Pharmacy Work Group - Orlando



Pharmacy Working Group Meeting MinutesMontreal, PQ, CanadaMay 9 – 12, 2016Table of Contents TOC \t "Heading 1,1" Monday 09 May 2016 – Q1 PAGEREF _Toc451488610 \h 3Monday 09 May 2016 – Q2 PAGEREF _Toc451488611 \h 4Monday 09 May 2016 – Q3 PAGEREF _Toc451488612 \h 5Monday 09 May 2016 – Q4 PAGEREF _Toc451488613 \h 6Tuesday 10 May 2016 – Q1 PAGEREF _Toc451488614 \h 7Tuesday 10 May 2016 Q2 – Joint with FHIR PAGEREF _Toc451488615 \h 8Tuesday 10 May 2016 Q3 PAGEREF _Toc451488616 \h 10Tuesday 10 May 2016 Q4 – Joint with PHER (PHER Hosted) PAGEREF _Toc451488617 \h 11Wednesday 11 May 2016 Q1 PAGEREF _Toc451488618 \h 12Wednesday 11 May 2016 Q2 PAGEREF _Toc451488619 \h 14Wednesday 11 May 2016 Q3 PAGEREF _Toc451488620 \h 15Wednesday 11 May 2016 Q4 – Cancelled – Pharmacy attended Patient Care PAGEREF _Toc451488621 \h 16Thursday 12 May 2016 Q1 PAGEREF _Toc451488622 \h 17Thursday 12 May 2016 Q2 PAGEREF _Toc451488623 \h 19Thursday 14 May 2016 Q3 PAGEREF _Toc451488624 \h 21Thursday 14 May 2016 Q4 PAGEREF _Toc451488625 \h 22Full list of attendees PAGEREF _Toc451488626 \h 24Action List TOC \t "ActionItem,1" Action: Tom will check with Rik Smithies about attending Clinical Statement Thursday Q3. PAGEREF _Toc451488627 \h 4Action: John to check with Hans about attending the O&O. PAGEREF _Toc451488628 \h 4Action: To close the only 2012 hot topic left (v3 item) PAGEREF _Toc451488629 \h 4Action: Follow-up with Epic and Cerner to see which resources have been testing as part of Argonaut project. PAGEREF _Toc451488630 \h 10Action: Reach out to Argonauts to see if they have used PAGEREF _Toc451488631 \h 10Action: Review this in the context of what information is needed if a list of resources is display – what is needed to identify which resource you want to look at PAGEREF _Toc451488632 \h 10Action: Send an email to FMG to request exemptions PAGEREF _Toc451488633 \h 10Action: Melva to post minutes to website PAGEREF _Toc451488634 \h 13Action: Melva to send out Doodle Poll to see if there are better times - complete PAGEREF _Toc451488635 \h 13Action: Melva to send DMP to Anne PAGEREF _Toc451488636 \h 13Action: Melva to forward to the DESD for approval - complete PAGEREF _Toc451488637 \h 13Action: Schedule 1 quarter for September WGM for an NCPDP update PAGEREF _Toc451488638 \h 13Action: Co-chairs to discuss getting agenda posted by Wednesday PAGEREF _Toc451488639 \h 13Action: Melva to add 3 year plan item with milestone date of September 2016 WGM PAGEREF _Toc451488640 \h 13Action: Melva to let Jay Lyle know - complete PAGEREF _Toc451488641 \h 14Action: Melva to add change request to change effective to effective time - complete PAGEREF _Toc451488642 \h 16Action item: add tracker for precondition, examples are sliding scale and hold if HR<50 PAGEREF _Toc451488643 \h 20Action item: ask Lloyd what is meant by Kind … we don't understand the question PAGEREF _Toc451488644 \h 20Action: Melva to attach 8378 to EventHistory in spreadsheet - complete PAGEREF _Toc451488645 \h 20Action: Melva to add 8276 to EventHistory on spreadsheet - complete PAGEREF _Toc451488646 \h 20Action: Melva to check with Lloyd – is adding "list" something we can do? Looks like it would be done in the List resource PAGEREF _Toc451488647 \h 21Action: invite Brett to telecom to discuss DAF tracker items PAGEREF _Toc451488648 \h 21Action: For Q3/Q4, new group of trackers all related to Status (group names "Discuss at WGM") - complete PAGEREF _Toc451488649 \h 21Action: add 9203 value set to next teleconference PAGEREF _Toc451488650 \h 22Action: follow up with Sean Moore to address 8783 on an upcoming teleconference PAGEREF _Toc451488651 \h 23Action: does