Pharmacy Work Group - Orlando



Pharmacy Working Group Meeting MinutesSan Antonio, TXJanuary 19 – 23, 2014Table of Contents TOC \t "Heading 1,1" Monday 19 January 2015 Q1 PAGEREF _Toc284755435 \h 3Monday 19 January 2015 Q2 PAGEREF _Toc284755436 \h 5Monday 19 January 2015 Q3 PAGEREF _Toc284755437 \h 6Monday 19 January 2015 Q4 PAGEREF _Toc284755438 \h 7Tuesday 20 January 2015 Q1 PAGEREF _Toc284755439 \h 8Tuesday 20 January 2015 Q2 PAGEREF _Toc284755440 \h 9Tuesday 20 January 2015 Q3 PAGEREF _Toc284755441 \h 10Tuesday 20 January 2015 Q4 – Joint with PHER PAGEREF _Toc284755442 \h 11Wednesday 21 January 2015 Q1 PAGEREF _Toc284755443 \h 12Wednesday 21 January 2015 Q2 PAGEREF _Toc284755444 \h 13Wednesday 21 January 2015 Q3 PAGEREF _Toc284755445 \h 15Wednesday 21 January 2015 Q4 PAGEREF _Toc284755446 \h 16Thursday 22 January 2015 Q1 PAGEREF _Toc284755447 \h 17Thursday 22 January 2015 Q2 PAGEREF _Toc284755448 \h 18Thursday 22 January 2015 Q3 PAGEREF _Toc284755449 \h 19Thursday 22 January 2015 Q4 PAGEREF _Toc284755450 \h 20Action List TOC \t "ActionItem,1" Action: Review and clean up hot topic list (Scott) PAGEREF _Toc284755451 \h 3Action: Melva will set up teleconferences and Wiki PAGEREF _Toc284755452 \h 4Action: John to work on spreadsheet PAGEREF _Toc284755453 \h 4Action: confirm recon post and notice to ballotters (Scott) PAGEREF _Toc284755454 \h 6Action: finish examples; finish stylesheet (Scott) PAGEREF _Toc284755455 \h 6Action: confirm status of project with DESD (Scott) PAGEREF _Toc284755456 \h 6Action: push through TSC and ballot process (Scott) PAGEREF _Toc284755457 \h 6Action: Provide links for projects described (Kai) PAGEREF _Toc284755458 \h 8ACTION: Pharmacy should review the CCDA mappings when available if possible PAGEREF _Toc284755459 \h 9Action: Melva set up a meeting with Brett to review further - Complete PAGEREF _Toc284755460 \h 15Action: John to share the Pharmacy Use Case document with Brett PAGEREF _Toc284755461 \h 15Action: John to share the Pharmacy Overview document with Brett PAGEREF _Toc284755462 \h 15Action: Brett to send examples to Pharmacy PAGEREF _Toc284755463 \h 15Action: Pharmacy to review with modeling facilitators PAGEREF _Toc284755464 \h 15Action Item: follow up with Steve to ensure that his work on FHIR is reflective of Pharmacy FHIR work. PAGEREF _Toc284755465 \h 18Monday 19 January 2015 Q1AttendeesNameOrganizationCountryEmailScott Robertson (Chair)Kaiser PermanenteUSScott.m.robertson@Hugh GloverBlue Wave InformaticsUKHugh_glover@Julie JamesBlue Wave InformaticsUKJulie_james@John HatemOracleUSJohn.hatem@Melva PetersGevity ConsultingCANmpeters@Nicolais CanuPHASTFRNicolas.canu@phast.frDaniel LamphearMcKessonUSDaniel.lamphear@Frank McKinneyUSfm@frankChristof GessnerHL7 GermanyDEchristof@gessner@mxdx.deQuorum Met: YAgenda TopicsIntroductionsReview and finalize WGM agendaApprove September 2014 WGM minutesDetermine representatives to other meetingsAssign roles for Pharmacy QuartersHot TopicsConference call scheduleAction List (if John available)Prep for meeting with SDWG repsSupporting DocumentsAgenda Draft Minutes Minutes/Conclusions ReachedReview of the agendaChanges made to the agenda on the WikiMove action item list review to WednesdayRepresentatives to other MeetingsTuesday Q2 O&O – Julie will attendWednesday Q2 EHR WG – Jean will attendApproval of the September 2014 WGM minutesMoved by John – seconded by Hugh to accept the minutes as circulated. CARRIED 7/0/0Review of Hot TopicsAction: Review and clean up hot topic list (Scott)Conference Call ScheduleWill book teleconference for 60 minutes for weekly but will have a business meeting every 2 weeks. Second meeting will be held only if there is work to be done. Keep meeting at the same time.Next teleconference – February 2nd at 4pm EasternAction: Melva will set up teleconferences and WikiPrep for the SDWG meetingThere are some action items coming forward from SDWGAction: John to work on spreadsheetDiscussion of interests of new attendeesLearning and interest in FHIROncology medicationsReview of examples for oncology medication orders to