2020-10-20 Meeting Notes

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Last updated: Jan 04, 2021
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Date  10:00 AEDT

Attendees

 

@Andrew McIntyre (Co-Chair)

@Michael Legg (Co-Chair)

@Angus Millar

@Dalisay Giffard

@David McKillop

@Eric Browne

@Jared Davison 

@Kieron McGuire

@Kyle Macdonald

@Nick Ferris

@Tony Cruice

@Vincent McCauley

@Vanessa Cameron (Secretariat)


Apologies

@Brett Esler

@Christian Holmes

@Danielle Tavares-Rixon

@Jakub Sielewicz

@Lars Becker

@Liam Barnes

@Michael Czapski

@Michael Osborne

@Paul Carroll

@Philip Wilford

@Roger Hill

@Robert Flatman

@Scott Ferris


Goals:   1) Address remaining HL7v2-FHIR issues not discussed in Meeting 18 Tue 06 Oct 2020

                             

Discussion items (included the following):

  • Notes from Meeting 18 on 06 October 2020 were accepted by members in attendance

 

1. Introduction – This document and the specifications in it supersede those in AS 4700.2-2012 - Implementation of Health Level Seven (HL7) Version 2.4 - Pathology and diagnostic imaging (diagnostics) and HB 262 (Rev)-2012 - Guidelines for messaging between diagnostic providers and health service providers, and AS 4700.6-2006 Implementation of Health Level Seven (HL7) Version 2.4 Part 6: Referral, discharge and health record messaging -  Nick and Andrew to review wording of introduction to cover radiology and clinical referral

1. Introduction Table 1.1 Message Element Attributes – Length definition altered slightly from change drafted for HL7AU OO HL7 Meeting 9 07 April 2020 Action Point 18 (based on HL7V2.4 Int):  Because the maximum length is that of a single occurrence, the repetition separator is not included in calculating the maximum length (See HL7 International V2.4 Section 2.7.5, “Repetition”). Each occurrence of a repeating field may contain the number of characters specified by the field’s maximum length. (See HL7 International V2.4 Section 2.7.2, “Maximum length.”).

1.8 Acknowledgement Processing  – Acknowledgement wording updated: The International HL7 standard specifies two levels of acknowledgement processing: Original and Enhanced Modes.

(a) Original Mode...

(b) Enhanced mode…

This Australian HL7 standard requires the use of Enhanced Mode Acknowledgment and this is described in 8 Acknowledgement.

8. Acknowledgement – all chapter headings updated + enhanced mode requirement altered: The international HL7 standard describes 2 modes of acknowledgement in chapter 2: "original mode" and "enhanced mode". For Australian purposes enhanced mode acknowledgement is required.

8. Acknowledgement – references to international standard updated: The international HL7 standard describes 2 modes of acknowledgement , 8.2.1 Acknowledgements: in chapter 2: "original mode and 8.2.2 Acknowledgements: " and "enhanced mode". For Australian purposes enhanced mode acknowledgement is required.

2. Patient Administration for Pathology – HL7 Attribute Table - MSH-10 field length updated: †† Australian variation to HL7 V2.4 with the length changed from 20 to 36 199 characters to accommodate a globally unique identifier. This has been pre-adopted from HL72.6-2.9.

2. Patient Administration for Pathology – 2.1.9.18 MSH-18 Character set (ID) 00692: restricted to single character set: †††††† Australian variation to HL7 V2.4, field repeat is disallowed. 

2. Patient Administration for Pathology – 2.1.9.0 MSH field definitions updated: ...

The International standard allows repeats of this field, but this standard has constrained it to a single character set for the entire message. 

Appendix 5 Conformance Statements (Normative) – HL7OO: Merged HL7au:00048.3.2 into HL7au:00048.3.1 (r3).  HL7au:00048.3.1 ( r2 r3)  Senders  Orders, Results, Referrals  MSH-18 may must only contain one of the following values "", "ASCII" , or by site agreement "UNICODE UTF-8", "8859/1" may be used. It is hoped to allow "UNICODE UTF-8" in a future version, but this depends on widespread receiver support. Receivers are encouraged to develop capability for UTF-8. It is hoped to allow "UNICODE UTF-8" in a future version, but this depends on widespread receiver support. Receivers are encouraged to develop capability for UTF-8.  Senders  Referrals  MSH-18 must only contain one of the following values "", "ASCII". (r1)  Deleted. Merged into HL7au:00048.3.1 (r3)

3. Datatypes 3.22.3 Separator/suffix (ST) – Example appears to say this should be 228 not 128.  Updated to 128.

Examples:

|>^100| (greater than 100)

|^100^-^200| (equal to range of 100 through 200)

|^1^:^128228| (ratio of 1 to 128, e.g., the results of a serological test) …

3.1 Introduction Figure 3-1 HL7 data types by category – Numerical Example (SN) Structured numeric example also incorrect e.g. should be 128 not 228.  Also updated to 128.

3. Datatypes 3.29.16 Name context (CE) – Consider specifying PR and HCS to assist consuming systems in understanding mapping. HCS = Healthcare Service.  PR = Practitioner Role. Jared will draft words about how to indicate this XCN is a health care service.  HL7OO suggestion:

PractitionerRole^^FHIR

HealthcareService^^FHIR

Propose moving work from Appendix 8 Simplified REF profile A8.12.2 Intended Provider / Individual recipient level addressing including A8 12.2.1 PRD-1 provider role (CE) into new chapter ‘9 Addressing’(?) or add to 6. Identifiers (?) and provide mappings for XCN. Use FHIR resource name for ID value.  For review in next meeting

4. Observation Reporting  4.4.1.24 OBR-24 Diagnostic service section ID (ID) 00257 – Discussion surrounding need to extend table contents to include ‘Molecular Biology’ as an output in MyHR e.g. pathology ‘department’ responsible for testing is currently listed underneath Pathology Test Name.  If adding more ‘departments’, greater likelihood of LIS users not utilising field content correctly, won’t be as easy to find things currently listed under ‘Microbiology’ etc.  LISs would be required to update ‘department’ if Table 00074 content updated.  Latest HL7 FHIR table does not include Molecular Biology.  VC to contact Catherine Pitman (Microbiologist requesting table update)  

    

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
  • 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
  • 44. @Jared Davison to update draft with proposed changes to HL7 Attribute table
  • 45. @Jared Davison to prepare PDF of draft Standard
  • 47. @Dalisay Giffard to share authorised outcomes of Queensland Health meeting discussions on gender identification
  • 48. @Vanessa Cameron to request updates from RCPA on Transgender work being progressed

 

New Meeting actions:

  • 49. @Andrew McIntyre and @Nick Ferris to review wording of introduction to cover radiology and clinical referral
  • 50. @Dalisay Giffard to provide @Nick Ferris with Queensland Health contacts as potential Radiology Informatics working group members
  • 51. @Jared Davison to draft words about how to indicate this XCN is a health care service. 
  • 52. @Jared Davison to draft work on Appendix 8 Simplified REF profile A8.12.2 Intended Provider / Individual recipient level addressing including A8 12.2.1 PRD-1 provider role (CE) into new chapter ‘9 Addressing’(?) or add to 6. Identifiers (?) and provide mappings for XCN
  • 48. @Vanessa Cameron to contact Catherine Pitman re need to update Table 00074 content

Next meeting: Tuesday 03 November 2020 10:00 – 11:30 AEDT