<p>Pharmacy Working Group Meeting Minutes</p><p>Madrid, Spain May 8-11, 2017 Table of Contents a) Action List</p><p> b) c) Monday 8 May 2017 Q2 Attendees Name Organization Country Email Melva Peters (Chair) Gevity Canada [email protected] John Hatem (Scribe) US [email protected] Jose Costa Teixeira HL7 Germany Portugal [email protected] Svein Kristiansen Helse-vesti-ikt Norway [email protected] Inger.helen.storetvedt-khateeb@helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Ronny H. Andersen Helse-vesti-ikt Norway [email protected] Frederik Strom SALAR / SKL Sweden [email protected] Christof Gessner HL7 Germany Germany [email protected] Roman Radomski HL7 Poland Poland [email protected] Tom de Jong HL7 NL Netherlands [email protected] Jenni Syed Cerner US [email protected] Quorum Met: Yes Agenda Topics Finalize Agenda Reps to other quarters Assign Roles for Quarters - completed If we have new attendees, review Overview of Pharmacy material - V2, V3, FHIR Overview of Template work Hot Topics Approval of January 2017 WGM Minutes Supporting Documents Agenda http://wiki.hl7.org/index.php?title=May_2017_Pharmacy_WGM_Agenda Minutes January 2017 WGM Minutes Minutes/Conclusions Reached Introductions by attendees. A very international group of attendees. Representatives from Canada, US, Norway, Sweden, Germany, Netherlands, UK, Poland, Portugal/Belgium. Finalize Agenda completed. Melva made updates to agenda. See latest agenda. Reps to other WGs Tuesday Q2 - OO - 1 rep - will include a Catalogue Services update Tuesday Q3 - SD - CDA Product Family - 1 rep Wednesday Q2 - CDS - 1 rep - update on Chemotherapy Guide Wednesday Q4 Patient Care - allergy/intolerance - 1 rep Thursday Q1 Patient Care- Care Plan - 1 rep Assign Roles for Quarters Overview of Pharmacy material – FHIR by John and Melva. Overview of Template work – we suggested coming to Wednesday to understand this work. Approval of January 2017 WGM Minutes Motion to approve January 2017 minutes by Tom/ seconded by Jenni; Passed: 4-0-7 Action: Melva to post final January 2017 Minutes - complete d) Monday 8 May 2017 Q3 Attendees Name Organization Country Email Melva Peters (Chair) Gevity Consulting Canada [email protected] John Hatem ( Scribe) US [email protected] Jenni Syed Cerner US [email protected] Frederik Strom SALAR / SKL Sweden [email protected] Jose Costa Teixeira HL7 Germany Portugal [email protected] Svein Kristiansen Helse-vesti-ikt Norway [email protected] Inger.helen.storetvedt-khateeb)helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Ronny H. Andersen Helse-vesti-ikt Norway [email protected]</p><p>Quorum Met: Yes Agenda Topics Prep for Joint FHIR meeting Prep for Clinicians on FHIR - needs to be rescheduled to another quarter this week. Supporting Documents Agenda http://wiki.hl7.org/index.php?title=May_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached Prep for Joint FHIR meeting QA rules & Workflow patterns that will be used for R4 We discussed whether “patterns” refers to Workflow patterns is more broadly interpreted, and can be applied to QA rules too. For this week: e) What (if anything) does your WG want to be a candidate for normative in the next release? None of our current Pharmacy resources are ready for normative. f) What new resources/profiles/IGs would you like to be candidates for STU in the next release? Pharmacy has no plans to create any new resources. Pharmacy is interested in creating profiles and has started discussions, but we are in the very early phases. Pharmacy is still expecting there to be changes to the Medication resource. 3. Maturity levels for other resources/profiles/pages: What are your targets for R4? Medication Statement and Medication Request FYI: the other Pharmacy resources MM are: Medication Dispense – 2 Medication Administration – 2 Medication - 3 How will you get there? One need is to find a way to collect information on implementations – internationally. 