2020-11-17 Meeting Notes

Date:  

Attendees

 

@Andrew McIntyre (Co-Chair)

@Michael Legg (Co-Chair)

@Dalisay Giffard

@David McKillop

@Eric Browne

@Jakub Sielewicz

@Jared Davison 

@Kieron McGuire

@Kyle Macdonald

@Philip Wilford

@Scott Ferris

@Tony Cruice

@Vincent McCauley

@Vanessa Cameron (Secretariat)


Apologies

@Angus Millar

@Brett Esler

@Christian Holmes

@Danielle Tavares-Rixon

@Lars Becker

@Liam Barnes

@Michael Czapski

@Michael Osborne

@Nick Ferris

@Paul Carroll

@Roger Hill

@Robert Flatman


Goals:   1) Address remaining HL7v2-FHIR issues not discussed in Meeting 20 Tue 03 Nov 2020

                      

Discussion items (included the following):

Notes from Meeting 20 on 03 November 2020 were accepted by members in attendance.

  

Appendix 8 Simplified REF profile (Normative)

http://ns.hl7.org.au/hl7v2/profiles/HL7AU-OO-REF-SIMPLIFIED-201706-L1 - Url is broken even adding the "-L1" at the end which appears to not highlight when hovering doesn't fix the issue.  There is a note below about these being URIs and may not resolve. Resolved.

 


It is not always feasible for sending systems to have access to the messaging system directory.  Rather than being prescriptive about the values being "copied from" the directory, we should just say that they should match.  See also my comment on HL7au:00045.7 re ensuring that they match.  Resolved via comment about endpoint content matching  - When using the Australian Profile for Provider Directory Services, the values from this field must be copied from match with the sending party's HealthcareService.Endpoint[x].au-receivingfacility as published in the directory of the messaging system being used for the transaction.

 

There may be multiple identifiers in the PractionerRole identifier list. It is important to map the routable identifers in the order specified in the directory entry. Note that HL7v2 systems often will consider only the first repeat of this field. 

The current AU-FHIR-PD profile does not support ordering of identifiers, hence the order cannot be guaranteed.


HL7OO: Request extensions as drafted by Jared to HL7AU PA:

e.g.

<identifier> 

<extension url="http://proposed-routability-extension">

<valueBoolean value="true"/>

</extension>

<extension url="http://proposed-selection-preference-order-extension">

<valueInteger value="3"/>

</extension>

</identifier>

 

copied from

It is not always feasible for sending systems to have access to the messaging system directory.  Rather than being prescriptive about the values being "copied from" the directory, we should just say that they should match.  See also my comment on HL7au:00045.7 re ensuring that they match.


HL7OO: drafted fix in  A10.1.3.1 MSH-3 Sending application (HD)



HealthcareService

The provider directory IG allows endpoints to be referenced from HealthcareServices, PractitionerRoles, and Locations.  There are valid scenarios where the acknowledgement endpoint may not be referenced from the HealthcareService.  We should just say the endpoint that the acknowledgements are to be sent to rather than specifying "HealthcareService".

HL7OO: drafted in A10.1.3.1 MSH-3 Sending application (HD)

 

au-receivingfacility

this link does not resolve - i think it should be -

http://build.fhir.org/ig/hl7au/au-fhir-pd/StructureDefinition-au-pd-sm-endpoint-definitions.html#Endpoint.extension:receivingFacility

as per other links for HCS and Endpoint

PractitionerRole.location.address

Should this be PractitionerRole.location.address.line?  Move done.

 

HealthcareService.location.address

Should this be HealthcareService.location.address.line? Move done.

 

 

Appendix 5 Conformance Statements (Normative)

HL7au:00044.5.6 CNE datatype conformance points and HL7au:00044.6.6 CWE datatype conformance points: <alternate text (ST)> component must be valued and this must be whit is intended for display to the user.


This implies that alternate text is mandatory; which is not true if no alternate text exists.

