HL7 Pediatric Data Standards Special Interest Group

HL7 Pediatric Data Standards Special Interest Group

Conference Call Meeting Minutes

Monday, October 25, 2004

11:00 – 12:00 CT (09:00 – 10:00 PT; 10:00 – 11:00 MT; 12:00 – 13:00 ET)

Dial In Number: 1-866-365-4406

Passcode: 1436132

CALL OBJECTIVE: Continue to define and refine draft pediatric functional requirements for EHR-S in preparation of submission to EHR-TC for informative ballot (targeted for May 2005).

Participants:

Andy Spooner David Classen Cheri Throop

Hema Bisarya Nancy Anthracite Paul Biondich

Aileen Sedman Deb Coonen Terese Finitzo

Scott Hamstra Shaun Grannis Henry Shapiro

Carl Weigle Dan Russler

Following roll call, new members were introduced:

·  Henry (Hank Shapiro), a pediatrician affiliated with USF and All Kids Hospital in St. Petersburg, has extensive expertise in developmental and behavioral pediatrics. In conjunction with a pilot grant, he is working to incorporate developmental pediatric requirements into the EHR. Hank participated previously with our SIG via conference call during our January May 2004 WGM.

·  Deb Coonen, RN, Pediatric Informatics, at Children’s Hospital of Wisconsin, has hands-on experience in information technology implementation.

·  Scott Hamstra, a pediatrician with the Indian Health Services, is working on the pediatric component of clinical health record.

·  Shaun Grannis is a medical informatics investigator at Regenstreif Institute.

AGENDA ITEM #1: Approval of September 29th Minutes

The minutes were approved as presented without revision.

AGENDA ITEM #2: Report on September SNOMED CT meeting

Paul Biondich attended the September SNOMED CT meeting on behalf of our SIG. This was an opportunity to show SNOMED CT what our SIG is doing and also assure pediatric representation within this key group. As a result of this interaction, SNOMED will be sending David and Andy, our co-chairs, a formal request that our SIG assist them in forming a pediatric subspecialty group within the SNOMED structure. As is the case for our SIG within HL7, this will be the first subspecialty group within SNOMED as well. Once this formal request has been received, our SIG will need to publicize this in order to recruit pediatric support for the new SNOMED working group. This linkage with SNOMED, as well as our relationship with LOINC, both through Paul, enhances ways to integrate our pediatric vocabulary needs into both nomenclatures.

Aileen asked Paul to further explain how the major vocabulary standards (LOINC; SNOMED) and other international nomenclature (ICD-10) link. Paul explained that LOINC describes a clinical question while SNOMED is used to answer this. Any major changes to ICD-10 will be mapped to SNOMED; thus, for every ICD-10 code, there will be a corresponding SNOMED code. Differences between terminologies used to store data versus what is used to share information were also discussed briefly. SNOMED has a large synonym build-up; currently, Paul is unaware of anyone using SNOMED CT as their user interface.

ACTION ITEM:

Publicize to other specialties what we are doing (PDSSIG), the new SNOMED CT pediatric group (once formally approved) and recruit for both working groups.

David will follow up with Ed Hammond regarding SNOMED CT.

SNOMED and LOINC will use our SIG as their clearinghouse for pediatric issues.

Hank specifically asked that our SIG address three issues (see parking lot); Paul responded to two of the three:

SEE ALSO “PARKING LOT”

Question: Hank Shapiro / Response: Paul Biondich
1) How do we handle external vocabularies? / 1) Recommend that vocabulary be built when need to share individual events (based on use case)
2) How do we deal with existing guidelines in developing a standardized approach? / 2) Our PDSSIG will be able to work together to identify a standardized approach.
3) Functionality of decision support (issues of) related to vocabulary, specific context, and measures.

Dan shared the work in the nursing area to standardize Apgar to LOINCs for example and their quest to identify vocabulary to support this. They are working on the broader scale to identify granular components.

AGENDA ITEM #3: AAP Meeting (Information Infrastructure)

This meeting, including participants from AAP and EMR researchers and which both Andy and Paul attended, concluded with the need to get in front of policy development with statements before they are approved nationally from other venues. A proposal was developed for AAP consideration; when policy statement comes to their membership for approval, an implementer should be at that table.

Another recommendation from the meeting was that AAP should consider supporting EMR development through an advocacy office as part of the organization. The AAP continues to set minimal functional requirements for the IT systems based on their initial position paper, currently under revision. Our SIG is using this document as a double check system for our EHR functional requirements.

