2020-09-01 Meeting Notes

01 Sep 2020 11:00 AEST

Attendees

@Andrew McIntyre (Co-Chair)

@Michael Legg (Co-Chair)

@Angus Millar

@Dalisay Giffard

@Danielle Tavares-Rixon

@Kyle Macdonald

@Michael Czapski

@Philip Wilford

@Roger Hill

@Scott Ferris

@Tony Cruice

@Vanessa Cameron (Secretariat)

Apologies

@Brett Esler

@Christian Holmes

@Kieron McGuire

@Lars Becker

@Liam Barnes

@Michael Osborne

@Nick Ferris

@Paul Carroll

@Roger Hill

@Robert Flatman

@Vincent McCauley

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

2) Receive RCPAQAP Conformance activities update by @Michael Czapski

3) Address remaining HL7v2-FHIR issues not discussed in Meeting 15 Tue 11 August 2020

Discussion items (included the following):

Notes from Meeting 15 on 11 August 2020 were accepted by members in attendance

Action Item 36. @Kyle Macdonald sent email 28 August advising HealthLink executive team had reviewed the proposal for (8.1.4) to populate the user details in the MSH-3 field of the proposed READ receipt by the specific recipient who has viewed the message and withdraw their initial objections. @Vanessa Cameron forwarded email to HL7 O&O members during the meeting

Action Item 35. MSH-8 discussions 1) use case for token 2) where to put token 3) valid reasons to include token in pathology / radiology messages. @Vincent McCauley looked at existing rules and provided potential conflicts, proposed to pre-adopt 2.9 – coded with exceptions, so barcode can be placed in ID field; any system coding scheme can interpret barcode scheme. Is a repeating field, allowing multiples entries. @Jared Davison to forward MSH-8 work progressed.

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

Existing content to be updated e.g. Discharge Summaries, Referrals etc

New content to be added e.g. Echocardiograms, Sleep Studies, Physiology etc to be added to MyHR
Clinical Informatics Team Profile designs being developed in FHIR; MyHR content aiming to move to FHIR at some stage
Three main domains: 1) Pathology 2) Diagnostic Imaging 3) Other Diagnostic Reports, each with their own specific content e.g. DiagnosticReport (Atomic Pathology Report) etc
Two main use cases for design Profiles: 1) My Health Record Content 2) Atomic Data Content
Originally, pathology users only wanted PDFs to go to MyHR to mitigate potential data misinterpretation errors; with more requests for Atomic data, designs progressed to handle Atomic data
CDA3 relies solely upon Atomic data; will be up to developers to determine how they wish to utilise new Atomic Data Content
No firm plans to move away from CDA to accepting data for upload by FHIR for current Diagnostic reports
Current standardisation is on V2, so could be converted easily to FHIR
Presentation stopped due to poor connection – will attempt full presentation at next meeting

@Michael Czapski – Update on RCPAQAP Conformance activities:

RCPAQAP has 12 disciplines with over 700 modules and ~ 200 programs run annually
Conformance work being undertaken for Australian & New Zealand laboratories although NZ laboratories are working mostly with HL7 Messaging Standard v2.2 and have different terminologies
Laboratories have requested ability to provide External Quality Assurance Program results by HL7 messages as opposed to manual data input in myQAP Portal to stop duplication of effort & reduce manual transcription errors
Hoping to also encourage industry-wide adoption of Australian Diagnostics and Referral Messaging – Localisation of Hl7 Version 2.4 – HL7 Australia Standard for electronic exchange of pathology results + hoping to motivate Practice Management System vendors to adopt receipt of HL7AUSD-STD-OO-ADRM-2018.1, incorporating electronic results receipt
ADHA looking at extending Secure Messaging Industry Offer to include orders and results
Current RCPAQAP External QA Programs supporting HL7 messaging are: Chemical Pathology, Cytopathology, Haematology & Immunopathology
Caristix Conformance software being utilised, also being used by QLD Health, Victoria etc
@Michael Czapski is seeking validation of Conformance Profile document from HL7 O&O members, but is a 12 MB file; to be refined further before HL7 O&O work to undertake full review
Several OBX validation error messages observed, many relating to terminology e.g. Code [LN-RCPA-00080] or similar (placeholders for result codes not yet created by LOINC); noted that many LOINC codes for structured Colorectal cancer protocol have yet to be created - validation errors expected
Structured reporting of cancers not widely utilised at this point in time
Other errors observed e.g. PID.7 error (Date of birth) due to timezone not being included – Standard states timezone must be specified
Suggest trialing Conformance software using simple HL7 standards compliant Chemical Pathology message as found on HL7 site, separate out non-conformance error not relating to terminology before considering updating HL7 Standard v2.4 if necessary

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
34. @Tony Cruice – Provide successful read message acknowledgement sample for 8.1.3 Accept vs Application Acknowledgments

New Meeting actions:

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
39. @Eric Browne to email Healthbase HL7 Interpreter link to @Michael Czapski
40. @Vanessa Cameron – provide @Dalisay Giffard email to @Michael Czapski re QLD Health’s use of gender and sex data elements for pathology resulting
41. @Angus Millar to work with @Michael Czapski on Exemplar messages; @Vanessa Cameron to work with @Michael Czapski on Colorectal messages
41. Next meeting agenda 1) @David McKillop to provide presentation on ADHA Diagnostic Report FHIR Implementation Guide (20 – 30 mins) 2) @Michael Czapski to present first 10 errors encountered after running HL7 messages via Medical Objects & Healthbase & with Angus

Next meeting: Tuesday 15 September 2020 10:00 – 11:00 AEST