determine additional requirements for FHIRCycle LengthDosing issues – can’t be representedMonday 19 January 2015 Q2Attendees PHER meeting. John Hatem attended from PharmacyAgenda TopicsPHER FHIR resolutionsGeneral FHIR discussion by Ewout Kramer. Supporting DocumentsAgenda Minutes/Conclusions ReachedOpen issues for PHER FHIR – 11 issues were discussed and all resolved. See gForge and filtered by PHER for status of these issues. Some of these issues were solved such that the current Immunization Resource is more closely aligned with Pharmacy Medication Administration resource. Ewout Kramer spoke about Project Argonaut generally and spoke about this US based effort to provide funding and resources to aid in getting DSTU 2 for FHIR out. EK stated that FHIR is going to use the security work done with SMART and incorporate that into FHIR. EK described the FHIR Clinical Connectathon and identified David Hay as the contact for reviewing and providing input into the next round of use cases for discussion next May. Monday 19 January 2015 Q3AttendeesNameOrganizationCountryEmailBrad ArnoltCernerUSBrad.arnolt@Charlie MeadVidal GroupCharles.normanmead@Christof GessnerHL7 GermanyDEchristof@gessner@mxdx.deFrank McKinneyUSfm@frankHugh GloverBlue Wave InformaticsUKHugh_glover@Jae Woo SinIHISCom3352001@Jean DuteauDuteau DesignCanjean@John Hatem (chair)OracleUSJohn.hatem@Matthew GrahamMayo ClinicUSGraham.matthew@mayo.eduScott Robertson (scribe)Kaiser PermanenteUSScott.m.robertson@Quorum Met: YAgenda TopicsUpdate on MTM ballot & reconciliation (Scott)Update on Pharmacy Guidance - Endorsement Project (Scott)Pharmacy FHIR WorkSupporting DocumentsAgenda Minutes/Conclusions ReachedUpdate on MTM ballot & reconciliation (Scott)MTM reconciliation complete (unsure if posted)Edits "done" but need examples and stylesheet (software issues)Action: confirm recon post and notice to ballotters (Scott)Action: finish examples; finish stylesheet (Scott)Update on Pharmacy Guidance - Endorsement Project (Scott)Pending Domain Experts Steering DivisionOn target for this coming ballot cycleAction: confirm status of project with DESD (Scott) Action: push through TSC and ballot process (Scott)Pharmacy FHIR WorkPharmacy FHIR overview and walk-thru for newer attendees (John)All Pharmacy Resources were reviewed with the attendees. This generated discussion and feedback from the attendees. No new action items were generated from this discussion. Monday 19 January 2015 Q4AttendeesNameOrganizationCountryEmailFrank McKinneyUSfm@frankHugh Glover (chair)Blue Wave InformaticsUKHugh_glover@Rob SavageUSRob.savage50@Jean DuteauCAjean@John Hatem (scribe)OracleUSJohn.hatem@Matthew GrahamMayo ClinicUSGraham.matthew@mayo.eduEric LarsonCDCUSvevs@Katherine DuteauCAKatherine@Keith WillardSureScriptsUSKeith.willard@Tim McNeilSureScriptsUSTim.mcneil@Joon Hyun SongIHISJhsong??35@Jae Woo SinIHISCom3352001@Do Yann LeeIHISkeveni@Christof GessnerHL7 GermanyDeChristof.gessner@mxdx.deQuorum Met: YAgenda TopicsFHIR Pharmacy review of our issuesSupporting DocumentsAgenda Minutes/Conclusions ReachedJean Duteau is reviewing all open issues for Pharmacy FHIR as listed on gForge. Review results of discussions as documented by Jean Duteau in the gForge Pharmacy list of issues. All issues have been completed and the Motion was entered by Rob Savage to accept the solutions. Seconded by Tim McNeil. Vote was passed: 12 /0 /0Jean Duteau is entering resolutions into gForge at the end of the quarter. And as time permits he is entering in FHIR changes to the Pharmacy Resources. Tuesday 20 January 2015 Q1AttendeesNameOrganizationCountryEmailHugh Glover (scribe)Blue Wave InformaticsUKHugh_glover@Jean DuteauCAjean@John Hatem (chair)OracleUSJohn.hatem@Tim McNeilSureScriptsUSTim.mcneil@Christof GessnerHL7 GermanyDeChristof.gessner@mxdx.deKai HeimanHL7 GermanyDeHl7@kheitman.deQuorum Met: YAgenda TopicsIHE profilesSupporting DocumentsAgenda Minutes/Conclusions ReachedCDA Templates in Europe and GenerallyKai described some IHE involvement in pharmacy profiles and the consequent development of CDA profiles.IHE profile: Overarching condition based therapy plan – medication is part of this.ePSOS templates are available There are also some Polish and Lithuanian templatesart - decor () is used to document CD|A for many Eutropean projects. Kai walked through some examples.Action: Provide links for projects described (Kai)Kai is willing to help Pharmacy WG work on CDA templates.Christof asked about Pharmacy project to create CDA templates – we have a project for this which is currently on hold. Medication Statement would be the most appropriate starting point for this. Kai believes Medication Statement would take 2 days in an out of cycle meeting to prepare. Christof thinks that with a clear vision there could be a good attendance from Europe for a Paris meeting.Tuesday 20 January 2015 Q2AttendeesNameOrganizationCountryEmailJohn Hatem (chair)OracleUSJohn.hatem@Hugh Glover (scribe)Blue Wave InformaticsUKHugh_glover@Jean DuteauCAjean@Tim McNeilSureScriptsUSTim.mcneil@Mike MarshAAULDMkm1829@ Ashi RavichandraMedfusion Ashi.ravichaandra@Brady KeelerMedfusion Brady.keeler@Jeffrey TingSystems Made SimpleJeffrey.Ting@ Nicolais CanuPHASTFRNicolas.canu@phast.frBrad ArnottCernerBrad.arnott@ Daniel LanphearMcKessonDaniel_Lanphear@ Quorum Met: YAgenda TopicsMeeting with FHIR TeamSupporting DocumentsAgenda Minutes/Conclusions ReachedFHIRFHIR Tracker Items should be done and QA complete in 8 week’s timeArgonautLloyd gave some background – Argonaut will deliver for the next ballot, but the output and mappings will be available before that. ACTION: Pharmacy should review the CCDA mappings when available if possibleConsistency of resourcesJohn asked whether there is a process for achieving consistency. Not really – it’s a ballot function.FHIR WGNew WG for FHIR core will be created to do some of the basic allocation and management.FHIR Comment ResolutionMotion – add status field to Medication statement P:Duteau, S:McNeil Discussion: Add an unknown status? Conclusion not to add. Motion carried 10,0,0Tuesday 20 January 2015 Q3AttendeesNameOrganizationCountryEmailJohn Hatem (scribe)OracleUSJohn.hatem@Hugh Glover (chair)Blue Wave InformaticsUKHugh_glover@Jean DuteauCAjean@Christof GessnerHL7 GermanyDeChristof.gessner@mxdx.deQuorum Met: YAgenda TopicsPharmacy Webinar discussionSupporting DocumentsAgenda Minutes/Conclusions ReachedThis discussion covered a review of the Pharmacy Overview document which described at a very high level the core Pharmacy constructs of Prescription/Medication Order, Medication Administration, Medication Dispense, Medication Statement and other healthcare processes where Pharmacy information is often used. This was a lead in to Hugh’s review of some of the presentation approaches/content he has provided. Hugh did work on an outline of the topics we should cover in our webinar, but did not distribute this material. Other areas covered in the Overview discussion: Architectures; Clinical Processes where pharmacy information is part of the process; Medication Knowledge e.g. FDB drug-drug checking, drug monographs, contraindications/indications; Medication Lists; Medication Supply Chain. These ideas were not discussed in depth, nor was there a discussion to include or leave these subjects out of a webinar. We agreed to continue the discussion on our weekly conference calls and identify specific action items during the call. Note that the list of attendees was lost and I need confirmation that Jean attended this quarter. I also believe that Christof G attended and another individual who I don’t have the name for. I am still looking for that list of attendees. Tuesday 20 January 2015 Q4 – Joint with PHERSee meeting minutes from PHERWednesday 21 January 2015 Q1AttendeesNameOrganizationCountryEmailJohn HatemOracleUSJohn.hatem@Melva PetersHL7 CanadaCANmpeters@Quorum Met: NoAgenda TopicsForward PlanningMission and CharterSWOTWork Group Health MetricsPBS MetricsProject Review3 year planPlanning for May 2015Work on agendas for upcoming teleconferencesAction List (if John available)Supporting DocumentsAgenda Minutes/Conclusions ReachedNo decisions