Attendee - Health Level Seven International



Orders & Observations

Cologne Working Group Meeting

May 2007

Meeting Minutes

Table of Contents

Attendees 3

Monday Q1, Tuesday Q3, Friday Q1 – OO – V3 Ballot Reconciliation 6

Monday, Q2 – OO/Pt Care/PHER/Pt Safety/Rx 7

Exposure Report 7

Substance Administration 7

Immunization 8

Monday Q3 – V2.7 Proposals 9

Specimen Shipment 9

Proposal 492 - Make OBX-8 CWE 9

Proposal NN - Pharmacy Order Type 9

Monday Q3 – OO/Pt Care/CDS 10

Order Set Ballot Reconciliation 10

Tuesday Q1 – OO/Rx/Lab 11

Tuesday Q2 – OO/Rx/Lab – Dynamic Model 13

Tuesday Q3 – OO/Pt Safety/BTO/PHER/Rx 14

Immunization 14

Wednesday Q1 – Implementation Guide 16

Wednesday Q2 17

Thursday Q1 – Genomics 18

Pedigree 18

Genotype 18

Thursday Q3/Q4 - Clinical Statement 19

Change Request 19

Overall direction including: 19

Topics/Common fragments - Larry McKnight 19

T3F related discussion on content of Clinical Statement material 20

CEN 13606 harmonisation - Charlie McCay 20

Duplicated TargetOf/SourceOf relationships - Keith 20

Ballot Reconciliation 20

Friday Q1 – V3 Ballot Reconciliation 21

Attendees

Attendee |Company/E-Mail |Mon AM |Mon PM |Tue AM |Tue PM |Wed AM |Wed PM |Thu AM |Thu PM |Fri | |Joseph Baptist |Baptist@nictiz.nl | | | |√ | | | | | | |Keith Boone |Keith.boone@ |  |  |  |  |  |  |  |√  |  | |Bill Braithwaite |bill@ | √ |  |  |  |√  |  |  |  |  | |Rianne te Brake |a.tebrake@ziekenhuis-mst.nl | | | |√ | | |√  | | | |Louise Brown |Louise.brown@tntglobal.ca |  |  |√  |√  |  |  |  |  |  | |Nicholas Brown |Nbrown.mimic@ |  |  |  |  |  |  |  |  |  | |Hans Buitendijk |Hans.buitendijk@ |√ |√ |√  |√ |√  | √ | √ |√  | √ | |James Campbell |Campbell@ummc.edu |√ |√ | |  |  |  |  |  |  | |Nicolas Canu |nicolas.canu@phasl.fr |  |  |√  |  |  |  |  |  |  | |Lisa Carnanan | | | | | |√ | | | | | |Jim Case |Jtcase@ucdavis.edu |√ |  |  | √ |  |  |  | √ |  | |Michael Celeste |Michael.celeste@ |√ |  |  | √ |  |  |  |  |  | |Lee Coller |Lee.coller@ |  |  |  |  |  |  |  | √ |  | |Kevin Coonan |Kevin.coonan@ |  |√ |  |  |  |  |  |  |  | |Todd Cooper |t.cooper@ |√ |  |  |  |  |  |  |  |  | |Garry Cruickshank |g.cruickshank@sympatico.ca |  |√ |√  | √ |√  |  | √ | |  | |Richard Dixon-Hughes |Richard@.au |  |  |  |  |  |  |  |√  |  | |Bob Dolin |Robert.h.dolin@ |  |  |  |  |  |  |  |√  |  | |Robert Dunlop |Robert.dunlop@ |  |  |  |  |  |  | √  |  |  | |Daigoro Ebina |Ebina-daigoro@pmda.go.jp |√ |  |  |  |  |  |  |  |  | |Kristi Eckerson |Kee8@ |√ |  |  | √ |  |  |  | √ |  | |Jamie Ferguson |Jamie.ferguson@ | √ |  |  |  | √ |  |  |  |  | |Clive Flashman |Clive.flashman@npsa.nhs.uk |√ |  |  |  |  |  |  |  |  | |Isobel Frean |isobelfrean@ |√ |√ |  |  |  |  |  | √ |  | |Len Gallagher |lgallagher@ | √ |  |  |  |  |  |  |  |  | |Gay Giannone |Gay.giannone@ |  |  |  |  |  |  |  |√  |  | |Hugh Glover |Hugh_glover@bluewaveinformatics.co.uk |√ |  | √ |  |  |  |√  |  |  | |William Goossen |Williamtfgoossen@ |√ |√ |  |  |  |  |  |√  |  | |W. Gregory |Gregow@ |√ |  |  | √ |  |  |  |  |  | |Peter Goldschmidt |pgg@ |√ |  |  | √ |  |  |  |  |  | |Rob Hallowell |Robert.hallowell@ |√ |  | √ |  |  |  | √ | |  | |Christina Hansson |Christina.hansson@ |√ |√ | √ |  |  |  | √ |√ |  | |Dick Harding |Dick_harding@health..au |  |  | √ |  |  |  |  | √ |√  | |John Hatem |John.hatem@ |√ |  |  |  |  |  | √ | |  | |Rob Hausam |Robert.hausam@ |√ |  | √ | √ |  |  |  |√  |  | |Rusty Henry |rhenry@ | | |√ | | | |√  |√ | | |Andrew Hinkly |Andrew.hinkly@ |  |  |  |  |  |  |  | √ |  | |Hans Houben |Hans.houben@ |  |  | √ | √ |  |  |√   |  |  | |Sabarna Mukhopadhyay |sabarna@ |  |√ |  | √ |  |  |  |  |  | |Julie James |Julie_james@bluewaveinformatics.co.uk |√ |  |  | √ |  |  | √ | |  | |Lenel James |Lenel.james@ | | | | | | | |√ | | |Gaby Jewell |gjewell@ |  |  |  |  |  |  |  |√  |  | |Tom de Jong |Hl7@tdejong.demon.nl |  |  | √ |  |  |  | √ |  |  | |Wiggert Kalis |Wiggers.kalis@mips.be | | |√ | | | |√  | | | |Yoon Kim |yoonkim@snu.ac.kr | | | | | | | |√ | | |Gert Koelewijn |koelewijn@nictiz.nl |√ |  |  |  |  |  |  |√  |  | |Astrid Koenders |a.koenders@mca.nl |√ |  | √ | √ |  |  | √  | |  | |Helmut König |Helmut.Koenig@ |  |  |  |  |  |  |  |√  |√  | |Austin Kreisler |Austin.kreisler@duz1@ |√ |  | √ |  |√  |  |  | √ |  | |Thom Kuhn |tkuhn@ |  |√ |  |  |  |  |  |  |  | |Sanjaya Kumar |skumar@ |√ |  |  |  |  |  |  | |  | |Joann Larson |Joann.larson@ |√ |√ | √ |  | √ |  |  |√ |  | |Patrick Loyd |Patrick.loyd@ |√ |√ | √ |  | √ |  | √ | √ | √ | |Craig Lucas |Craig.lucas@ | | | | | | |√  | | | |Joginder Madra |Joginder.madra@ |√ |  |  | √ |  |  |  | |  | |David Markwell |david@clinical-info.co.uk |  |  |  |  |  |  |  |√ |  | |Brett Marquard |bmarquar@ |  |  |  |  |  |  |  | √ |  | |Susan Matney |Susan.matney@ |√ |√ |  |  |  |  |  | |  | |Jim McCain |James.mccain@med. |  |  |  |  |  |  |  |  |  | |Ken McCaslin |Kenneth.h.mccaslin@ |  |  | √ |  | √ |  |  | |  | |Charlie McCay |Charlie@ramseysystems.co.uk |  |  |  |  |  |  |  |√ |  | |Brian McCourt |Brian.mccourt@duke.edu | | |√ | | | | | | | |Clem McDonald | | | | | | | |√  | | | |Barbara McKinnon |Bm.n15e@ | | | | | | |√  | | | |Scott McKinnon |Scott.mckinnon@ | | | | | | |√  | | | |Larry McKnight |Lawrence.mcknight@ |√ |√ |  |  |  |  |  |√ |  | |Patrick Mitchell-Jones |Patrick.mitchell-jones@npfit.nhs.uk |  |  | √ |  |  |  |  |  |  | |Linda Mook |mook@nictiz.nl |√ |  |  |  |  |  |  |  |  | |Karen Nocera |kyn@ |√ |  |  |  |  |  |  |  |  | |Kaori Nomura |Nomura-kaori@pmda.go.jp |√ |  |  | √ |  |  |  |  |  | |Frank Oemig |Frank.oemig@ |  |√ |  |  |  |  |  |  |  | |Charles Parisot |Charles.parisot@med. |√ |  |  |  |√  |  |  | |  | |Craig Parker |Craig.parker@ |  |√ |  |  |  |  |  |  |  | |Vesa Paxazinov |Vesa.paxazinov@vh.fi | | | | | | | |√ | | |Andrew Perry |Andrew@clinical-info.co.uk |  |  |  |  |  |  |  |√ |  | |Yvonne Pijnacker Hordijk |Yvonne.pijnackerhordijk@tna.nl | | | | | | | |√ | | |Cecile Pistre |Cecile.pistre@sanfi- |√ |√ |  |  |  |  |  |  |  | |Philip Pochon |Phil.pochon@ |  |  |  |  |  |  |√  | |  | |Craig Robinson |Craig.robinson@ |  |  | √ |  |  |  |  | |  | |Gunther Schadow |Schadow@regenstrief.iupui.edu |√ |  | √ | √ | √ |  | √  | | √ | |Amnon Shabo |shabo@il. |  |  |  |  |  |  | √  | |  | |Mark Shafarman |Mark.shafarman@ | | | | | | | |√ | | |Abdul-Malik Shakir |abdulmalik@ |√ |  |  | √ |  |  |  | |  | |Olivier Simoen |Oliver.simoen@emea.europa.eu |√ |√ |  |  |  |  |  |  |  | |Rik Smithies |Rik.smithies@cfh.nhs.uk |  |√ |  |  |  |  |  | √ |  | |Harry Solomon |Harry.Solomon@med. |  |  |  |  |  |  | √  | |  | |Steve Steindel |Sns6c@ | √ |  |  |  | √ |  |  | |  | |Lise Stevens |stevensl@cber. |√ |  |  |  |  |  |  |  |  | |Fredrik Strom |Fredrik.strom@brainpool.sc |  |  | √ |  |  |  |  |  |  | |Michael Tan |tan@nictiz.nl |√ |  |  |  |  |  |  |  |  | |Sylvia Thun |Sylvia.thun@dimdi.de |√ |  |  |  |  |  |  | √ |  | |Mollie Ullman-Cullere   |mullmancullere@ |  |  |  |  |  |  | √  |  |  | |Michael VanCampen |Michael.vancampen@ |  |  | √ |  |  |  |  | |  | |Geraldine Wade |gmwade@ |  |  |  |  |  |  |  |  |  | |Steve Wagner |Steve.wagner@ | √ |  |  |  |√  |  |  |  |  | |Mead Walker |dmead@ |√ |  |  |  |  |  |  |  |  | |Linda Walsh |Linda.cook@ |  |  |  |  |  |  |  |√ |  | |Taku Watanabe |Watanabe-taku@pmda.go.jp |√ |  |  |  |  |  |  |  |  | |Scott Whyte |white@chw.edu |  |  |  |  |  |  |√   |  |  | |Tim Williams |twillia@ |√ |  |  |  |  |  |  |  |  | |Michelle Williamson |mwilliamson@ |√ |  |  | √ |  |  |  |  |  | |Grant Wood |Grant.wood@ |  |  |  |  |  |  |√   | |  | |