Appendix 10 Addressing messages using Australian Profile for Provider Directory Services (Normative)

HL7OO: resolve comment from A8.12.1.1.1 Australian Profile for Provider Directory Services. When using the Australian Profile for Provider Directory Services, the values from this field must be copied from sending match with the sending party's HealthcareService.Endpoint[x].au-receivingfacility as  for receiving acknowledgements or responses to this message as published in the directory of the messaging system being used for the transaction  

HL7OO: resolve comments from A8.12.3.1.1 Australian Profile for Provider Directory Services

...  When using the Australian Profile for Provider Directory Services, the values from this field must be copied from sending match with the sending party's HealthcareService.Endpoint[x].au-receivingapplication as  for receiving acknowledgements or responses to this message as published in the directory of the messaging system being used for the transaction. ...

HL7OO: fix links from A8.12.1.1.1 Australian Profile for Provider Directory Services ...

When using the Australian Profile for Provider Directory Services, the values from this field must match with the sending party's Endpoint[x].au-receivingfacility for receiving acknowledgements or responses to this message as published in the directory of the messaging system being used for the transaction.

Each component of the MSH-4 (HD) field must be valued with the FHIR valueString according to each of the extensions Endpoint resource's au-receivingfacility as per the following table.  ...

HL7OO: resolve comment from Appendix 8 A8.12.2.5 PRD-5 Provider communication information (XTN)

XTN Component / sub-component

FhirResource element

Comment

[NNN] [(999)]999-9999 [X99999] [B99999] [C any text] 

PractitionerRole.telecom.value

if ContactPoint.use.code system is either phone, fax, pager, sms

 

HL7OO: resolve comment from A8.12.2.5.2 Healthcare Service providers

 

XTN Component / sub-component

FhirResource element

Comment

[NNN] [(999)]999-9999 [X99999] [B99999] [C any text] 

HealthcareService.telecom.value

if ContactPoint.use.code system is either phone, fax, pager, sms

 

HL7OO: resolve comment on A8.12.3.2.1 Australian Profile for Provider Directory Services. only when a-recevingapplication is populated

 

... When using the Australian Profile for Provider Directory Services, the values from this field must be copied from receiving party's HealthcareService.Endpoint[x].au-receivingapplication as published in the directory of the messaging system being used for the transaction when the extension is present.

Each component of the MSH-5 (HD) field must be valued with the FHIR valueString according to each of the extensions Endpoint resource's au-receivingapplication as per the following table. ...

HL7OO: resolve issue with au-receivingfacility links

HL7OO: fix link as commented on A8.12.1.2.1 Australian Profile for Provider Directory Services

...  When using the Australian Profile for Provider Directory Services, the values from this field must be copied from receiving party's HealthcareService.Endpoint[x].au-receivingfacility as published in the directory of the messaging system being used for the transaction.

Each component of the MSH-6 (HD) field must be valued with the FHIR valueString according to each of the extensions Endpoint resource's au-receivingfacility as per the following table.

 

HD Component

http://hl7.org.au/fhir/StructureDefinition/au-receivingfacility extension

<namespace ID (IS)> 

namespace-id

<universal ID (ST)>

universal-id

<universal ID type (ID)>

universal-id-type


HL7OO: resolve comments on HealthcareService.location.address.line[0..*] from A8.12.2.3 PRD-3 Provider address (XAD)

draft fix remove A10.1.1.2 MSH-6 Receiving facility (HD) HealthcareService to make generic

... When using the Australian Profile for Provider Directory Services, the values from this field must be copied from receiving party's HealthcareService.Endpoint[x].au-receivingfacility as published in the directory of the messaging system being used for the transaction.

 

XAD Component / sub-component

FhirResource element

Comment

<street or mailing address (ST)>

PractitionerRole.location.address .line[0..*]

Concatenate each address.line separated by a comma ",".