Melva remember who this person is … can we reach out to them PAGEREF _Toc451488652 \h 23Action: include the concept of "temporarily not taking" to the teleconference discussion of codes for notTaken (gForge item xxxx) PAGEREF _Toc451488653 \h 24Monday 09 May 2016 – Q1AttendeesNameOrganizationCountryEmailMarla Albitz (Scribe)Wolters Kluwer HealthUSA Marla.albitz@Daniel ZhangEpicUSAdzhang@Tom De JongHL7 NetherlandsNetherlandstom@nova-pro.nlScott RobertsonKaiserUSAScott.m.robertson@Jenni SyedCernerUSAJenni.syed@Christof GessnerHL7 GermanyGermanyChristof.essner@gematik.deJohn Hatem (Chair)USAjmhatem@Quorum Met: YesAgenda TopicsFinalize agenda Topics from Lee - NCCN Order Templates (to be confirmed with Lee) Reps to other WG - CompletedMonday Q4 - RCRIM - TomTuesday Q2 - O&O - John will check with Hans / FHIR hosting Pharmacy Tuesday Q4 - Patient Care - Tom / PHER - John Wednesday Q4 - Patient Care – Tom De JongThursday Q3 - Clinical Statement - Christof/Tom/ maybe RikAssign roles for Quarters - CompletedIf we have new attendees, review (no new attendees)Overview of Pharmacy material - V2, V3, FHIR resources Overview of Pharmacy template work Hot Topics – 1 topic found from 2012, will closeReview outstanding FHIR GForge tracker itemsDiscussed question from implementer, Jenni Syed. Issue: how to reference a TPN medication without the use of a contained reference. She finds use of a contained reference to not address Cerner’s needs. Jenni is proposing that the medication attribute would be changed from 1:1 to 1:many.Supporting DocumentsAgenda Minutes/Conclusions ReachedJohn will go to PHER on Thursday for Q4Tom will attend the RCRIM meeting for pharmacy.Tom De Jong will rep for us at Patient Care Wednesday Q4Christof will be attending the Clinical Statement Thursday W3.Marla and John will attend Patient Care on Wednesday Q4.Discussed Formulary PSS with Christof Gessner.Cancelled Monday Q4 – will be attending RCRIM. Action: Tom will check with Rik Smithies about attending Clinical Statement Thursday Q3. Action: John to check with Hans about attending the O&O. Action: To close the only 2012 hot topic left (v3 item)Monday 09 May 2016 – Q2AttendeesNameOrganizationCountryEmailMarla AlbitzWolters Kluwer HealthUSAMarla.albitz@John HatemUSAjmhatem@Jean DuteauDuteau DesignCanadajean@Daniel ZhangEpicUSAdzhang@Melva PetersGevityCanadampeters@Shelly SpiroPharmacy HIT CollaborativeUSAShelly@Sarah GauntLantanaAustraliaSarah.gaunt@Mike TushanLantanaUSAMike.tushan@Katherine DuteauDuteau DesignCanadakatherine@Scott RobertsonKaiserUSAScott.m.robertson@Tom De JongHL7 NetherlandsNLtom@nova-pro.nlChristof GessnerHL7 GermanyDEChristoc.gessner@gematik.deSue ThompsonNCPDPUSAsthompson@Quorum Met: YesAgenda TopicsUpdate - Pharmacy Care Plan (Shelly Spiro) Patient Care PSS - should we be an interested party? Allergy and Intolerance substances value sets Pharmacy FHIR work Supporting DocumentsAgenda Care Plan presentation – Scott has/permission from Sue to share and could be posted, if so insert link here.Allergy and Intolerance substances value sets Minutes/Conclusions ReachedSue Thompson presented status of Pharmacy Care Plan – project waiting for further funding to proceed.Allergy and Intolerance substances conclusion – Motion to be “interested party” to PSS, seconded. Vote Melva/Tom 13:2:0GForge # 8840 – Melva motioned to leave ReasonNoteTaken as a codeable concept but will not provide an exemplar, but will provide explanation that a local valueset could be used. Therefore would be “not persuasive, with mod”. Gforge #7742/5990 – Epic and Cerner reps will research to determine if method is in the 80%. Group is leaning towards removing method. Does not