.webex.com/join/ihepharmacy | or go to https://phastinternational.webex.com and paste 956 796 372

Access code: 956 796 372

9:00 - 10:00 - Welcome with General Manager

Meeting with the general manager of Chania General Hospital. Discussion about IHE strategy ( due to Lower Austria).

10:00 - 10:20 Administration

• Work on MMA profile
• Rename other IHE profiles to Community or Hospital profiles.
  • decision to leave MMA as it is for the time being.
  • scoping is explained in the profile.
• Cross Check of the profile ADM with MMA.
• Summary key aspects - structure and data (for aligning with ADM)

10:20 - 12:30 CDA/Community Administration

• Work on ADM profile
• change proposal for renaming.
  • CP 123: Editorial changes
  • CP 126: Editorial changes
  • CP 127: Editorial changes on validity period.

The abbreviation of Community Medication Administration is CMA.

• Issues discussed: vomitting ( to dealt thru adverse event).
• Align fulfillment notes on dispense to CMA ( CP 134).
• Adverse event can be documented in PADV.
• Status of PADV does not allow "note". It only has: OK, Change, Refuse etc. Would require a CP. To be discussed.
• Note added: not administered drug. Administration is set to completed with quantity on zero.
• The impact on administration not given on the workflow is left as open issues.
• Glossary terms:
  • Medication Administration: circular reference with the verb "administering". Changed to applying.
• Point in time, instantaneous, or single point.
• further editorial changes in CMA document.
• With the use case of the simple interval administraton we leave out the exceptional cases.
• We need an example of a complex interval administration. Example could be chemotherapie where a pump is adjusted.
• Do we need to capture the completeness of the administration. For example 1 of 5 administrations and you are missing the last partial administration.
• The performer has no knowledge that the medication has been substituted, therefore we leave out the section on substitution.
• status code not only completed, but also aborted, in error etc. Look at the FHIR status.
• Internal review before publication.
• Patient medication instructions has been left out. The event has already happened and instructions have no purpose.

13:30 - 17:00: MMA profile - implementation

• the Actor diagram shows 2 actors:
  • the MA performer and an MA informer. This could result in systems that only wants to develop an informer.
  • Is it not a closed loop? The Consumer seems the same as the requester.
  • Question to make it into 1 actor. A use case could be that a informer just reports back what has been administered, looking at the Baxter strips that have instructions to administer without a request list. Add a note to add a use case. We leave it as 2 actors.
  • The numbering in the technical framework of Pharmacy should be sequential. Rename to Pharm-2, Pharm-3
  • Rename interaction to report administration result.
  • The names in the actors should match with the diagram.
  • An actor should have at least one mandatory interaction. It makes no sense to only have optional interactions.
• Push or Pull: FHIR REST concept is now focussing on pull concepts. Leave the Push option for future use.
• In the case of reporting the tablet sets connection to the EHR server and pushes information back to the server.
• the arrow in the sequence diagram of the query has to be inverted in the other direction.
• Jurgen question whether an icon of a nurse should be in the diagram. The nurse is generated by the tool.
• The OTC medication is entered manually. The download of a product catalogue can be downloaded in future.
• Identification of the nurse or patient is point of attention. Ask advice from ITI.

• Decision to consider the IHE Word document as the master version of the IHE MMA profile. If necessary Nictiz will asl assistance from Furore to create a FHIR profiles on Simplifier.net. Marc and Jose will do the initial profiling. Jose will participate in the discussion with IHE DCC on how IHE will publish their documents, because IHE Pharmacy should stay in line with the organizational approach.
• If the HTML publication (Forge, Simplifier) is accepted within IHE, then the HTML implementation guide will be prevalent. This then is from that moment on the master version.
• We could consider adverse events or reactions, but the FHIR resource is not mature enough. We decide to postpone this part.
• Marc will take the document and constrain the FHIR profiles before 21 June.
• Conference call Friday 23 at 11:00.
• The resource profiles will be pasted into the WORD document and used for the publication.
• The publication will be done end of July.
• The review period will be dealt in August.
• Share the IHE profile with HL7 Pharmacy at the HL7 WGM in San Diego.
• Mary Jungers will edit the final version only. Jose should confirm the publication agenda with Mary Jungers.