4. Any concerns/issues? We will raise these issues in our joint meeting with FHIR. What is the process for FMM4? How do we gather implementation data from folks who are using our resources? What is the criteria used for “production ready”? What is FMG criteria for ready for “lock down”? What tooling should we use to create profiles? Is there training available? Is the tool Forge? We are exploring getting access to Simplifier to review existing profiles. g) Monday 8 May 2017 Q4 Attendees Name Organization Country Email Melva Peters (Scribe) Gevity Consulting Canada [email protected] John Hatem (Chair) US [email protected] Jenni Syed Cerner US [email protected] Frederik Strom SALAR / SKL Sweden [email protected] Svein Kristiansen Helse-vesti-ikt Norway [email protected] Inger.helen.storetvedt-khateeb)helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Ronny H. Andersen Helse-vesti-ikt Norway [email protected] Michael Brody Frederik Strom SALAR / SKL Sweden [email protected] Jean Duteau Duteau Design Canada [email protected] Tom de Jong HL7 NL Netherlands [email protected] Quorum Met: Yes Agenda Topics Pharmacy Co-Chair elections Update on Podiatry Functional Profile Project (Michael Brody) Swedish Project overview Prep for Clinicians on FHIR FHIR Tracker Items Supporting Documents Agenda http://wiki.hl7.org/index.php?title=May_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached Review of Podiatry Functional Profile Michael Brody provided a status of the FP that is being developed Some WGs still being consulted to see if they want to be a co-sponsor Will come back to Pharmacy and report in San Diego Swedish Project Have created an information model Will be mapping conceptual model to FHIR Model can be used by any project Currently only in Swedish – could translate concept model to English which would allow the Pharmacy WG to review Would be useful for Pharmacy WG to have it in English to contribute to pharmacy DAM Pharmacy Co-Chair elections Pharmacy electing 2 positions 4 candidates: Jean Duteau, Scott Robertson, Jose Costa Texeira, Yunwei Wang Please vote before Wednesday at 6pm Prep for Clinicians on FHIR Discussion of possible medication track topics – possibly dosage related questions from Chemotherapy Implementation Guide Reach out to Martin Smits to see if there is anything that came out of the Connectathon John to attend lunch meeting on Wednesday FHIR Tracker Items – see updated tracker items 7910 - http://gforge.hl7.org/gf/project/fhir/tracker/? action=TrackerItemEdit&tracker_item_id=7910&start=0 8106 http://gforge.hl7.org/gf/project/fhir/tracker/? action=TrackerItemEdit&tracker_item_id=8106&start=0 Action Items</p><p>Action: Reach out to Martin Smits to see if there is anything that came out of the Connectathon that could be looked at during Clinicians on FHIR - complete h) Tuesday 9 May 2017 Q1 Attendees Name Organization Country Email Michael Tan Nictiz NL [email protected] Christof Gessner HL7 Germany DE [email protected] Frederik Strom SALAR / SKL Sweden [email protected] Tom de Jong HL7 NL NL [email protected] Svein Kristiansen Helse-vesti-ikt Norway [email protected] Inger.helen.storetvedt-khateeb)helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Ronny H. Andersen Helse-vesti-ikt Norway [email protected] Jose Costa Teixeira HL7 Germany Portugal [email protected] Michelle Miller Cerner US [email protected] Melva Peters Gevity Consulting Canada [email protected] Quorum Met: Yes Agenda Topics NL Project Update and Discussion (Michael Tan) Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached NL Project Update and Discussion (Michael Tan) Profile includes 2 scenarios – nurse administers medications and patient administers medications Prescription for a patient to take medications. Derive instance orders Nurse queries for administration schedule Need a way to query administrations assigned to a specific performer – nurse does not have the list of patients in advance – currently not supported but there is a tracker item (http://gforge.hl7.org/gf/project/fhir/tracker/?action=TrackerItemEdit&tracker_item_id=12439&start=0 ) Nurse scans the bar code of the medication – may include the patient name Medication – when administered – record lot number and expiry date. Need to use medication reference to include this information. Need to use a contained medication resource to include it. Patient administered medications – could be medication statements or administrations Tom will attend O&O on Wed Q4 to participate in discussion around medication patterns Intended performer on Medication Request – will continue discussion this week i) Tuesday 9 May 2017 Q2 – Joint with FHIR-I Attendees Name Organization Country Email Svein Kristiansen