2020-05-26 Meeting notes

Date: 26 May 2020 11:00 AEST

Attendees: 

@Andrew McIntyre (AMc – co-Chair)

@Michael Legg (MLe - co-Chair)

@David McKillop (DMc)

@Danielle Tavares-Rixon (DTR)

@Eric Browne (EB)

@Jared Davison (JD)

@Kieron McGuire (KiM)

@Kyle Macdonald (KyM)

@Liam Barnes (LB)

@Paul Carroll (PC)

@Tony Cruice (AC)

@Vanessa Cameron (VC - Secretariat)

Apologies:

@Angus Millar (AMi)

@Brett Esler (BE)

@Christian Holmes (CH)

@Dalisay Giffard (DG)

@Jakub Sielewicz (JS)

@Lars Becker (LB)

@Michael Osborne (MO)

@Philip Wilford (PW)

@Robert Flatman (RF)

@Scott Ferris (SF)

@Vincent McCauley (VM)

Meeting purpose: To continue reviewing suggested updates to the Australian Diagnostics and Referral Messaging – Localisation of HL7 v2.4 Standard not discussed in Meeting 10 on 21 April 2020

Agenda items:

25. @Andrew McIntyre & @Jared Davison -  Draft re message Retrieval Codes [2.1.9.8 MSH-8 Security (ST) 00008] not ready for distribution, requires simplification to make it implementable.

Notes from Meeting on 24 April 2020 were accepted.

Discussion items:

27. @David McKillop – update on ADHA Clinical Informatics team collaborations with @Brett Esler. Progressing translation of HL7 FHIR Australian Base Implementation Guide (AU Base 2): Base Diagnostic Report, Diagnostic Observation & Diagnostic Service Request Profiles from FHIR STU 3 to R4.  AU Base doesn’t have any ‘Must Support’ items, some binding statuses have been changed, new identifier slices and related terminology.  Don’t believe these new profiles are in currently in use as still being refined & not yet balloted.  ADHA Profiles are derived from HL7 AU Base Profiles, with Diagnostics broken up into 3 components 1) Pathology 2) Diagnostic Imaging 3) Other Diagnostics, catering for use cases of MyHR and Point-to-point. When systems receive a pathology report, entry will contain either: Atomic Pathology Report (option to provide atomic content, with rendering optional) or My Health Record Pathology Report (PDF with metadata).  New formats could be developed, all work underway is up for discussion.  Anticipate work to be completed by 30 June 2020 with assistance from HL7 O&O members (preliminary reviewers) and other stakeholders.

Current work supports mobile gateway that converts existing CDA into FHIR; not always an expectation this will be implemented by vendor then having to send FHIR to MyHR.  Short term use for MyHR Profile would be scenario where pathology & diagnostic imaging view are FHIR-based, hence why it is replicating existing requirements. Widely shared concern that atomic results aren’t currently making it into MyHR.  ADHA are progressing two profiles 1) Atomic content with one set of recommendations 2) MyHR content with MyHR implementation team (more constrained format).  If user has atomic data, they can still send results into MyHR as long as it conforms to additional conformance requirements.  Note: joint decision between RCPA & pathology industry experts that MyHR would not store atomic data at this point in time due to various safety concerns.  By working toward atomic data upload into MyHR, clinicians would receive greater benefits e.g. cumulative report display etc, which would improve decision-support. Current use case is converting CDA into FHIR to be displayed by FHIR-knowledgeable systems; intent is to have a constrained version of grander FHIR rendering of FHIR diagnostics, with as little variance among the three components 1) Pathology 2) Diagnostic Imaging 3) Other Diagnostics.  @David McKillop – will update HL7 O&O when further content is available after 30 June 2020.

May be an opportunity to invite pathology sector to move directly to FHIR, then transform to atomic information in the context of FHIR interfaces.  Suggest a use case of FHIR-based atomic structured pathology reporting of cancer (SPRC) would prove if this work can be successful.  @Grahame Grieve has been engaged by RCPA to deliver FHIR-rendering translations of three SPRC protocols by 30 June 2020: Polypectomy, Colorectal and Endometrial cancer.

26. 8. Acknowledgements (DRAFT).  All acknowledgments listed within the current Draft Standard have been compiled in one location, rather than throughout whole Standard.  All references obtained from original v2.4 International Standard.  Australian content requires review by SMEs, especially @Vincent McCauley and @Eric Browne.  HL7 O&O to review Word version / Confluence with emphasis on HL7 O&O use.  Detail is vital, as acknowledgements are major safety components within messaging; this is where diagnostic errors occur. Suggest referring back to previous work undertaken in AS 4700.2 and aim to describe one thing that all Australian administrators should do, but a simplified version.  Real examples to be added for Orders, ORU, REF, MDM & READ Acks. Unreviewed results on screen are marked as reviewed as user cycles through the results via clicking or use of space bar; utilises user’s Provider number as the ‘application’ performing the review.     

New Meeting actions:

• 25. @Andrew McIntyre & @Jared Davison – Progress work on Draft re message Retrieval Codes [2.1.9.8 MSH-8 Security (ST) 00008]
• 26. @Tony Cruice & @Jared Davison – Update Confluence & forward draft Acknowledgements document (Word version) to @ Vanessa Cameron to distribute to HL7 O&O - @Vince McCauley & @Eric Browne review specifically requested.  @Kieron McGuire – forward draft to ADHA’s Secure Messaging Group. Feedback requested prior to next meeting on Tuesday, 16 June 2020.
• 27. @David McKillop – Provide further updates on ADHA’s Clinical Informatics team collaborations with @Brett Esler to progress translation of HL7 FHIR Australian Base Implementation Guide (AU Base 2): Base Diagnostic Report, Diagnostic Observation & Diagnostic Service Request Profiles from FHIR STU 3 to R4.  Ensure @Grahame Grieve & @Brett Esler are available to assist with ADHA FHIR review post 30 June 2020.
• 28. @Vanessa Cameron – Schedule Meeting 12

Outstanding Meeting actions:

• 17. @Brett Esler - Update links to all Standards on the HL7 Australia O&O WG page – link still broken for HL7AUIG-STU-FHIR-BASE AU Base 1 on FHIR STU3 (v1.0.2)

Next meeting – Tuesday 16 June 2020 @ 11:00 AEST