AGENDA ITEM #4: National Update

David shared that the CCHT (collaborative coalition of NIMSS, AHIMA, OHIT) continues their work toward certification of IT systems. Cheri shared an update from the most recent NQF annual meeting; NQF initial hospital indicators (from their set of 39 measures) are beginning to be used by payors, coalitions, others as part of performance improvement reporting requirements. Our SIG charter includes…”identify critical pediatric-specific data standards necessary for standardized quality and outcomes reporting and measuring.” Thus, members are encouraged to visit www.qualityforum.org to review the 39 hospital indicators.

AGENDA ITEM #5: Draft 2 version of Pediatric Functional Requirements

The following proposal was presented for consideration:

Suggestion for SIG consideration: Direct Care section champions (Aileen and Steve) convene a small group to fine-tune verbiage post October meeting. Cheri will coordinate this conference call with interested participants is this is an acceptable option.

Based on SIG discussion, the group decided working together is more effective than trying to break into subgroups and then combine these results. SIG members also decided, in order to accomplish our goal, we would extend our November and December conference calls from 1 hour to 3 hours. Members are encouraged to participate as long as possible on these two calls.

GOAL:

By January 2004, we will have completed the draft of general pediatric EHR requirements for subsequent review and feedback from our respective constituents.

This is only the first phase of our SIG’s overall work.

FOR YOUR INFORMATION (FYI):

·  We have received a copy of the newly designed excel tool for our use. Cheri will begin transferring content to this new tool post October conference call.

·  Harry Rhodes has provided a copy of Power Point presentation on balloting process.

Next Conference Calls: (3 hour sessions)

Monday, November 22, 2004 from 11:00 – 2:00 CT (09:00 – 12:00 PT; 10:00 – 1:00 MT; 12:00 – 3:00 ET)

Dial In Number: 1-866-365-4406

Passcode: 1436132

Monday, December 20, 2004 from 11:00 – 2:00 CT (09:00 – 12:00 PT; 10:00 – 1:00 MT; 12:00 – 3:00 ET)

Dial In Number: 1-866-365-4406

Passcode: 1436132

NEXT HL7 WORKING GROUP MEETING:

January 23 — 28, 2005

January Working Group Meeting
Location: The Hilton in Walt Disney Resort
Orlando, FL

Early Bird Registration and Hotel Cutoffs: December 22, 2004
Hotel Phone: 1-407-827-4000 or 800-782-4414

Pediatric Data Standards Special Interest Group Tracking Log:

ITEM: / Responsible
Party: / Date
Initiated / Date
Closed / Additional Comments: /
Finalize education day / Cheri Throop / November 14, 2003 /

