2020-12-01 Meeting Notes

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Last updated: Jan 04, 2021
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Attendees

@Andrew McIntyre (Co-Chair)

@Michael Legg (Co-Chair)

@Angus Millar

@Dalisay Giffard

@David McKillop

@Eric Browne

@Jared Davison 

@Kieron McGuire

@Kyle Macdonald

@Philip Wilford

@Scott Ferris

@Tony Cruice

@Vincent McCauley

@Vanessa Cameron (Secretariat)


Apologies

@Brett Esler

@Christian Holmes

@Danielle Tavares-Rixon

@Jakub Sielewicz

@Lars Becker

@Liam Barnes

@Michael Osborne

@Nick Ferris

@Paul Carroll

@Roger Hill

@Robert Flatman

@Tarun Narayan


 Goals:   1) Address remaining HL7v2-FHIR issues not discussed in Meeting 21 Tue 17 Nov 2020

               2) @ Dalisay Giffard - Discuss use of PV1-9 for Intended Recipient from previous meeting

                      

Discussion items (included the following):

Notes from Meeting 21 on 17 November 2020 were accepted by members in attendance.

 

 

2 Patient Administration for Pathology

2.2.2.9 PV1-9  Consulting doctor (XCN) 00139

Updated to accommodate scenario where pathology messages don’t have a specified intended recipient and consultant isn’t intended recipient e.g. Registries (NOCS, NCSR etc), GP practices (COVID-19 results, etc), RFDS etc, taking into account receiving providers don’t like to receive reports unless they are directly responsible for the patient.

Check for relevant content on receiving pathology messages within 1) RCPA SPIA 2) RACGP Standards for General Practices and draft content to align with both standards for A10.2 below.

Placeholder: Appendix 10 Addressing messages using Australian Profile for Provider Director Services (Normative) 10.2 Responsibilities of Receivers - Intended recipients which are Healthcare Services or inactive providers must be managed by the receiving system to ensure the message content is reviewed for triage. See HL7au:000025.1.1.

Received messages without an intended recipient which must be managed by the receiving system to ensure the message content is reviewed for triage.  See HL7au:000025.1.2.

Appendix 5 General Conformance Statements

 

HL7au:000025.1.1

Receivers

Results, Referrals, Orders

Intended recipients which are Healthcare Services or inactive providers must be managed by the receiving system to ensure the message content is reviewed for triage.


HL7au:000025.1.2

Receivers

Results, Referrals, Orders

Received messages without an intended recipient which must be managed by the receiving system to ensure the message content is reviewed for triage.


 

  

 

Appendix 8 A8.12 Addressing – unresolved comment There may be multiple identifiers in the PractitionerRole identifier list. It is important to map the routable identifiers in the order specified in the directory entry. Note that HL7v2 systems often will consider only the first repeat of this field - moved to  Appendix 10 Addressing messages using Australian Profile for Provider Directory Services (Normative) as per HL7 O&O Patient Administration wg 2020-11-18 Minutes on routability extensions. 

HL7OO: add responsibility for default receiver handling – multiple changes made to this section.


 

 

 

The current AU-FHIR-PD profile does not support ordering of identifiers, hence the order cannot be guaranteed.  Refer to Section 4.26 Encapsulated data attachments and conformance points under HL7au:00101

 

 

7.2.2. Patient Referral Acknowledgment Message structure (RRI_I12) - add note regarding privacy of extra segs:

The RF1, PID, and PRD  segments must echo what was received in the referral message (REF).

Note that the RRI may contain personally identified information, therefore the handling of the message must account for the potentially sensitive nature and that RF1, PID, PRD may be made optional in future versions for privacy reasons. 

 

Wg query – is anyone aware of RF1, PID or PRD currently being used in ACK message?  If no one currently using then suggest removing from draft Standard as lifted from International Standard.  The only mandatory segments in International Standard 2.9 are MSH and PID. AS4700.6 indicates RRF1 was main reason for RRI response message.  Leave message structure as is for the moment while @Tony Cruice investigates further

 

7.1.1 Purpose – section like 4.25 Delete message for reports and results needed for REF deletion (status markers already exists for ORU). RF1-1 has corrected values already incorporated into draft au Standard. Notes added to clarity: When a corrected referral snapshot is sent, all information from the previous snapshot identified by the same RF1-6 Originating referral identifier (EI) must be replaced with the current snapshot. e.g. Allergies, Medication, Results, etc. 

7.3.2.2 RF1-2 Referral priority (CE)

Anchor


RF1-2


RF1-2

 


Re: 7 Patient Referral DELETED

HL7OO: RF1-1 has corrected value in the table. Notes added to clarify.

 




@Jared Davison tried to move A11.3 The Indication of Consent into draft Standard as an appendix, but has a lot of PCHR-specific content, not generic enough for O&O.  Needs governance to review before next meeting

@Vanessa Cameron advised secretarial support for HL7 O&O will end in December 2020, with Jason Steen advised via email on 12 Nov 2020; need to ascertain RCPA membership intention beyond 2020

@David McKillop ADHA update - initial presentation of ADHA Diagnostic Report FHIR Implementation Guide encompassed three components: Pathology, Diagnostic Imaging and Other Diagnostics. New project being initiated for Clinical document categorisation (non-pathology, non-diagnostic imaging) e.g. echocardiographs, lung function tests, etc.  ADHA refining designs by February 2021 with MyHR release anticipated for June 2021.  HL7 O&O may want input e.g. OBR-4 (Diagnostic service section ID Table 0074).  Decision to update HL7au Standard Table 0074 to match DICOM table - @David McKillop will contact Nick Ferris to progress work

Outstanding Meeting actions:

  • 17. @Brett Esler  - Update links to all Standards on the HL7 Australia O&O WG page – Australian Diagnostics and Referral Messaging – Localisation of HL7 v2.4 Standard is still referenced as ‘Current Draft Standard’ as per  https://confluence.hl7australia.com/display/OO/Current+Draft+Standards
  •  32. @Kieron McGuire - Contact @Brett Esler to have pages for Profile URIs (FHIR Provider Directory) & update link for FHIR R4 Value sets to return user to correct version of HL7 Standard
  •  33. @Jared Davison – create a checklist prior to final draft Standard being published
  •  41. @David McKillop to provide presentation on ADHA Diagnostic Report FHIR Implementation Guide (20 – 30 mins) after 06 October meeting
  • 43. @Jared Davison to review draft Standard to ensure no other reversions have occurred
  • 45. @Jared Davison to prepare PDF of draft Standard

 

New Meeting actions:

  • 57. @Vanessa Cameron to forward 1) RCPA SPIA 2) RACGP Standards re pathology messaging to HL7 O&O
  •  58. @Andrew McIntyre & @Jared Davison to draft intended recipient content for HL7au Standard to align with RCPA SPIA & RACGP Standards
  •  59. @Vanessa Cameron to email O&O members re current use of RF1, PID or PRD being used in ACK messages
  •  60. @Vincent McCauley to check International Standard for reference to use of RF1, PID or PRD in ACK messages
  •  61. @Tony Cruice to investigate if making changes to use of RF1, PID or PRD in ACK messages will break anyone’s systems
  •  62.  @Vanessa Cameron asked to approach RCPA for advice on their intent re HL7 O&O membership going forward
  •  63. @ Tony Cruice to draft additional comment for deletions made to 7. Patient Referral

  

Next Meeting: Tuesday 08 December 2020 10:00 – 11:30 AEDT