Helse-vesti-ikt Norway [email protected] Inger.helen.storetvedt-khateeb)helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Ronny H. Andersen Helse-vesti-ikt Norway [email protected] Melva Peters Gevity Consulting Canada [email protected] Danielle Friend Epic US [email protected] Alexander Henket HL7 NL NL [email protected] Ewout Kramer NL Jenni Syed Cerner US [email protected] Frederik Strom SALAR / SKL Sweden [email protected] John Hatem US [email protected] Jean Duteau Duteau Design Can [email protected] William Jones [email protected] Dennis Paterson Cerner US [email protected] Marten Smits Furore NL [email protected] Quorum Met: Yes Agenda Topics QA rules & Workflow patterns that will be used for R4 Planned ballot timeline: What (if anything) does your WG want to be a candidate for normative in the next release? What new resources/profiles/IGs would you like to be candidates for STU in the next release? Maturity levels for other resources/profiles/pages Any concerns/issues? Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached QA rules & Workflow patterns that will be used for R4 Feedback on existing rules and patterns by end of May 2017 (issues with existing ones, proposals for change) – addition of workflow – not a lot of guidance of how to apply – took very literally. Made it more complex. QA rules – not a lot of information on how to interpret Need support for determining who has implemented. Can we move to a higher maturity level if only DSTU2 has been implemented? Maybe able to use test servers V3 mappings – hasn’t been an issue for Pharmacy as there is experience in V3 in this WG. In some cases, is useful to compare across attributes by looking at mapping Publication: Data types must be normative for the resource to go normative For this week: 1. What (if anything) does your WG want to be a candidate for normative in the next release? - None 2. What new resources/profiles/IGs would you like to be candidates for STU in the next release? May have profiles on dosage Tool of choice is Forge IGuides – chemotherapy IG, MedList IG Discussion of extension – will be removing 3. Maturity levels for other resources/profiles/pages: What are your targets for R4? MedicationRequest, MedicationStatement = 4; all others will be 3 4. Any concerns/issues? Concerns about the tooling – issues with multiple builds and broken builds and error messages Melva may have some additional cycles to help other WGs j) Tuesday 9 May 2017 Q3 Attendees Name Organization Country Email John Hatem US [email protected] Jenni Syed Cerner US [email protected] Inger.helen.storetvedt-khateeb)helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Frederik Strom SALAR / SKL Sweden [email protected] Christof Gessner HL7 Germany DE [email protected] Alegjandro Vergara France Jose Costa Teixeira HL7 Germany Portugal [email protected]</p><p>Quorum Met: Yes Agenda Topics FHIR Tracker Items Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached Trackers # 5827 (Medication status code) This was added in STU 3. Motion to close/resolve (this is already in STU 3) Motion: Jose/Frederik seconded 5/0/1 # 7406 (Medication Statement List) We don’t typically call this out on the resource when it’s an “any” (eg: bundle isn’t called out). This would belong elsewhere in the spec (resource guide or an IG) Not Persuasive. Motion: Christof/Jose seconded 5/0/1 # 7641 (moving extensions to core) Not going to vote on it, Melva is working on discussions in the background. # 12332 (search by code vs. chained to Medication.code) This may be a unique problem for meds? Does any other resource have a code field. Agree it is hard. You would need to search for code, OR medication (after searching Medication by code first), OR contained? IE: /Medication?code=SOMESNOMED1 /MedicationStatement?medication=123,456 (from search above) /MedicationStatement?code=SOMESNOMED1 /MedicationStatement? ?? (how to search chained to either a reference or contained?). Will defer/discuss with FHIR-I. What can we do to make this work? How would they search the contained or referenced Medication via chaining (we don’t think this is possible right now?) Is there a means to know if FHIR server employees codeable or reference? Answer: No, not easily. Could be determined assuming all profiles are published, but that may not be true. And a system