appear to be commonly exchanged.GForge #9303 – Intent of MedicationOrder – Motion to be not persuasive.Motion to vote on 8840, 9303 – Vote – Melva/Katherine 10:0:0Monday 09 May 2016 – Q3AttendeesNameOrganizationCountryEmailJohn Hatem (Scribe)N/AUSAjnhatem@Marla AblitzWoltersKluwerUSAMarla.albitz@Daniel ZhangEpicUSAdzhang@Jenni SyedCernerUSAJenni.syed@Melva Peters Chair)Gevity IncCAmpeters@Jean DuteauDuteau DesignCAjean@Tim McNeilSureScriptsUSATim.mcneil@Fang CaoeHealth OntarioCAFang.cao@ehealthontario.on.caQuorum Met: YesAgenda TopicsPharmacy FHIRSupporting DocumentsAgenda ReachedFeedback on use of method code was presented by Jenni Suyed, Daniel Zhang and Jean Duteau. After discussion a motion was put forth to leave the attribute and remove the exemplar value set. This is associated with g Forge tracker items 5990 and 7742. Motion by Daniel Zhang, seconded by Tim McNeil. Vote: Abstain – 2, Against – 1, For – 4Tracker item 8442 led to a discussion about where to put verification and whether there are types of verification. We need to talk to FHIR Workflow team about a proposed change Pharmacy wanted to make for this issue – to add an Event tracker to order, and other resources as needed. Tracker item 9301 – long discussion about the use of medication statement and the status associated with Medication Statement. Item is still open. See “outstanding issues” spreadsheet for more details. Item 9545 was discussed and a motion was put forth by Jean /Duteau and seconded by Jenni Syed. Vote: Abstain – 1, Against – 0, For -6Monday 09 May 2016 – Q4Monday session was joint with RCRIM. No minutes. Tuesday 10 May 2016 – Q18144220984100AttendeesNameOrganizationCountryEmailMelva Peters (Chair)HL7 CanadaCAmpeters@John Hatem (Scribe)N/AUSAjnhatem@Tom de JongHL7 NetherlandsNLtom@nova-pro.nlMarla AlbitzWoltersKluwerUSAMarla.albitz@Daniel ZhangEpicUSAdzhang@Tim McNeilSureScriptsUSATim.mcneil@Scott RobertsonKaiserUSAScott.m.robertson@Michelle WilliamsCernerUSAMiichelle.m.miller@Cindy JiangeHealthOntarioCACindy.jiang@ehealthontario.on.caFrancois MacaryHL7 FranceFRQuorum Met: YesAgenda TopicsPharmacy Overview for new attendeesPharmacy FHIRSupporting DocumentsAgenda Minutes/Conclusions ReachedPharmacy Overview provided my Melva Peters. During the overview of the Pharmacy resources, we identified that we need to discuss the “FLAG” item and assure we are using the flags correctly. Issue raised that there may be a requirement from Ontario, CA to add an attribute that the medication is e.g. a narcoticOther discussions related to how FHIR Workflow fits with the Pharmacy resources. FHIR Pharmacy issuesMaturity model requirements and the impact on our Pharmacy resources. 8476: Motion to remove MedicationOrder.DispenseRequest.medication and leave the DispenseRequest as the grouper by Scott Robertson, seconded by Tom de Jong. Vote: Abstain – 0, Opposed – 0, For – 98409 – Substitution Allowed on the Medication Order needs to be a Boolean and renamed to medicationOrder.substitution.allowed – will vote in later quarterTuesday 10 May 2016 Q2 – Joint with FHIRAttendeesNameOrganizationCountryEmailMarla AlbitzWolters KluwerCanadaMarla.albitz@John HatemUSjnhatem@Katherine DuteauDDICanadaKatherine@Andrea MacLeanCanada Health InfowayCanadaamaclean@infoway.caO EggeHL7 SwitzerlandSUIOlive.egge@aholis.chKepperHL7 NorwayNorwayShirin ZaidiGevity ConsultingCanadashaiderzaidi@Scott RobertsonKaiser PermanenteUSScott.m.robertson@Shelly SpiroPharmacy HIT CollaborativeUSshelly@pharmacy.Sean MooreEpicUSsrmoore@Daniel ZhangEpicUSdzhang@Tim McNeilSurescriptsUSTim.mcneil@Francois MacaryHL7 France/PHASTFRFrancois.macary@phast.frTom de JongHL7 NLNLtom@nova-pro.nlCindy JiangeHealth