were made due to lack of quorumSWOT was updated and will brought to a different quarter for review and approval3 year plan was updated and will brought to a different quarter for review and approvalDiscussion of May 2015 WGMWebinar discussion may help drive some of what we can do for May 2015 WGM in quarters where we have participants from EuropeWednesday 21 January 2015 Q2AttendeesNameOrganizationCountryEmailJohn Hatem (scribe)OracleUSJohn.hatem@Christof GessnerHL7 GermanyDEChristof.gessner@imxdx.deMichael TanNictizNLtan@nictiz.nlWilliam GoossenNLwgoossen@results4care.nlMelva PetersHL7 CanadaCANmpeters@Christian HayGSACHChristian.hay@Giorgio CangioliHL7 ItalyItalyGorogio.cangiloi@Julie JamesBlue Wave InformaticsUKJulie_james@bluewaveinformatics.co.ukHugh Glover (scribe)Blue Wave InformaticsUKHugh_glover@bluewaveinformatics.co.ukJean DuteauDuteau DesignCAjean@Catherine ChronakiHL7 FoundationGRchronaki@Quorum Met: YesAgenda TopicsISO UpdateseRx specificationIHE PharmacyOpenMedicine ProjectReview of ISO SKMT Pharmacy related terms and definitionsStatus of email threadsDiscussion of Out of Cycle Meeting in conjunction with HL7 WGM in Paris - May 2015Supporting DocumentsAgenda Minutes/Conclusions ReachedISO updates per Christian Hay. Christian presented ISO status including Road Map. (presentation (PPT) will be sent by Christian to Pharmacy WG). General discussion about how to most effectively provide comments to ISO regarding various ISO work products. Jean Duteau raised issues regarding how to effectively communicate issues. Christian asked Jean to contact him directly to identify an approach that will work. It was confirmed in discussion that the messaging work developed by HL7 Pharmacy WG for use by ISO has been dropped. They chose to use SPL approach. This is not new news, but just an affirmation of where we stand. Implementation guide work is being written by folks from FDA and Gunther. IHE Pharmacy report by Michael TanMichael reviewed the current and planned work activity. Current primary project is on Medication distribution and supply. Driver is Jose. IHE catalogs links to MPD work – comment by Julie James. General statement, some of the IHE projects are still very abstract as noted by Michael Tan in his presentation. Pharmacy OOC in ParisDiscuss plans and agenda. John H discussed the thoughts that came out of earlier Pharmacy WG discussion with Kai H and a suggestion to create a Medication Statement Universal template. It was suggested by Michael that this may not be possible in our 1 day OOC meeting in Paris. Michael did agree to discuss with this team and Melva and John agreed to evaluate whether we could accomplish this work in the actual HL7 Pharmacy WGM in Paris. Open Medicine Project update by Catherine Chronaki. Ask Catherine for the slides. Georgio discussed some of the issues that resulted in the creation of this project. Challenges in sharing medication information across cross-border country boundaries in Europe as seen in various epSOS projects. Goals were identified that related to finding practical deployment options. Georgio sent slides to Melva PetersAdditional presentation by Christian Hay confirming and adding in more details and information about the Open Medicine project. General discussion about how to use IDMP content in the direct to patient care types of projects of which the Open Medicine is an example. Wednesday 21 January 2015 Q3AttendeesNameOrganizationCountryEmailChristof GessnerHL7 GermanyDEChristof.gessner@mxdx.deJohn Hatem (Chair)OracleUSJohn.hatem@Wendy HuangCanada Health InfowayCANwhuang@infoway-inforoute.caMelva Peters (Scribe)HL7 CanadaCANmpeters@Brett MarquardRiver RockUSbrett@George ColeAllScriptsUSGeorge.cole@Benjamin FlessnerEpicUSBenjamin@Dave ParkerDOD/VAUSDavid.parker@defined-Quorum Met: YAgenda TopicsCCDA mappingSDWG issues related to issuesSupporting DocumentsAgenda Minutes/Conclusions ReachedCCDA MappingIf Pharmacy has started mappings, should share with BrettAction: Melva set up a meeting with Brett to review further - CompleteReview of Pharmacy Use Case