may allow both. Is there a means to know if they’re fully populated? No, not always. If a specific profile flagged a field as required, yes. But often either codeable or reference could be used within a server. Similar to issue above, it depends on if a field is marked required – but many servers may allow for both. # 12899 (link med admin to instance order) Rename MedicationAdministration.prescription to MedicationAdministration.request and update the documentation accordingly to make it clear that you can use the request to reference the MedicationRequest order or the MedicationRequest instance order. Persuasive with Mod Motion: Jose/Frederik seconded 6/0/0 # 12790 (Dosage should include device and pharmacist may need to include instructions on admin device usage) We’re confused about the use case. Why would this change Dosage rather that Med Admin fields? We think, perhaps, this is for closed loop? EG: allowing the pumps to send adjustments back based on BP or other conditionals set out by the order? Dispensing and Admin can be the device, but a human prescribes (ie: vary drip between X and Y based on heart rate). We need more info to confirm intent from Stephen. There’s not enough info to determine the use case. # 13043 (fix performer on Med Dispense, update description and add role back with appropriate value set) Add performer.role back? Punt, longer discussion, need to determine value set for role. # 13044 (same as above but Med Admin) Punt, longer discussion, need to determine value set for role. # 13157 (rateSimpleQuantity for a simple rate) Ran out of time, probably should add new example for simpleQuantity Action Items Action: Update Tracker 5827 (Close/resolve, see notes above) Done by John Hatem on May 9, 2017 Action: Update Tracker 7406 (Not persuasive, see notes above) Done by John Hatem on May 9, 2017 Action: Update Tracker 12332 (need input from FHIR-I on easy way to do this, see notes above) Action: Update Tracker 12899 (Persuasive w/Mod, see notes above) Done by John Hatem on May 9, 2017 Action: Update Tracker 12790 (Need input from Stephen) k) Wednesday 10 May 2017 Q1 Attendees Name Organization Country Email John Hatem US [email protected] Frederik Strom SALAR / SKL Sweden [email protected] Melva Peters Gevity Consulting Canada [email protected] Christoff Gessner HL7 Germancy DE [email protected] Jose Costa Teixeira HL7 Germany Portugal [email protected] Jenni Syed Cerner US [email protected]</p><p>Quorum Met: Yes Agenda Topics Schedule for Conference calls DMP M&C SWOT Forward Planning Project Review 3-year plan review Action Item list review Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached Time/Day for conference call Current day is Monday at 4pm Eastern Update to Mission and Charter Moved by Jenni – seconded by Frederick to approve updated M&C – 5-0-0 SWOT Is there marketing material for FHIR – do they need something from Pharmacy Moved by Jose – seconded by Frederick to approve updated SWOT – 5-0-0 Carried 3-year Plan Review See Action Items</p><p>Action: Melva to send doodle poll to confirm day/time for the meetings - complete Action: Melva to send M&C draft to TSC Action: Reach out to FMG re: FHIR marketing material for Pharmacy l) Wednesday 10 May 2017 Q2 Attendees Name Organization Country Email John Hatem US [email protected] Melva Peters Gevity Consulting Can [email protected] Jenni Syed Cerner US [email protected] Jose Costa Teixeira HL7 Germany Portugal [email protected] Mark Shafarman Sebastian Bojanowski HL7 Poland Christof Gessner HL7 Germany DE [email protected] Quorum Met: Agenda Topics Pharmacy Template Work Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached From last time – had updated Medication Order based on previous discussions Medication Order – cannot prescribe compounded products (via ingredient) – will discuss later Could do a simple Medication Statement and then an enriched Medication Order that supports fully specified ingredients – Kai will use IHE work to bring this work in Medication Dispense – needs the enriched ingredient drug Medication Administration – use simple drug Medication Statement –EVN or INT Medication Order –RQO Medication Dispense – EVN Medication Administration – EVN Ballot as comment only for September ballot – Medication Order and Medication Statement Moved by Kai – seconded by Mark to ballot as Comment Only in September. 