OntarioCanadaCindy.jiang@ehealthontario.on.caYunwei WangIMOUSywant@c-Melva PetersHL7 CanadaCanadampeters@Ewout KramerQuorum Met: Agenda TopicsFHIR updatesGForge #8442FlagsHow do we apply for an exemption?Additional Instructions issueMedicationOrder – Method exemplar valuesetMedication – requirement for all resources to have an identifierSupporting DocumentsAgenda Minutes/Conclusions ReachedSTU3 PublicationsPlan to publish in December – date proposed December 31, 2016Will depend on the number of ballot comments are receivedContent deadline for July 24, 2016 – must be updated in the build and committed. QA will take place in the next two weeksBuild validationAll information and warnings should be goneInformation items can existReview of GForge trackerHave about 33 items remaining – expect that the majority will be closedMaturity LevelLevel 2 - doesn’t have to be exchanged between systems to meet Level 2 requirements and doesn’t have to be a connectathon – but is being used. Need to submit something to FMG but there isn’t a formal documentLevel 3 includes quality issues – can use sample value sets rather than having to find an actual terminology value setAction: Follow-up with Epic and Cerner to see which resources have been testing as part of Argonaut project.Action: Reach out to Argonauts to see if they have usedConnectathon track proposals New Resources or Profiles – none for the next BallotEvaluation Project of system for tracking items – if interested, contact FMGNo change for next ballot – will be using GForgeFlags – need to do some work to understandPharmacy needs to look and these and update thisAction: Review this in the context of what information is needed if a list of resources is display – what is needed to identify which resource you want to look atTracker 8442 – had proposed adding EventHistory to MedicationOrderIf keeping track of a list of status for a resource – should do it as part of the resourceProvenance – may not be supported by all vendors – problematic for vendors to expose Provenance If common in the resource – could use provenance – contains all of the roles that would be requiredHow do we apply for an exemption?Additional Instructions issueMedicationOrder – Method exemplar valueset – can use a sample value set that doesn’t exist in a terminologyMedication – requirement for all resources to have an identifierAction: Send an email to FMG to request exemptionsTracker 8409 - Motion to change substitution.type to “substitution.allowed” and make it a Boolean on MedicationOrder and leave reason – John – Jean – 13/1/4 – CarriedTuesday 10 May 2016 Q3 AttendeesNameOrganizationCountryEmailMichelle MillerCernerUSAMiichelle.m.miller@Tim McNeilSureScriptsUSATim.mcneil@Daniel ZhangEpicUSAdzhang@Marla AlbitzWolters KluwerUSAMarla.albitz@John Hatem (Scribe)USAjnhatem@Tom de JongHL7 NetherlandsNLtom@nova-pro.nlScott Robertson (Chair)Kaiser USAScott.m.robertson@Quorum Met: YesAgenda TopicsPharmacy FHIRSupporting DocumentsAgenda Minutes/Conclusions ReachedPharmacy FHIR issues were discussed during this quarter. Updates on earlier quarter Pharmacy FHIR changes were communicated to this quarters attendees. This update included the following key change on Medication Order resource: 8409 - update MedicationOrder.substitution.type (CodeableConcept) to be substitutionAllowed (boolean)No vote was recorded as this was voted on previously. Medication Summary Flag updates were discussed in this quarter. 9978 - Medication Order Summary Flag changes. Vote was made to update the summary flags on the MedicationOrder resource: Marla made motion, and Tom seconded. 