Pharmacy Working Group Meeting Minutes

Baltimore, MD

September 19-23, 2016

Table of Contents

Monday 19 September 2016 – Q3 3

Monday 19 September 2016 – Q4 – Joint with RCRIM 5

Tuesday 20 September 2016 – Q1 6

Tuesday 20 September 2016 Q2 – Joint with FHIR 7

Tuesday 21 September 2016 Q3 9

Tuesday 20 September 2016 Q4 – Joint with PHER (PHER Hosted) 10

Wednesday 21 September 2016 Q1 11

Wednesday 21 September 2016 Q2 13

Wednesday 21 September 2016 Q3 15

Wednesday 21 September 2016 Q4 16

Thursday 22 September 2016 Q1 17

Thursday 22 September 2016 Q2 18

Thursday 22 September 2016 Q3 - Cancelled 19

Thursday 22 September 2016 Q4 - Cancelled 20

Full list of attendees 21

Action List

Action: Melva to send email to cancel Quarter Q4 – Pharmacy will attend RCRIM 4

Action: Melva to follow-up with Patient Care about what the Clinical Statement Care plan is about 4

Action: Melva to send email to cancel Pharmacy meetings for Thursdays Q3 and Q4 4

Action: 5

Action: Melva to confirm if we need new projects for the re-affirmation ballot 11

Action: Melva to schedule a teleconference to discuss further 12

ACTION: add to list of implementations 13

ACTION: create wiki page with links to implementations … Marla has many, plus this one 13

ACTION: Need OID for templates and value sets – find or create 13

ACTION: send “what’s next” items to Kai … MedicationStatement 13

ACTION: FHIR examples to transform into CDA 13

Action: 19

Action: 20

Monday 19 September 2016 – Q3

Attendees

Name / Organization / Country / Email
Melva Peters (Chair) / Gevity / Canada
Marla Albitz (Scribe) / Wolters Kluwers Health / USA /
Tom De Jong / Netherlands /
Scott Robertson / Kaiser / USA
John Hatem / USA /
Jenni Syed / Cerner / USA
Tim McNeil / Sure Scripts / USA /
Hugh Glover / UK
Christof Gessner / DE
Quorum Met: Yes

Agenda Topics

·  Finalize Agenda

·  Formulary PSS or Formulary discussion for FHIR

·  Reps to other WGs

·  Monday Q4 - EHR WG (Mega Report-Out (EHR WG hosting) with 9 related WGs • EHR and other WG Reports Head count does NOT include formally invited WGs) and RCRIM (RCRIM/Pharmacy collaboration. Topics of discussion would include CPM, FHIR, OpenMedicine PSS per their Jan 2016 WGM presentation, and any other topics as applicable.)

·  Tuesday Q2 - O&O (Address UDI and CPM topics. Remainder will be on joint FHIR resources of interest.)

·  Tuesday Q4 - Patient Care (PCWG hosting FHIR, ECWG, Vocab and Clinical Genomics, OO, CIMI, StrucDocs - topic = negation modelling + vocab discussions Please send reps)

·  Wednesday Q4 - Patient Care (PCWG hosting reps from SDWG and Pharmacy re Allergy and intolerance: vocab and harmonization discussions)

·  Thursday - Q1 - Patient Care (PCWG Care Plan projects - FHIR and C-CDA harmonization discussions, please send reps IHE Dynamic Care Plan Profile Pharmacy Care Plan - PSS Update/Vote on CP DAM Publishing C-CDA on FHIR IHE DCP profile)

·  Thursday Q3 - Clinical Statement (Only expect representatives from Pt Care, Rx, Struc Doc depending CS agenda as we are in maintenance mode. Rest of the agenda will be OO.) and EHR ("FP Reports / Internal Business Pharmacy EHR, Child Development, Dental, UDI FPs (R2) • Review Website, Recommend Updates Invitees: S. Thompson, S. Spiro, P. Yu, Headcount does NOT include formally invited WGs)