6-0-0 Carried Next template to start working on is Kai Action Items</p><p>Action: NIB – Melva to submit Action: Kai to create PDF – needs an introductions and contributors from Pharmacy WG Action: Kai will send an example to Melva and John Action: Melva to update project timelines Action: Melva and John to provide examples to Kai m) Wednesday 10 May 2017 Q3 Attendees Name Organization Country Email Melva Peters (Chair) Gevity Canada [email protected] John Hatem (Scribe) US [email protected] Svein Kristiansen Helse-vesti-ikt Norway [email protected] Inger.helen.storetvedt-khateeb)helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Ronny H. Andersen Helse-vesti-ikt Norway [email protected] Jenni Syed Cerner US [email protected]</p><p>Quorum Met: Yes Agenda Topics FHIR Tracker Items Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached Discussed “core extensions” to Pharmacy materials that have been in place since 2015. The spreadsheet that lists these extensions is updated with our decisions, comments, and questions. Tracker Item review Melva is updating tracker items directly in gForge. Items being discussed are: 13184 13341 – this tracker item has also informed our work to review all core pharmacy extensions on all of our resources. 7641 13150 10125 – duplicate of 7641 Action Items</p><p>Action: Melva will send core extensions spreadsheet to CDS to ask for a follow-up meeting to address our questions and inform them of – Melva talked to Claude Nanjo on Friday – he is okay with us removing the extensions - complete n) Wednesday 10 May 2017 Q4 Attendees Name Organization Country Email Melva Peters (Chair) Gevity Canada [email protected] John Hatem (Scribe) US [email protected] Svein Kristiansen Helse-vesti-ikt Norway [email protected] Inger.helen.storetvedt-khateeb)helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Ronny H. Andersen Helse-vesti-ikt Norway [email protected] Jenni Syed Cerner US [email protected] Danielle Friend Epic US [email protected] Michelle Miller Cerner US [email protected] Quorum Met: Y Agenda Topics Rep to Patient Care FHIR Tracker Items Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached FHIR Tracker Items discussed in this meeting listed below. Note that the tracker items are being updated with votes and our resolutions. See gForge for this information. 13157 12791 12790 12732 – resolved no change 13222 13317 13329 – resolved no change Action Items</p><p>Action: Melva to contact CDS and Tim from SureScripts to assess requirements for a coded precondition on MedicationRequests. Other parties can also be contacted. o) Thursday 11 May 2017 Q1 Attendees Name Organization Country Email Melva Peters (Chair) Gevity Canada [email protected] Oyvind Aassve Norway [email protected] Ashley Duncan Furore [email protected] Vadim Peretoken Furore [email protected] John Hatem (Scribe) US [email protected] Svein Kristiansen Helse-vesti-ikt Norway [email protected] Inger.helen.storetvedt-khateeb)helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Ronny H. Andersen Helse-vesti-ikt Norway [email protected] Jenni Syed Cerner US [email protected]</p><p>Quorum Met: Yes Agenda Topics Norwegian Project Update - MedicationStatement Profile FHIR Tracker Items Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached Norwegian Project - Kule Implementing an electronic charting systems – integrated with electronic health region (DIPS) Kule – transferring information about drug use between charting system and drug system Use Case – when admitted or discharged – gather information from sources including patient Using MedicationStatement Extensions – 3 in MedicationStatement and 9 in dosage 3 extensions are superceded by STU3 MedicationStatement authoredOn – to capture the date the prescription was authored on DrugUseType – binds to a value set – includes treatment types and drug types (vaccine and nutrition) Status – this can be removed – “on hold” is now in STU3 calculationBasis – to specify what forms the basis for calculating the dose – NO team will create a tracker item for core daysAdministeredAmount – number of days the drug is to be used within the specified period daysNotAdministeredAmount – number of days drug not administered in a period NO team will create a tracker item for core for these two