6/0/0. Currently all attributes are included in the summary.? Update Medication Order resource to include in summary:statusmedicationpatientdateWritten prescriber9979 – Medication Dispense Summer Flag changes. Vote was made to update the summary flags on the MedicationDispense resource: John made motion, and Daniel seconded. 5/0/0. Update Medication Dispense resource to include in the summary:statusmedicationpatientwhenPrepared8442 – Discussed (and voted) this issue previously last October. During this meeting we had a discussion to reconfirm that the definitions for dateWritten and prescriber will be updated to make them more clear, and to confirm that the addition of Event history will not include the original dateWritten and prescriber information but only changes to the original order. No vote was taken on this during this quarter as this was voted on previously. Tuesday 10 May 2016 Q4 – Joint with PHER (PHER Hosted)AttendeesNameOrganizationCountryEmailQuorum Met: Agenda TopicsSupporting DocumentsAgenda Minutes/Conclusions ReachedNo minutes – PHER hostedWednesday 11 May 2016 Q1AttendeesNameOrganizationCountryEmailJohn HatemUSjnhatem@Marla AlbitzWolters KluwerUSMarla.albitz@Daniel ZhangEPICUSdzhang@Tony SchuethPoint of Care PartnersUStonys@Tom de JongHL7 NLNLtom@nova-pro.nlMelva PetersHL7 CanadaCanadampeters@Quorum Met: YesAgenda TopicsApproval of January 2016 WGM MinutesSchedule for Conference callsDMPM&CSWOTForward PlanningProject ReviewFormulary PSS3-year plan reviewAction Item list reviewSupporting DocumentsAgenda Minutes/Conclusions ReachedApproval of January 2016 minutes - Motion to accept Minutes as corrected – Marla/Tom – 5/0/0Action: Melva to post minutes to websiteTeleconference – Doodle PollAction: Melva to send out Doodle Poll to see if there are better times - completeMotion – Melva – Tom to approve the Default DMP – 5/0/0 CarriedAction: Melva to send DMP to AnneM&C – Motion – Melva – Tom to approve updated M&C – 5/0/0 – CarriedAction: Melva to forward to the DESD for approval - completeAction: Schedule 1 quarter for September WGM for an NCPDP updateSWOT – Motion to accept the updated SWOT – Melva – Tom – 5/0/0 CarriedAction: Co-chairs to discuss getting agenda posted by WednesdayProject 1129 – motion to close Project 1129 – Marla/Melva – 5/0/0 CarriedProject 814 – motion to close Project 814 – Melva/Tony – 5/0/0 CarriedProject 856 – will review again in Baltimore – Melva to update the milestone dateProject 1221 – agenda time in BaltimoreFormulary PSS – Action: Melva to add 3 year plan item with milestone date of September 2016 WGMTom provided an update on the Negation Project in Patient CareMotion: Tony moved and Tom seconded that Pharmacy is an interested party on the Negation project – 5/0/0 CarriedAction: Melva to let Jay Lyle know - completeWednesday 11 May 2016 Q2AttendeesNameOrganizationCountryEmailMelva Peters (Chair)HL7 CanadaCAmpeters@John Hatem (Scribe)USAjnhatem@Daniel ZhangEpicUSAdzhang@Tom de JongHL7 NetherlandsNLtom@nova-pro.nlKatherine DuteauDuteau DesignCAkatherine@Kai HeitmannAbdul Malic ShakirHI3USAQuorum Met: YesAgenda TopicsPharmacy Template WorkSupporting DocumentsAgenda Minutes/Conclusions ReachedKai presented his current understanding of the pharmacy template work. This generated discussions around the pharmacy artifacts. Changes that need to be implemented in the template: Remove header – once removed, then the focal act is the SBADM and the SPLY RQO is now attached to this SBADM act. Remove coverageInclude “indication”Include “pertinent information” but constrained to “observation”Include “substance allowed” and a “reason for substitution” in the template. Include encounter id and code ( only) in the templateInclude prior order relationshipInclude