·  Assign Roles for Quarters

·  If we have new attendees, review

·  Overview of Pharmacy material - V2, V3, FHIR

·  Overview of Template work

·  Hot Topics

·  Approval of May 2016 WGM Minutes

·  FHIR Ballot Reconciliation

Minutes/Conclusions Reached

·  Shelly Spiro will be attending Tuesday Q1 to discuss Care Plan project

·  Cancelling Pharmacy meeting for Monday Q4 to allow Rx committee to attend RCRIM

·  Marla to attend Wednesday Q4 – Patient Care – Allergy and intolerance discussion

·  Add agenda item for Wednesday morning – Joint meeting for IHE, ISO and Pharmacy – requested by Christof Gessner

·  Due to lack of attendee availability, cancelling Thursday Q3 and Q4

·  Moved to accept Montreal 2016 working group meeting minutes. Vote Passed 7:1:0

Action: Melva to send email to cancel Quarter Q4 – Pharmacy will attend RCRIM

Action: Melva to follow-up with Patient Care about what the Clinical Statement Care plan is about

Action: Melva to send email to cancel Pharmacy meetings for Thursdays Q3 and Q4

Monday 19 September 2016 – Q4 – Joint with RCRIM

Attendees

Name / Organization / Country / Email

Agenda Topics

Supporting Documents

·  Agenda

·  http://wiki.hl7.org/index.php?title=September_2016_Pharmacy_WGM_Agenda

Minutes/Conclusions Reached

Action:

Tuesday 20 September 2016 – Q1

Attendees

Name / Organization / Country / Email
Shelly Spiro / PharmacyHIT / USA
Scott Robertson / Kaiser Permanente / USA
Robin Williams / Lantana / USA
Sue Thompson / NCPDP / USA
David Hay / NZ /
Christof Gessner / DE
Tim McNeill / Sure Scripts / USA
Tom De Jong / NL
Marla Albitz / Wolters Kluwer / USA /
Yunwei Wang / IMO / USA /
Tony Schueth / Point of Care Partners / USA
John Klimer / NCPDP / USA /
Oskar Thunman /
John Hatem / USA
Lee Surprenant / IBM / USA
Quorum Met: Yes

Agenda Topics

·  Update on Pharmacist Care Plan Project (Shelly Spiro)

·  Preparation for Clinicians on FHIR meeting

·  FHIR Ballot Reconciliation

·  Review of 2 ballots that need to be reaffirmed

·  Reaffirm HL7 EHR-System Pharmacist/Pharmacy Provider Functional Profile, R1 - US Realm

·  Reaffirm HL7 Version 3 Standard: Medication; Knowledge-Based Query, R1

·  Reps

·  Tuesday Q2 O&O - not needed

·  Thursday Q3 - Clinical Statement - not needed

Supporting Documents

·  Agenda

·  http://wiki.hl7.org/index.php?title=September_2016_Pharmacy_WGM_Agenda

Minutes/Conclusions Reached

·  David Hay provided demonstration of the FHIR Resource Creator for “Clinicians on FHIR”

·  Shelly Spiro presented a project update

·  Motion to reaffirm HL7 HER-System Pharmacist/Pharmacy Provider Functional Profile, R1 – US Realm – Motion/Second – Scott/Shelly 13:0:0

·  Motion to reaffirm HL7 Version 3 Standard: Medication; Knowledge-Based Query, R1 – Motion/Second Scott/Tim 13:0:0

Tuesday 20 September 2016 Q2 – Joint with FHIR

Attendees

Name / Organization / Country / Email
Marla Albitz / Wolters Kluwer / USA /
Cristof Gessner / DE
Yunwei Wang / USA /
Tom de Jong / NL
John Hatem / USA
Scott Robertson (scribe) / Kaiser / USA
Oskar Thunman
Alexander Henuet / NL
Inger Helen Storetvet-khaheeb
Melva Peters / CAN
Eldina Kroamer / Furore /
Mary Visceglia / NCCN /
B…. K…
Lee Suprenant / IBM /
Quorum Met: Yes