extensions Shortdosage – binds to a value set – expresses doses at a time – over 200 codes – NO team will create a tracker time AdministerAtSpecificTime – medication must be given/taken at exact times Extension – number of units of time that must pass before next dose is given – minimum/maximum – bound to units of time dayOfWeek – now covered in STU3 specificTime – now covered in STU3 timePeriod – will add tracker to add new codes/change to extensible p) Thursday 11 May 2017 Q2 Attendees Name Organization Country Email Melva Peters (Chair) Gevity Canada [email protected] John Hatem US [email protected] Michelle Miller Cerner US [email protected] Isabelle Gibaud FR [email protected] Ronny H. Andersen Helse-vesti-ikt Norway [email protected] Michael Tan Nictiz NL Christof Gessner HL7 Germancy DE [email protected] Jose Costa Teixeira HL7 Germany Portugal [email protected] Jenni Syed Cerner US [email protected]</p><p>Quorum Met: Yes Agenda Topics Overview of IDMP (Jean) FHIR Tracker Items Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached IDMP Review Pharmaceutical Product – uses ingredients/individual substances Packaged medicinal product Medicinal Product MPID - Multiple levels of identifiers – will be globally unique Product Classification Name/Country Substance Ingredient Discussion of whether we should re-vamp the medication resource – package Action Items</p><p>Action: Jean to create tracker item related to revising the medication resource - complete q) Thursday 11 May 2017 Q3 Attendees Name Organization Country Email John Hatem (Chair) US [email protected] Jenni Syed Cerner US [email protected] Isabelle Gibaud FR [email protected] Svein Kristiansen Helse-vesti-ikt Norway [email protected] Inger.helen.storetvedt-khateeb)helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Ronny H. Andersen Helse-vesti-ikt Norway [email protected] Jose Costa Teixeira HL7 Germany Portugal [email protected] Grahame Grieve Mead Walker</p><p>Quorum Met: Yes Agenda Topics FHIR Tracker Items Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda Minutes/Conclusions Reached FHIR Tracker Items 7641 - Made sure we reviewed extensions on all Resources. Medication: medication-usualRoute: Don’t feel this would be a core extension, possibly not an extension at all. Would normally have route on Med Request. 12396 - Medication product vs package Gaps: no way to indicate inactive in the package section (but there’s an open tracker to fix this, and add Substance). Inconsistent info may always exist. Examples exist with both ingredient and package. Usage is most common to have substance at top and actual product lists in the package section. Requested guidance from submitter to review examples, we don’t believe invariant is need. No action other than this yet. 12439 – Med Request administration performer Most assignments in patient not done at this level – the nurse is assigned to a patient (inpatient)? Jose’s assignment is done very close to time of admin, once they know who will be giving. Norway has use case where doctor would demonstrate to parent, then pharmacy would know that prescription would be given by parent. May also know role type for MAR rather than specific person. Motion (Jose): include intendedPerformer field to MedicationRequest (similar to the intended dispenser). Grahame (seconded). 7/0/1 Persuasive with Mod Note: have separate elements for actual (person, related person, practitioner…) and one for “role” (mother, nurse, oncologist). Both can be set. 12993 – NonMedicationAdministrationObject May fit into Procedure/ProcedureStatement? RE: Blood Products and tube feedings (4 and 5 on the tracker), we’ve had some discussions about this. Should admin be typed so you could indicate blood product, tube, dialysis… Could be broader discussion combined with OO Are we sure 4 (dialysis) fits here? Common approach is appealing. Would we rename it to make it more generalized for these problems? Discussion with OO 1, 2, 3 are not part of Med Admin. Bounce to OO, but we don’t need to be part of this discussion FDA is calling Blood a device. Action Items</p><p>Action: John to follow up with Melva to ensure we reviewed the extensions in the context of each resource when it applied to each resource - complete Action: Create new tracker on Med Admin, to add a section header to break up extensions that are part of this resource vs. extensions that reference this resource Action: create tracker for Medication.medication-usualRoute extension to follow up with creator Action: 12439: Mark persuasive with mod, see notes above - complete Action: 12993: Discuss with OO. See notes above. 