precondition (verification) – Action item: follow up and discuss this. Remove method code on SBADMAction item: discuss DeviceRemove goalRemove optionRemove triggerWednesday 11 May 2016 Q3AttendeesNameOrganizationCountryEmailMarla Albitz (Scribe)Wolters KluwerUSAMarla.albitz@Tom de JongHL7 NetherlandsNetherlandstom@nova-pro.nlJohn HatemUSAjnhatem@Melva Peters (Chair)HL7 CanadaCanadampeters@Yunwei Wangywang@e-USIsabella GibaudFranceDaniel ZhangEPICUSAdzhang@Quorum Met: YAgenda TopicsFHIR WorkSupporting DocumentsAgenda Dropbox FHIR items spreadsheetMinutes/Conclusions ReachedGForge #9684 Motion: John/Tom 6:0:0GForge #8442 – Issue concluded – Michelle to make build update as resolution described in GForge October note.GForge #9301 – will use the same approach used in GForge #8442. Motion to accept change - John/Daniel Vote: 6:0:0GForge #9764 – Motion to agree to add MedicationStatement.Dosage.AdditionalInstructions. Vote: John/Tom 4:0:2.GForge #9982 – Motion to accept change - John/Daniel Vote: 6:0:0GForge #9980 – Motion to accept change – John/Daniel Vote: 6:0:0GForge#5990/7742 – changed resolution - Identified list of methods for exemplar valueset for MedicationOrder.method – use SNOMED of dosing instruction imperative. Motion to use identified method value set. Motion John/Marla Voted 6:0:0Action: Melva to add change request to change effective to effective time - completeWednesday 11 May 2016 Q4 – Cancelled – Pharmacy attended Patient CareAttendeesNameOrganizationCountryEmailQuorum Met: Agenda TopicsSupporting DocumentsAgenda Minutes/Conclusions ReachedThursday 12 May 2016 Q1AttendeesNameOrganizationCountryEmailMarla Albitz (Chair)Wolters KluwerUSAMarla.albitz@Tom de JongHL7 NetherlandsNetherlandstom@nova-pro.nlJohn HatemUSAjnhatem@Melva Peters HL7 CanadaCanadampeters@Yunwei WangIMOUSywang@e- Scott Robertson (Scribe)KPUSAScott.m.robertson@Daniel ZhangEPICUSAdzhang@Quorum Met: YesAgenda TopicsPharmacy FHIR workSupporting DocumentsAgenda Minutes/Conclusions ReachedChemotherapy Use Case – Composite & Concurrent orders (coordinating multiple medication)Two proposals: Protocol – coordinate any set of resourcesOrder Set – was simple multiple resources, has grown to be much like ProtocolCurrent thought is to combine the two (still being discussed) and then have a lightweight profile for a simple Order Set and a more complex profile for ProtocolAn issue with Pharm group. Protocol has the detail of the individual order resources in the Protocol resource. Some attributes of MedicationOrder would be replicated (?)/moved(?) into ProtocolConcurrent vs sequential ordersWhere should this life. Lee's approach is to put this coordination in the Protocol. But this is not set at this time.Examples: <paste in Lee's email>Example 1Example 2 - Concurrent administrationProtocol is allowing either 4 meds in separate bags or 1 bag with 4 medsExample 3 - FHIR 9761 Total accumulated life time doseThis is an addition to maxDosePerLifetimeThis came up in the discussion on adding maxDosePerLifetimeThis was not brought up by an implementer … this is just a good ideaNot part of the 80% - do this as an extension or free textAction item: ask Lloyd if there is somewhere to track Motion to not add (Tom/John) 7-0-29984 Allow SimpleQuantity for MedicationDispense.rate and MedicationAdministration.rateThis is a follow on to 8689 which added SimpleQuantity to MedicationOrder.rateA lot of discussion. In the end, the decision is to have the rate attributes to be the same in all of the MedOrder, MedDispense, MedAdmin, Motion to accept (Daniel/Melva) 8-0-1Michelle question: should we have wasNotGiven as a summary element. Discussed, agreed, asked Michelle to add