Agenda Topics

·  Pharmacy hosting FHIR-I

·  Introductions

·  FHIR-I coordination session

Supporting Documents

·  Agenda

·  http://wiki.hl7.org/index.php?title=September_2016_Pharmacy_WGM_Agenda

Minutes/Conclusions Reached

·  Pharmacy hosting FHIR-I

·  Introductions

·  FHIR-I coordination session

·  Plans for the coming month, up to publication

·  General overview

·  Ballot recon for SU3 … publication target 31Dec2016

·  ~700 comments across all work groups

·  (21 for pharmacy)

·  Half of comments referenced to gForge items

·  Oct 9 for change requests

·  Nov 27 deadline for substantive changes

·  Dec 4 final content deadline

·  Then QA and publish

·  Pharmacy

·  9 negatives

·  1 question, 1 question

·  1 we think needs to more to FHIR-I (Ewout agrees move to tooling)

·  Workflow discussion

·  eventHistory vs Provenance

·  who … action … why … date

·  no negative on eventHistory

·  changing will be a substantive change

·  resource name change … *Order to *Request

·  some chatter that the change may not happen

·  QA report

·  A lot are eventHistory … will go away when addressed

·  “INFORMATION:phx: …” don’t know what this is

·  Duplicate descriptions

·  Maturity Level

·  Review of the level definitions

·  Want to be at level 3 to publish (not required)

·  Our levels in google sheet are not reflected in the FHIR site

·  Specific review of our current maturity levels and what we

·  Medication at 2, goal is 3

·  MedicationOrder at 2, goal is 3

·  MedicationAdministration at 1, need to find implementations. In hospitals, tracked in EHR with no business need to expose as a resource. Need to find business cases to get some vendor on board. Likely will stay at 1

·  MedicationDispense at 1. No implementers at present. International is looking at looking at possible implementation. Likely will stay at 1 for publication

·  MedicationStatement at 2, goal for 3

Tuesday 21 September 2016 Q3

Attendees

Name / Organization / Country / Email
Tom De Jong / NL
Marla Albitz (Scribe) / Wolters Kluwer Health / USA
Inger Helen Storehedt-khahees / Norway
Scott Robertson (Chair) / Kaiser / USA
Tim McNeill / Sure Scripts / USA
Michelle Miller / Cerner / USA
John Hatem / USA
Quorum Met: Yes

Agenda Topics

·  John to Patient Care

·  Action Items

·  FHIR Ballot Reconciliation

Supporting Documents

·  Agenda

·  http://wiki.hl7.org/index.php?title=September_2016_Pharmacy_WGM_Agenda

Minutes/Conclusions Reached

·  Motion to vote for 11182 as Persuasive and 11185 as Persuasive with mode – Motion/Second Marla/Tim Vote 6:0:0

Tuesday 20 September 2016 Q4 – Joint with PHER (PHER Hosted)

Attendees

Name / Organization / Country / Email
Quorum Met:

Agenda Topics

·  Bullet

·  Bullet

Supporting Documents

·  Agenda

·  http://wiki.hl7.org/index.php?title=September_2016_Pharmacy_WGM_Agenda

Minutes/Conclusions Reached

Wednesday 21 September 2016 Q1

Attendees

Name / Organization / Country / Email
John Hatem
Tom de Jong
Tim McNeil
Cristof Gessner
Francois Macary
Daniel Zhang
Michael Tan
Melva Peters
Marla Albitz
Steve Posnack
Brett Marquard
Quorum Met: Yes

Agenda Topics

·  Schedule for Conference calls

·  DMP

·  M&C

·  SWOT

·  Forward Planning

·  Project Review

·  Formulary PSS

·  3-year plan review

·  Action Item list review

·  Pharmacy FHIR Maturity Project Review (Brett, Eric, Melva)

· 

Supporting Documents

·  Agenda

·  http://wiki.hl7.org/index.php?title=September_2016_Pharmacy_WGM_Agenda

Minutes/Conclusions Reached

·  Discussion of teleconference calls

·  Will keep the calls Mondays at 4pm Eastern

·  Next call will be in 2 weeks

·  DMP, M&C, SWOT

·  No need to review

·  Forward planning and Project Review

Action: Melva to confirm if we need new projects for the re-affirmation ballot

·  Should we consider starting the work on the Formulary Project?

