2020-09-15 Meeting notes

15 Sep 2020 10:00 AEST

Attendees

@Andrew McIntyre (Co-Chair)

@Michael Legg (Co-Chair)

@Brett Esler

@Dalisay Giffard

@Danielle Tavares-Rixon

@Kieron McGuire

@Kyle Macdonald

@Michael Czapski

@Nick Ferris

@Philip Wilford

@Tony Cruice

@Vanessa Cameron (Secretariat)

Apologies

@Angus Millar

@Christian Holmes

@Lars Becker

@Liam Barnes

@Michael Osborne

@Paul Carroll

@Roger Hill

@Robert Flatman

@Scott Ferris

@Vincent McCauley

Goals: 1) Receive presentation on HL7 FHIR work progressed at ADHA by @David McKillop

2) Address initial RCPAQAP Conformance testing issues noted by @Michael Czapski

3) Address remaining HL7v2-FHIR issues not discussed in Meeting 16 Tue 01 Sept 2020

Discussion items (included the following):

Notes from Meeting 16 on 01 September 2020 were accepted by members in attendance

@David McKillop – Update on ADHA Diagnostic Report FHIR Implementation Guide published 30 June 2020:

Presentation stopped due to poor connection – will attempt full presentation again at next meeting

@Michael Czapski – RCPAQAP issues as per conformance profile built for RCPA SPIA Exemplar Lipid message:

PV1 (Patient Visit Segment) error – mandatory for HL7 AU but optional for International Std. Business rule states ORU^R01^ORU_R01 Message Structure group constrained - must contain PV1 segment as part of message structure. Previous consensus decision not to change AU message structure, instead modify business rules. @Michael Czapski to update conformance rules to enforce PV1 segment presence
MSH.4 (Sending facility) namespace ID error – must be reliable practice identifier (as per Table 0300) to allow ACK response. For pathology messages, Hierarchical Designator (HD) must utilise AUSNATA ID. RCPAQAP database should contain real IDs to enable realistic message testing

@Michael Czapski to check Appendix 5 Conformance Statements HL7au:00044.2.3 and RCPAQAP database for AUSNATA numbers and other data as required for survey customers (RCPAQAP business issue, not HL7 messaging issue). RCPAQAP should have its own valid HD, and should have provided enough information in survey request to enable return of proper HL7 message content

MSH.4 (Sending facility) universal ID type error – Table 0301 was not populated; error now rectified
MSH.10 (Message Control ID) field length error – field length limit 20 characters extended to 36 characters; error now rectified
MSH.12.2 (Internationalization Code Component) error– recently addressed in current version
MSH.12.3 (Name of Coding System SubComponent) error – version ID’s recently addressed in current version; flag as ‘warning’ with resolution pending update to Standard
MSH.16 (Application Acknowledgment) error – Std states must be valued as ‘AL’; error now rectified
MSH.19 (Principal Language of Message Field) error – must be valued as “en^English^ISO639” ; error now rectified
PID.3 (Patient ID) error – @Michael Czapski to check Std Chapter 6 Identifiers for namespace ID (Table 0300) and identifier type code value (Table 0203) as values not defined. Note: Table 0363 (Assigning Authority) to be used for patient identifier, not generic namespace ID Table 0300
PID.3[2].4.1errors x 3 – Invalid table entry values for Table 0300 – Namespace ID
PID.7 (Timezone & Timestamp) errors – Timezone must be specified & Timestamp is invalid – If result precision is > day for a date, then timezone is required. Consensus agreement to change draft Std accordingly
MyQAP Portal allows survey participants to manually enter survey data for: measurand ID; result value; and method. Remaining survey information relevant to HL7 message is generic, so of little value with relation to SPIA messaging compliance although most Australian laboratories are capable to producing a valid HL7 message
Major HL7 messaging items for RCPAQAP to address: 1) data not currently defined in tables 2) data must be correctly valued 3) RCPA SPIA reference set data missing e.g. SNOMED-CT or LOINC codes yet to be generated; reference ranges; units of measure
If MSH.21 isn’t populated, many errors occur e.g.: OBX[3].7 (INFO) OBX.3.1 Identifier [14646-4] not found in table R001. No Reference Range available – Hl7au:00050.1.6 – the OBX-7 Reference range [ST] should be valued as the APITS/SPIA harmonised reference intervals where defined and applicable
Australian laboratories should be reporting using the correct RCPA SPIA units of measure; perhaps RCPAQAP can ‘switch off’ SPIA compliance testing according to laboratory location e.g. for RCPAQAP participants from other countries

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 – pending
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
35. @Jared Davison – MSH-8 discussions 1) use case for token 2) where to put token 3) valid reasons to include token in pathology / radiology messages. Forward all MSH-8 work progressed
38. @Jared Davison to forward proposed MSH-8 work re 1) use case for token 2) where to put token 3) valid reasons to include token in pathology / radiology messages to all members

New Meeting actions:

41) @David McKillop to provide presentation on ADHA Diagnostic Report FHIR Implementation Guide (20 – 30 mins)
42) @Vanessa Cameron to include agenda item to discuss appropriate time to publish current draft Standard

Next meeting: Tuesday 06 October 2020 10:00 – 11:00 AEDT