a tracker, do it, and close it.Several status related items … we should consider collectively9666 relationship between 2 ordersOr multiple orders …Currently have priorPrescription where the current resource supersedes the prior prescription.Surprizing discussion on "supersedes"Thursday 12 May 2016 Q2AttendeesNameOrganizationCountryEmailDaniel ZhangEpicUSdzhang@Jenni SyedCernerUSAJenni.syed@John HatemUSAjmhatem@Marla AlbitzWolters Kluwer HealthUSA Marla.albitz@Melva PetersHL7 CanadaCanadampeters@Scott RobertsonKaiser PermanenteUSScott.m.robertson@Tim McNeilSureScriptsUSATim.mcneil@Tom De JongHL7 NetherlandsNetherlandstom@nova-pro.nlTony SchuethPoint of Care PartnersUSAtonys@Quorum Met: YesAgenda TopicsSupporting DocumentsAgenda Minutes/Conclusions ReachedFHIR5827 – defer until formulary discussion (Scott/Tony S) 8-0-0Formulary discussion after upcoming FHIR freeze8835 – review "as needed" – is codeableConcept sufficientCrossover discussion to sliding scale and preconditions to dosingRelated, but not the sameClosing this item (codeableConcept is sufficient) and create a new tracker for precondition (John/Tom) 8-0-0Action item: add tracker for precondition, examples are sliding scale and hold if HR<509203/9204 – table to Q3 for Sean/Epic9807 - Review this tracker when we deal with EventHistory9076 - can a medication be both a package and a kind? Discussed what is meant by "kind"Action item: ask Lloyd what is meant by Kind … we don't understand the question8516 – table to Q38378 – add MedicationPrescription.reasonToStop and reasonToStopAction: Melva to attach 8378 to EventHistory in spreadsheet - complete9266 – nothing to be done8554 – Clarify meaning and values of Substitution Code and ReasonOn an order, it is "substitution is allowed or not" and "why"On dispense or admin, it is "substitution was (not) done" and what kind of substitutionThere have been changes made based upon other tracker items. No further changes needed, closing this item (John/Tom) 8-0-08276 – add to EventHistory discussionAction: Melva to add 8276 to EventHistory on spreadsheet - complete7406 – add "List" as related resource for MedicationStatementNot a new attribute. There is a set of resources right before the attribute mapAction: Melva to check with Lloyd – is adding "list" something we can do? Looks like it would be done in the List resource6049 – DAFAction: invite Brett to telecom to discuss DAF tracker itemsFor Q3 there are tracker items for Sean/Daniel. Action: For Q3/Q4, new group of trackers all related to Status (group names "Discuss at WGM") - completeThursday 14 May 2016 Q3AttendeesNameOrganizationCountryEmailAndrea MacLeanCanada Health InfowayCanadaamaclean@infoway.caDaniel ZhangEpicUSdzhang@Jenni SyedCernerUSAJenni.syed@John HatemUSAjmhatem@Marla AlbitzWolters Kluwer HealthUSA Marla.albitz@Scott RobertsonKaiser PermanenteUSScott.m.robertson@Sean MooreEpicUSsrmoore@Tom De JongHL7 NetherlandsNetherlandstom@nova-pro.nlTony SchuethPoint of Care PartnersUSAtonys@ Quorum Met: YesAgenda TopicsPharmacy FHIR WorkSupporting DocumentsAgenda Minutes/Conclusions Reached8516 - rename MedicationStatement.wasNotTaken to notTakenAgree, change name and update the definition (add current tense)Persuasive with mod (John/Daniel) 8-0-09203 - Enhance MedicationStatement.wasNotTaken to be a code, rather than BooleanThe issue is how to document "I don't know" as a responseVery long discussionMotion to change notTaken to a code and define set on the next conference call (Daniel/Jenni) 8-0-0Action: add 9203 value set to next teleconference9204 - Clarifications on medicationStatement.wasNotTakenDidn't get to this item Thursday 14 May 2016 Q4AttendeesNameOrganizationCountryEmailAndrea