·  Pharmacy FHIR Maturity Project – Brett Marquard, Melva Peters, Steve Posnack – see presentation

·  Brett described a project that is underway supported by ONC to mature the pharmacy resouces

·  Key objective is to improve base resources – looking at vendors

·  MedicationAdministration is being used in Australia – check with Brian Postlewaite

·  Steve confirmed that it is US biased – goal is to mature the resources but can consider international requirements as necessary.

·  There may be requirements that expressed as extensions if they are US centric

·  Optimistic that we can get to Maturity Level 3

·  Use Cases involve patient access to an active medication list; dispense medication from pharmacy; access to prescriptions; add new medication to patient medication list; access to medication list – definition of the content should not define or limit how this will access will be done.

·  What is a medication list – NL is struggling with this.

·  Connect-a-thon in January

·  What is the right level of collaboration with Pharmacy WG? Tom is interested – relevant to what is going on in NL; Germany is interested as they are sharing med list on a barcode

Action: Melva to schedule a teleconference to discuss further

·  Project Scope Statement: Pharmacy has a PSS that is broad enough to support this work or DAF PSS.

·  New PSS: Pharmacy suggested a new PSS – would be required if the profiles go out to ballot.

·  Joint meeting – IHE Pharmacy, ISO, HL7 Pharmacy

·  Consider a meeting for Madrid WGM – need to determine the agenda

·  Can we find other ways to share overviews? Focus on joint topics where discussion is needed

Wednesday 21 September 2016 Q2

Attendees

Name / Organization / Country / Email
Melva Peters
Kai Heitmann
Marla Albitz
Daniel Zhang
Inger H.S. Khateeb
Scott Robertson
Christof Gessner
Tom de Jong
John Hatem
Mark Shafarman
Quorum Met: Yes

Agenda Topics

·  Germany Medication List project

·  Pharmacy Templates Project

·  Reaffirmation Ballots

Supporting Documents

·  Agenda

·  http://wiki.hl7.org/index.php?title=September_2016_Pharmacy_WGM_Agenda

Minutes/Conclusions Reached

·  Germany Medication List project

·  http://wiki.hl7.de/index.php?title=IG:Ultrakurzformat_Patientenbezogener_Medikationsplan

·  2 efforts to have a nation-wide

·  Limited capacity media

§  One coded with 2-D barcode

§  Other uses smartcard

§  CCD is not an option

·  Thinking to use FHIR MedicationStatement

§  “ultrashort” form. Minimized content, shortened tags, somewhat modified structure

§  Xslt to transform to normal version, maybe CCD

§  Still limited in content - Trying to put 15 lines in a barcode

·  Coded fits

·  Free text (eg uncoded Sig) needs second barcode

·  Probably a transient project 3-5 years

ACTION: add to list of implementations

ACTION: create wiki page with links to implementations … Marla has many, plus this one

·  Pharmacy Template project - Follow up from last WGM – V3 work/CDA

ACTION: Need OID for templates and value sets – find or create

·  <add material from Kai>

ACTION: send “what’s next” items to Kai … MedicationStatement

ACTION: FHIR examples to transform into CDA

·  Link from Kai for ArtDeco

·  Dates

·  MedicationOrder review next WGM

·  Can we ballot in May Cycle? Normative

·  Reaffirmation Ballots

·  Need PSS’s … Melva will address

·  Functional Profile - Scott will check on whether this is an EHR project or a Pharmacy project

Wednesday 21 September 2016 Q3