Orders & Observations Conference Call16 June 2016

+1 770 657 9270, Passcode: 398652#

Attendees:

Name Organization1 Kathy Walsh Lab Corp2 Hans Buitendijk Cerner Corporation3 Jenny Brush CDC4 Perri Smith Accenture Federal / ONC5 Lorraine Constable Constable Consuting6 Riki Merrick Vernetzt LLC / APHL7 Freida Hall Quest Diagnostics8 Jonathan Harber Strategic Development Partners9 Lauren Caruso

10 Margaret Dittloff The CBORD Group11 Ken McCaslin Accenture Federal12 Rob Hausam Hausam Consulting13 Rita Altamore Washington State Department of Health14 Vijay Shah JBS International / ONC15 Patrick Loyd iCode Consulting16171819202222232425

Co-Chair: Hans BuitendijkScribe: Riki Merrick, Hans Buitendijk

Agenda Review

Meeting Minuteso June 9

Motion to accept as distributed. Ken McCaslin, Kathy Walsh Against: 0; Abstain: 4; In Favor: 11

Project Updates (General, NIB)o Nutrition

Working through edits. Expect publication request within next couple of weeks. Almost all negatives have been withdrawn from May ballot – goal is July

2016 Lorraine can do the model changes mid July NIB has not yet been submitted. Lorraine will do so. Have to still check with Jean, if actually going forward

o UDI

Patrick did not find enough authoring time, so not going to Sep 2016 ballot – will adjust for Jan 2017 ballot

Updated schedule was shared with project team, waiting for feedback The schedule will include peer review Meetings have started back up.

o Lab US Realm eDOS/LOI/LRI/EHR-S FR

1 eDSO STU 1 new LRI DSTU from Clem McDonald to allow NR data type Maybe one for value sets.

CG Clem trying to figure out right format for LOINC coding. Creating a delta document against LRI. Unclear whether CG submitted NIB

NBS Working on delta document Motion to submit a NIB to have an option for September. Riki Merrick,

Lorraine Constableo Against: 0; Abstain: 4; In Favor: 11

Riki to submit before June 22, 2016 deadline.o CPM

RCRIM approved – SPL will not go to ballot in Sep 2016 – so no NIB needed

o V2.9 MUST have all content for Frank completed by July 1, 2016 – including

ACK Choreography (Hans working on 4, 4A and 7) Does not include harmonization proposals – initial are due by 6/26 Riki to bring some for the group to review next week

o SDC

Discussion around master files

Will that include changes to the data element resource At this point general discussion, no specific

Resources to be updated – changes discussed on calls Questionaire QuestionaireResponse Data element Valueset

There is a Master spreadsheet with discussion about IHE profile and FHIR resources – GET LINK

If September ballot is ONLY for FHIR resources, then SDC is covered through the general FHIR ballot, or is there a separate IG?

Yes, there will be changes to the SDC IG, so will need NIB for the IG part

Motion to submit a NIB for the implementation guide. Rob Hausam, Vijay Shah Against: 0; Abstain: 0; In Favor: 15

Hans to submit. Perri to forward summary of changes.o Lab Order DAM

Need project to disposition updates and STU expiration. Options Let is expire in Dec 2016 and not do anything Move forward with R1 into normative ballot process – did voted

on that in Montreal, but did not decide on timeline Knowing issues we have, review the issues and create STU R2 and

reset the requirements for the scope etc.

In Montreal vote was for option 2. Requires conformance statements. To go normative:

Need to add conformance statements to ensure the logical model is correctly based on the conceptual model

Order service functional model that is in the SOA process and there are comments being collected, so could have updates from that process (completion in Nov 2016)

Also as part of FHIR workflow discussion may have other changes needed to the model

With that Sep 2016 is very aggressive – with the timing of the comments Jan 2017 is not bad – expiring DSTU should not be too much of an issue

o AP-OO We have the correct checklist for AP fill out, run through DESD for approval.

PSS Reviewso EHR-PHR System Functional Model Release 2

Comment:

Copyright marked as “yes”, but TSC comment at the end seemed to contradict

Motion to approve with comment. Riki Merrick, Ken McCaslin Against: 0; Abstain: 3; In Favor: 11

o OO – CPM – OO generated, so support it.o OO – NBS – OO generated, so support it.

V2.9 Proposalso OSU Clarification

OSU was created in v2.7 timeline Since it has an acknowledgement message structure it is not clear when to

use it given the definition.o Action Codes to segments

Also email thread about possibly adding action code elements into segments in order and observation messages – since not further discussed, will not be able to include in v2.9

oo SSU (?) message needs PRT.

Editors to review ALL messages that used to have ROL segments for the proper replacement with PRT segments – when segment is deprecated will have to endure the status is marked, so it works out – SSU is the one that we found – needs to be errata and fixed for v2.9

Harmonization Proposals

o Relate to US realm CMS requirement to represent the codes needed in

transactions for reporting Add Riki as author / editor, and she can present, if Freida can’t make it INM owns the table Motion to accept as proposed. Riki Merrick, Freida Hall

Against: 0; Abstain: 2; In Favor: 12

FHIR – Not discussed

o 9823 Clarify conformance statements for OO core profiles (Lorraine Constable)o 9857 change Observation.category from Example to Extensible (Eric Haas)o 10142 align DR and Obs category codes (Eric Haas)o 9433 Observation.issued and DiagnosticReport.issued (Hans Buitendijk) Not Persuasiveo 9664 Observation needs to be able to point to DiagnosticOrder (Lloyd McKenzie)

Persuasiveo 10038 Clarify rules for use of components (Erich Schulz) Persuasive

SWOT Review – Not discussed