CLOSED

2/15/04 / April 13, 2004 in San Antonio
Recruitment / All SIG members / November 14, 2003 / Formal letter to FDA (David/Andy)
-See 1/19/04 minutes for specialty members still needed.
2/27/04: Efforts to enroll international pediatrician participant underway
3/31: Andy/Cheri develop draft brochure (COMPLETED)
5/3: Recruitment continues; need for international representation.
Request Liora Alshuler to attend May 3, 2004 meeting / Cheri Throop / January 19, 2004 / CLOSED
5/3/04 / 2/27: Liora has agreed to present
4/20/04: Follow up with Liora
Request Clem McDonald to attend May 3, 2004 meeting / Paul Biondich / January 19, 2004 / CLOSED
5/3/04 / 4/20/04: Communication to Paul regarding Clem’s availability.
4/25/04: Paul contacted Stan Huff who will be presenting at our meeting.
Request Clinical Decision Support SIG presentation at May 3, 2004 meeting / Cheri Throop / December 22, 2003 / CLOSED
4/21/04 / 2/27: Request made and DCS S:IG representative plans to attend
4/21: Matt Sailor to present
Growth Chart Project Update / Aileen Sedman / January 19, 2004 / OPEN / 2/27: See minutes
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Prenatal to Perinatal Care Project / Andy Spooner / January 19, 2004 / OPEN / 2/27: See minutes
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Developmental Care Project / Paul Biondich / January 19, 2004 / OPEN / 4/13: Update provided for education day
5/3: Update provided for WGM
5/3/04: integrate in to PIR-EHR
WIC documentation form project / Cheri Throop
Ellen Schwalenstocker / January 19, 2004 / OPEN / 2/27: See minutes
3/31: Hema Bisarya will assist with this project.
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Pediatric Electronic Health Record Project / Feliciano Yu / February 27, 2004 / OPEN / 3/31: David Milov will assist wit this project.
4/13: Update provided for education day
4/13: Noorullah Akhtar will assist with this project
5/3: Update at WGM
5/3/04: integrate in to PIR-HER
7/6/04: Accountability for specific sections assigned
Asthma Core Measures / Cheri Throop
Ellen Schwalenstocker / January 19, 2004 / OPEN / 2/27: see minutes
3/31: Hema Bisarya will assist with this project.
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Strawman proxy ballot process / Andy Spooner
David Classen / January 19, 2004 / CLOSED 5/3/04 / 2/27: See minutes
3/31: Draft document will be sent to SIG members prior to May meeting
4/26: PDSSIG Decision Making document to SIG members for approval
5/3: Agenda item for WGM
IOM Electronic Health Record framework –distribution to SIG members / David Classen / January 19, 2004 / CLOSED2/9/04 / 2/9/04: Distributed
Invite Helga Ripen to PDSSIG conference call / Cheri Throop / May 3, 2004 / OPEN / 5/3/04: member of NHII group
Form PDSSIG Vocabularies subgroup (Paul Biondich; Clem McDonald; Stan Huff) / Andy Spooner / May 3, 2004 / OPEN / 5/3/04: See minutes
Recruit and recommend pediatric representation on SNOMED CT working group (Kent Spackman)
·  Funding for representative / Andy Spooner/David Classen / May 3, 2004
June 1, 2004 / CLOSED6/1/04
OPEN / 5/3/04: See minutes
6/1/04: See minutes. Paul Biondich is willing to serve in this role.
6/1/04: SIG Co-chairs to work on this issue.
Conference call with Kent Spackman (SNOMED CT)
Discussion with Ed Hammond: Coordination efforts – our SIG and SNOMED CT
Funding inquiries: NLM and AAP / Andy Spooner/David Classen
David Classen
Andy Spooner / June 1, 2004 / CLOSED7/20/04
CLOSED
6/29/04
OPEN / Pediatric Representation
David had conversation with Ed Hammond on June 29 2004. He advised that we proceed with conference call as planned.
PDSSIG “one-pager” as communication tool / Andy Spooner/David Classen/ Cheri Throop / July 6, 2004 / CLOSED7/20/04 / (Due July 21 for upcoming AAP and NHII meeting)
Conference call with Dr. Dale Nordenberg / Andy Spooner/David Classen/Cheri Throop/ Carl Weigle / August 3, 2004 / CLOSED 9/1/04 / Conference call convened; Follow up communication regarding PDSSIG
Obtain copy of EHR-S excel tool from Patient Care TC / Cheri Throop / September 29, 2004 / CLOSED10/4/04 / Requested post HL7 meeting; received October 4, 2004
Obtain copy of storyboard examples from Patient Care TC / Cheri Throop / September 29, 2004
SIG Members sign up to monitor SIG/TC listserv / PDSSIG / September 29, 2004 / EHR TC – Andy Spooner
Public Health – Therese Finitzo
Data Modeling – Sam Walters
Patient Safety – Cheri Throop/ Aileen Sedman
Community Health - ?
Patient Care – Noorullah Akhtar
SNOMED Group: formal request to form pediatric group / Paul Biondich/Andy Spooner/David Classen / October 25, 2004 / Waiting for formal communication to co-chairs from SNOMED
Discussion on publicizing and recruitment needs
David to communicate with Ed Hammond

Parking Lot Issues:

ISSUE / Date Identified / Date Resolved: /
Aileen asked how we prevent redundant work across HL7 groups as well as across national entities / January 19, 2004 / September 29, 2004 (see meeting minutes)
Aileen asked for further guidance on what format our SIG projects need to be for delivery to other HL7 groups. / February 27, 2004 / September 29, 2004
(see meeting minutes)
Aileen asked how HL7 work is kept up to date. / May 3, 2004 / September 29, 2004
(see meeting minutes)
PDSSIG Logo model under review by HL7 for their approval / May 18, 2004 /

July 6, 2004

How do we handle external vocabularies?(Hank Shapiro) / October 25, 2004 /
How do we deal with existing guidelines in developing a standardized approach?(Hank Shapiro) / October 25, 2004 /
Issues of functionality of decision support as it relates to vocabulary, context, and measures (Hank Shapiro) / October 25, 2004 /

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Monday, October 25, 2004 Conference Call Meeting Minutes