documentAction: John to share the Pharmacy Use Case document with BrettAction: John to share the Pharmacy Overview document with BrettSubstanceAdministration FreeTextSig – proposal to create a new SubstanceAdministrationAct with only the text element supported – to be placed in an entryRelationship within the Medication ActivityCould represent the text in a couple of ways – with text or with a referenceAction: Brett to send examples to PharmacyAction: Pharmacy to review with modeling facilitatorsLoading DoseConcerns raised about example that has been posted and has proposed that only free text will be supportedWednesday 21 January 2015 Q4AttendeesNameOrganizationCountryEmailLisa NelsonLantanaUSJohn Hatem (Chair)OracleUSJohn.hatem@Wendy HuangCanada Health InfowayCANwhuang@infoway-inforoute.caMelva Peters (Scribe)HL7 CanadaCANmpeters@Brett MarquardRiver RockUSbrett@George ColeAllScriptsUSGeorge.cole@Benjamin FlessnerEpicUSBenjamin@Dave ParkerDOD/VAUSDavid.parker@defined-Jean DuteauDuteau DesignCANjean@Kevin ShekletonCernerCANKevin.shekleton@Quorum Met: YAgenda TopicsContinued SDWG discussionPharmacy FHIRSupporting DocumentsAgenda Minutes/Conclusions ReachedDiscussion of Free Text SigMoved to approve the medication status code states as per spreadsheet – Moved by Brent – seconded by Lisa. Carried (8/0/0)Discussion of Status Codes in CCDA – Moved to approve the medication status code states as per spreadsheet – Moved by Dave – seconded by Benjamin. Carried (8/0/0)Pharmacy FHIRDiscussion of adding “batch” to the Medication ResourceMoved by Jean – seconded by Melva – to add batch with lot number and expiration date – Carried (3/0/0)Thursday 22 January 2015 Q1AttendeesNameOrganizationCountryEmailJohn Hatem (chair)OracleUSJohn.hatem@Scott Robertson (scribe)Kaiser PermanenteUSScott.m.robertson@Quorum Met: NoAgenda TopicsStatus of email threadsPharmacy Template WorkSupporting DocumentsAgenda Minutes/Conclusions ReachedNo formal meetingReviewed pharmacy list emailMany FHIR-related issues have been addressed with ongoing FHIR pharmacy workExpression of dose timing in FHIR remains an issue. Need to include better discussion and examples to illustrate simple and complex dosing instructionNeed to confirm that relative use of MedicationStatement, MedicationPrescription and MedicationDispense is present in FHIR documentationRemaining issues closed or are being addressed with ongoing workThursday 22 January 2015 Q2AttendeesNameOrganizationCountryEmailJohn Hatem (chair)OracleUSJohn.hatem@Scott Robertson (scribe)Kaiser PermanenteUSScott.m.robertson@Melva PetersGevity ConsultingCAmpeters@Shelly SpiroPharmacy HIT CollaborativeUSshelly@Quorum Met: YesAgenda TopicsPharmacy Template workFHIR Use CasesAdd: PSS for "Pharmacist EHR-System Functional Profile Release 2"Supporting DocumentsAgenda Pharmacist Functional Profile 20150122.docm (on dropbox)Minutes/Conclusions ReachedPSS for "Pharmacist EHR-System Functional Profile Release 2"Reviewed PSS, minor editsNoted that Steve Hufnagel will be presenting MedMangement and Immunization FHIR resources to project team.Action Item: follow up with Steve to ensure that his work on FHIR is reflective of Pharmacy FHIR work.Motion to accept PSS (Shelly)Request for regular updates. Will be added to Pharmacy WGM ongoing until completeVote 4-0-0FHIR ExamplesNeed to decide what we want example for, rather than just random examplesReviewed current examples, brainstormed additional examples(see FHIR working documents)Thursday 22 January 2015 Q3 AttendeesNameOrganizationCountryEmailScott RobertsonKPUSScott.m.robertson@Shelly SpiroPharmacy HIT CollaborativeUSshelly@Quorum Met: NoAgenda TopicsPharmacy Template WorkSupporting DocumentsAgenda Minutes/Conclusions ReachedNo meeting due to lack of quorumThursday 22 January 2015 Q4AttendeesNameOrganizationCountryEmailMelva PetersHL7 CanadaCanadampeters@John HatemOracleUSJohn.hatem@Quorum Met: NoAgenda TopicsPharmacy TemplatesSupporting DocumentsAgenda Minutes/Conclusions ReachedNo meeting due to lack of quorum ................
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