1, 2, 3 won’t need us at the table. We would like to be present for 4 and 5. - complete r) Thursday 11 May 2017 Q4 Attendees Name Organization Country Email John Hatem (Chair) US [email protected] Jenni Syed Cerner US [email protected] Mead Walker Isabelle Gibaud FR [email protected] Jose Costa Teixeira HL7 Germany Portugal [email protected] Claude Nanjo Quorum Met: Yes Agenda Topics CIMI Medication Model Supporting Documents Agenda http://wiki.hl7.org/index.php?title=January_2017_Pharmacy_WGM_Agenda CIMI http://models.opencimi.org/ http://models.opencimi.org/cimi_doc/ (select Packages: Pharmacy in the upper left section to see pharmacy) Minutes/Conclusions Reached CIMI Logical models to back FHIR profiles for interop Issues faced with FHIR: anyone can profile resources in any way. The logical model from CIMI specifies down to details including terminologies. IE: In CIMI for Observations, it defines the types of Observations a provider would like to see (at the leaf level). However, intent is to do more. How priorities created (eg: Observations still being worked on) Try to get top level patterns for VMR and define core foundational logical patterns. Each resource in FHIR will have a logical model behind it. Then that would be the foundation that would build a FHIR profile on top of it. CIMI is an umbrella, would like pharmacy to take ownership of the logical models, and then CIMI would model them based on those requirements. Do any own any today? PC is helping on some, but the process for ownership has not been formalized. How does logical model compare to a DAM? Suggest to build logical models on CIMI. Close enough to not worry about any differences. Should real question be: does this resource have the right content to support the CIMI logical model? And who is going to handle this? Pharmacy WG defines requirements. Claude has a spreadsheet to show how CIMI aligns with Pharmacy. Should review that spreadsheet FHIR Trackers 13149: isBrand to conceptType/flag remove isBrand? We would need to look through why we added it. Different from substitution. Jose: proposed using system URL. EG: http://rxnorm…#brand (this is not legal/valid per the fhir defined urls for RxNorm. Similar issue for SNOMED-CT or other concepts that are well known terminologies with system URLs defined by FHIR) Action Items Action: Discuss how to work together between now and September so we can work together in September. Claude with contact John to send info re: current form of the models. John to discuss what the best approach might be with other co-chairs. Action: John to ask Claude for the existing spreadsheets. Action: 13149 – review why we have isBrand or why it was added. Discussion here can’t reach a use case where this would apply s) Full list of attendees Name Organization Country Email Alegjandro Vergara France Alexander Henket HL7 NL NL [email protected] Ashley Duncan Furore [email protected] Christof Gessner HL7 Germany Germany [email protected] Claude Nanjo Danielle Friend Epic US [email protected] Dennis Paterson Cerner US [email protected] Ewout Kramer NL Frederik Strom SALAR / SKL Sweden [email protected] Grahame Grieve Inger.helen.storetvedt-khateeb@helse-vest- Inger H. S-Khateeb Helse-vesti-ikt Norway ikt.no Isabelle Gibaud FR [email protected] Jean Duteau Duteau Design Canada [email protected] Jenni Syed Cerner US [email protected] John Hatem US [email protected] Jose Costa Teixeira HL7 Germany Portugal [email protected] Mark Shafarman Marten Smits Furore NL [email protected] Mead Walker Melva Peters Gevity Consulting Canada [email protected] Michael Brody Michael Tan Nictiz NL [email protected] Michelle Miller Cerner US [email protected] Oyvind Aassve Norway [email protected] Roman Radomski HL7 Poland Poland [email protected] Ronny H. Andersen Helse-vesti-ikt Norway [email protected] Sebastian Bojanowski HL7 Poland Svein Kristiansen Helse-vesti-ikt Norway [email protected] Tom de Jong Netherlands [email protected] Vadim Peretoken Furore [email protected] William Jones [email protected]</p>