<street or mailing address (ST)>

HealthcareService.location.address .line[0..*]

Concatenate each address.line separated by a comma ",".

 

Appendix 8 Simplified REF profile (Normative)

 

.au-receivingfacility

HealthcareService

The provider directory IG allows endpoints to be referenced from HealthcareServices, PractitionerRoles, and Locations.  There are valid scenarios where the acknowledgement endpoint may not be referenced from the HealthcareService.  We should just say the endpoint that the acknowledgements are to be sent to rather than specifying "HealthcareService".

 

HL7OO:

A10.1.1.1 MSH-4 Sending facility (HD)

 

 

Intended Provider/Individual recipient level addressing

Update specification to include mapping between FHIR elements and PV1-9 to support intended recipient addressing for ORM, ORR, ORU messages

 

PractitionerRole.location.address

Should this be PractitionerRole.location.address.line?  This needs to be copied into Appendix 10.

 

HealthcareService.location.address

Should this be HealthcareService.location.address.line?  Move to Appendix 10.

 

 

ContactPoint.use

 

Should this be ContactPoint.system?  HL7OO: done in A10.1.2.2.5.1 Individual Practitioner providers and


applied in A10.1.2.2.5.1 Individual Practitioner providers

 

transaction

It would be helpful to add a sentence saying that receivers may not populate au-receivingapplication and if it not populated, then MSH-5 can be omitted.

 

HL7OO: drafted in A10.1.3.2 MSH-5 Receiving application (HD)

 

published

Linkage to au-receivingfacility appears broken 

 


HL7OO drafted into A10.1.1.2 MSH-6 Receiving facility (HD)

au-receivingfacility

this link does not resolve - i think it should be -

http://build.fhir.org/ig/hl7au/au-fhir-pd/StructureDefinition-au-pd-sm-endpoint-definitions.html#Endpoint.extension:receivingFacility

as per other links for HCS and Endpoint

 

Drafted link to http://hl7.org.au/fhir/2020Aug/StructureDefinition-au-receivingapplication.html in table heading A10.1.1.2 MSH-6 Receiving facility (HD)

 

 

 

2 Patient Administration for Pathology

 

   HL7OO: clarify use of PV1-9 for target recipient and allow additional repeats for consulting doctor in table 00139

 






...

In the Australian setting for ORU messaging, the first repeat of this field is used to identify the target provider for this each message. A location specific ID is used and the field should not repeat as each message is unique for the target providerof the target provider for this message must be placed in the first repeat and will be unique for each instance of messages to be routed. Where available the Medicare provider number is used as this provides for a location specific identifier. Messages should be routed based on this field and only the first repeat is used.  

The consulting doctors can be specified in the second or following repeats of this field.  

In the Australian context, where possible, this XCN data must be populated using the method described in A10.1.2.1 XCN Datatype.

...

 

 

4 Observation Reporting

 

Examples include reporting the amount of inspired carbon dioxide for blood gasses, the point in the menstrual cycle for cervical pap tests, and other conditions that influence test interpretations

Could we either consider changing this field to FT or making \.br\ valid for the ST datatype. If there are multiple separate additional clinical information points in this field it will make it easier to read if they are on separate lines.

 HL7OO: we can't edit the datatype definition that would have massive consequences


 

HL7OO: options:

  1. repeating field extension possibility.

      2. escaped version of a line break. -  problems platform specific line break

 

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+Standardspending
  • 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
  • 47. @Dalisay Giffard to share authorised outcomes of Queensland Health meeting discussions on gender identification
  • 54. @Jakub Sielewicz to ensure @Jared Davison’s work on A10.1 Addressing messages Introduction is consistent with ADHA’s Secure Messaging Implementation Guidance Paper

New Meeting actions:

  • 56. @Jared Davison to write to HL7.au PA working group re routability extensions to be proposed at next PA working group meeting 18.11.20

 

 Next Meeting: Tuesday 01 December 2020 10:30 – 12:00 AEDT