MacLeanCanada Health InfowayCanadaamaclean@infoway.caDaniel ZhangEpicUSdzhang@Jenni SyedCernerUSAJenni.syed@John HatemUSAjmhatem@Julie JamesBluewave InformaticsUKjulie_james@bluewaveinformatics.co.uk Marla AlbitzWolters Kluwer HealthUSA Marla.albitz@Scott RobertsonKaiser PermanenteUSScott.m.robertson@Sean MooreEpicUSsrmoore@Tom De JongHL7 NetherlandsNetherlandstom@nova-pro.nlTony SchuethPoint of Care PartnersUSAtonys@ Yunwei WangIMOUSywant@c-Quorum Met: YesAgenda TopicsPharmacy FHIR workSupporting DocumentsAgenda ReachedStatus related FHIR items8276 Will be discussed on a tcon with Michelle presentHas to do with using EventHistory8783 - MedicationOrder Status ResolutionFirst, MedicationOrder.status addresses the order portion of the order-dispense life cycle.More overall granualityHierarchical codesThis overlaps with workflow considerations We agree that Signed and Verified are business elements, they are not part of the state machine.Action: follow up with Sean Moore to address 8783 on an upcoming teleconference 9296 - Consider new statuses for MedicationOrder and MedicationAdministrationStatus Proposed – is being proposed in workflow Status Draft – Status Under Review – Action: does Melva remember who this person is … can we reach out to them9666 - For statuses - consider removing "superseded" as a status and find a different way to represent a relationship between 2 ordersSuperceded has been removed from MedicationOrder.statusContinued discussion on the idea of representing the relationship form the MedicationOrder to one (or more?) PriorPrescription"A link to resource to an earlier, related, order/prescription (Tom/Tony) 6-0-19901 - Add "on hold" to MedicationStatement.status(Melva did not agree to this)Discussion … "the medication may be taken sometime in the future" is status IntendedStill considering "On Hold". There was a table by Michelle that looked at what does the combination of status and wasNotTaken implies. Doesn't include the "hold" concept. New thought: we just changed notTaken to a code with yes/no/unknown. Add "temporarily not taking".Action: include the concept of "temporarily not taking" to the teleconference discussion of codes for notTaken (gForge item xxxx)9304 –#2 is fixed – changed to a code in tracker xxxx#1 this can be addressed by doing a query across all statementsNot persuasive (Jenni/Scott) 4-0-3 Full list of attendeesNameOrganizationCountryEmailAndrea MacLeanCanada Health InfowayCanadaamaclean@infoway.caChristof GessnerHL7 GermanyGermanyChristof.essner@gematik.deCindy JiangeHealth OntarioCanadaCindy.jiang@ehealthontario.on.caDaniel ZhangEpicUSdzhang@Ewout KramerFang CaoeHealth OntarioCAFang.cao@ehealthontario.on.ca Francois MacaryHL7 France/PHASTFRFrancois.macary@phast.frIsabella GibaudFranceJean DuteauDuteau DesignCanadajean@Jenni SyedCernerUSAJenni.syed@John HatemUSAjmhatem@Julie JamesBluewave InformaticsUKjulie_james@bluewaveinformatics.co.uk Katherine DuteauDuteau DesignCanadakatherine@KepperHL7 NorwayNorwayMarla AlbitzWolters Kluwer HealthUSA Marla.albitz@Melva PetersHL7 CanadaCanadampeters@Michelle WilliamsCernerUSAMiichelle.m.miller@Mike TushanLantanaUSAMike.tushan@O EggeHL7 SwitzerlandSUIOlive.egge@aholis.chSarah GauntLantanaAustraliaSarah.gaunt@Scott RobertsonKaiser PermanenteUSScott.m.robertson@Sean MooreEpicUSsrmoore@Shelly SpiroPharmacy HIT CollaborativeUSAShelly@Shirin ZaidiGevity ConsultingCanadashaiderzaidi@Sue ThompsonNCPDPUSAsthompson@Tim McNeilSureScriptsUSATim.mcneil@Tom De JongHL7 NetherlandsNetherlandstom@nova-pro.nlTony SchuethPoint of Care PartnersUSAtonys@ Yunwei WangIMOUSywant@ ................
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