Communication with declared O&O participants can be done through ord@lists.. You can sign up through the HL7 website, . List servers for focused aspects of the O&O domain are: bloodbank@lists., pharmacy@lists., microbiology@lists., lapauto@lists., and dicom@lists..

Monday Q1, Tuesday Q3, Friday Q1 – OO – V3 Ballot Reconciliation

See spreadsheets attached.

[pic][pic][pic][pic]

No CMETs to be reconciled.

Monday, Q2 – OO/Pt Care/PHER/Pt Safety/Rx

Exposure Report

Reviewed the slides attached.

[pic]

Notes on Slides

o Typo – Siblings should be children

o ICSR may need to make same adjustments as a result of the Exposure model. Exposure was the right thing.

Harmonization before harmonization worked. The conclusion is to take this approach again in the future. Many thanks to Austin and Christi to facilitate the two day conference call rally to get the work done!

Substance Administration

Slides:

[pic]

There is a disconnect between HL7 archtypicals (substance administration is everything) and other worldly (“dinner is not substance administration, it’s dinner”). Need to:

o potentially be more generic,

o change the name to something more palatable for outsiders,

o modify the description to clarify it is more then “pills” and other substances only provided by health care provider.

Questions along the way:

o Where is the intent vs. the actual example.

o In case of lipstick example, may not know the dose, but there was a dose.

o Dose is a red herring as it implies intent. May need to enhance the description, clarification.

Exposure/Substance Administration –

Gunther – Everything on the slides should fit. HL7 used Substance Administration terminology knowing it was intended to be used beyond drugs. Need to sell that the name is already generic: oiling a machine would fit. Extend description to make it further clear.

Hugh – Totally agreed with Gunther on the principle. Caution on how we are trying to categorize, particularly avoiding stating what it is not. Only positive examples.

Julie – Concerned with oiling a machine since the subject is non-living.

Christi – Public Health very much interested in non-living subject.

Peter (?) Gentleman to my right – Could say that it has to be substance/energy on a living thing. Dose is not intentional

Larry – Need to consider probabilistic relationship through another object to the final interest. E.g., interested in side effect of oiling the machine on the person(s) involved

Gunther – Definition is not specific about the subject needing to be living or non-living.

Austin – Summarized the relationship discussion between exposure and substance administration. As part of exposure may document substance administration involved in the exposure as needed. Conclusion is that we need both, but they are not always both needed.

Julie - Pass

Mead – The reason we have an issue. Need to have clear descriptions. Challenge is that at times people react more to the name. RIM and Ballot description of Substance Administration are not in sync.

William – Humidifying a ventilator could be used as another example. Similar as oiling ann machine. In Patient Care using Supply for food.. Consider Supply for general and Substance Administration medically intended.

Julie –

Gunther – Supply for diet (tray that they may or may not eat).

Larry –

Nora – A tray is given in the context of a tray.

Proposal (Hugh, Mead):

o Follow-through on list discussion to extend the examples and wording of Substance Administration.

o Recognize that the ballot is not the best way how to use, rather to have an explanatory document reviewing Exposure, Substance Administration, Supply. Approach to get it into materials TBD.

o ICSR to change Exposure to Substance Administration

Mead/Julie offered to work on second bullet. Vetting through list servers (Pt Care, Rx, PHER, OO).

Against: 0, Abstain: 3, In Favor: 39

Immunization

No status on the Immunization message ballot. Provider to Registry and Registry to Registry.

In PHER there are other use cases to be covered, and other standards to be considered/developed. Need to have consistency. Consequently want to create an Immunization DMIM. Want to work on use cases, interactions, etc, as well as services. Want to create V3 and V2 messages from this, as well as templates and implementation guides. All as projects. Will be kicked off tomorrow.

Related – Pt Administration, Adverse Events, Research, PH Statement, General Order and Observation based, ICSR.

Monday Q3 – V2.7 Proposals

Attached is the most current list of V2.7 proposals. Those discussed below are all included.

[pic]

Specimen Shipment

Austin reviewed the proposal for a new message to support messaging around specimen shipment status.

1. Should consider using more generic names for the Specimen Shipment segments.

2. Agreed to change Specimen Shipment to Shipment Segment (SHP) and drop Specimen from attribute names.

3. Agreed to change Specimen Transport Waypoint Segment to Transport Waypoint Segment (WAY).

Motion: Move proposal with agreed to adjustments into V2.7 ballot process. Austin, Patrick.

Against: 0, Abstain: 0, In Favor: 5

Proposal 492 - Make OBX-8 CWE

Reviewed Frank Oemig’s proposal.

Motion: Accept Frank’s proposal without modification. Joann, Austin.

Abstain: 0, Against: 0, In Favor: 5

Suggest that we expand this review to all other IS data types in OO chapters. Mechanism should be suggested through INM and Publishing to make this a cross-the-board change to all chapters. Motion: Austin, Joann.

Against: 0, Abstain: 0, In Favor: 5 Joann will be forwarding to INM/Publishing.

Proposal NN - Pharmacy Order Type

Reviewed Ruth’s proposal.

Motion: Accept this proposal to move into V2.7, unless INM comes back that IDs cannot change to CWEs or another pertinent objection.

Abstain: 0, Against: 0, In Favor: 5

Monday Q3 – OO/Pt Care/CDS

Order Set Ballot Reconciliation

Need to reconcile Order Set and Care Plan between Pt Care and CDS.

Should we allow for model against care statement and structured document.

Patient Care will reconcile to the Clinical Statement once Clinical Statement passes ballot.

Tuesday Q1 – OO/Rx/Lab

Motion to accept Typos. Patrick, Dick. Against: 0, Abstain: 0, In Favor: 20

Device Order should move into Composite Order – Patrick will take first stab, then review.

Promise a Promise Plan – To be done.

Supply Request changes in the composite order:

Confidentiality Code:

ID - Motion Voted and accepted “to have OO Change the 1..* to 0..*” (moved by Garry; seconded by John Hatem; 10/0/0 - passé)

Reason Act Relationship

Rx has =AN / OO has ................
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