HL7 Child Health Work
Group Meeting Minutes
Location: San Antonio, TX
Facilitator
Date: 2014-01-21
Time: Q3 & Q4 | 1:45– 3:00pm; 3:30-5:00pm CST
Note
Pele Yu
taker(s)
Mike Padula
Attendee
Q3
email
Affiliation
Mike Padula,
padula@email.chop.edu
CHOP
Pele Yu,
yu_f@kids.wustl.edu
SLCH
Ewout Kramer,
e.kramer@furore.com
Furore, FHIR
John Roberts
john.a.roberts@tn.gov
TN eHealth
John Roberts
john.a.roberts@tn.gov
TN eHealth
Mike Padula
padula@email.chop.edu
CHOP
Pele Yu
yu_f@kids.wustl.edu
SLCH
Russ Leftwich
rleft@pobox.com
TN eHealth
Laura Haermann-Langford
Laura.haermann@imail.org
Intermountain Healthcare
Catherine Hoang
catherine.hoang2@va.gov
VA
Katherine Dubeau
katherine@dubeaudesign.com
Dubeau (DDI)
Harry Solomon
Harry.solomon@ge.com
GE
Q4
Quorum Requirements
Met: Yes
HL7 Child Health Work
Group Meeting Minutes
Location: San Antonio, TX
Facilitator
Attendee
Q1
Date: 2014-01-22
Time: Q1 & Q2 | 9:00 am -10:30 am; 11:00 am - 12:30pm CST
Note
taker(s)
Pele Yu
email
Michael Padula
Affiliation
Mike Padula
padula@email.chop.edu
CHOP
Pele Yu
yu_f@kids.wustl.edu
SLCH
John Roberts
john.a.roberts@tn.gov
TN eHealth
Alexander Henket
henkat@nictiz.nL
Nictiz
Anneke Goosen
agoosen@results4care.nL
R4C
Rick Kuchan
rick.kuchan@gmail.com
Kuchan HIT
Katherine Dubeau
katherine@dubeaudesign.com
Dubeau (DDI)
Mark Janczewski
mark.janczewski@verizon.net
Medical Networks, LLC
Q2
John Roberts
john.a.roberts@tn.gov
TN eHealth
Mike Padula
padula@email.chop.edu
CHOP
Pele Yu
yu_f@kids.wustl.edu
SLCH
Lura Daussat
ldaussat@oz-systems.com
Oz Systems
Rick Geimer
rick.geimer@lantana.org
Lantana
Quorum Requirements
Met: Yes
January 21, 2014
Q3
Attendees: Mike Padula, Pele Yu, Ewout Kramer, John Roberts
FHIR – ease of interoperability; rapid deployment sharing data (Roberts)
Came from developers group in HL7 v3, v3 could not meet emerging technologies. In a
meeting in Orlando, with the Fresh Look initiative, developers gathered and wrote a
standard that would replicate web 2.0 use cases. How you should work with FHIR, not how
we developed the FHIR model. REST, SOA – when you change paradigms, you change
models – they wanted to send a document and in a mobile phone could see that, use the
same data definitions.
FHIR is aimed at developers; does away with RIM; FHIR has extension mechanisms, make
the resource can be designed for majority of use cases;
Resources – is the basic value set for FHIR; resources are at the CMET layer, not in the
template level.
There is a standard in FHIR to write the extensions.
Hard to understand the V3 background, hence FHIR was conceived to do away with RIM
complexity.
How to communicate FHIR resources – there is a FHIR server, client managing the data;
communication mechanisms described; FHRI has documents too.
There are some people making FHIR – CDA bridges. CDA and FHIR are likely competitors
in creating documents.
Can FHIR be a potential solution for CHA PHIS+ like efforts? – FHIR is able to express the
data – either into messages or documents.
Josh Mandl – Boston Children’s interested in FHIR applications for SMARTplatform
FHIR connectathon coming for developers. Keith Boone is supportive of FHIR.
Can FHIR be used to implement the “portable health record”? Ewout says that it can, and
not have the background of RIM. FHIR can enforce value sets (terminologies, etc). Profiles
are the methods by which standardized data sets can be formalized.
FHIR is freely distributable. FHIR is open and have everyone (even outside of HL7). There
are a number of vendors now turning to FHIR, including PHR vendors.
FHIR documents can have similar Level 1, 2, and 3 CDA counterparts.
FHIR resources –
http://wiki.hl7.org/index.php?title=FHIR
http://www.hl7.org/implement/standards/fhir/
http://wiki.hl7.org/index.php?title=FHIR_email_list_subscription_instructions
Q4
Attendees: John Roberts, Pele Yu, Mike Padula, Katherine Dubeau, Russ Leftwich,
Catherine Hoang, Laura Heerman-Langford, Harry Solomon
Fall 2013 Minutes reviewed and approved.
CH WG success metric discussion:
We must set up a time to have “meeting” in between WGM. A good idea might be to assign
co-chair to lead the in between calls.1
Portable Health record for children with special healthcare needs:
- Goal is to design portable records with patients with complex care needs
o Need to have a contingency-based plan section; for example, if this patient has a
seizure, this is what needs to be done.
o Needs to have medical device section; how well can we model needs for trache,
G-tube care, etc)
- Scope? Is this restricted to children?
- Consider less complex kids?
- Can be used for school forms?
- What is the proposed name of document?
o Personal Health Record
o Portable Health record
o Emergency Information Form
- Format
o CDA versus FHIR
ACEP and AAP form was placed on exhibit during meeting. Russ said that Michael Warren
from TN was working on this form to implement. They are interested in having procedures
1
Plan for in between calls and assign call leader
that had problems with to be documented (i.e., don’t do this procedure, difficult IV access).
Hawaii government entity? and Seattle Children’s also has similar document per Laura.
Chris Lehmann (AAP) is interested in promoting this to expand to broader population. AAP
is interested in a broader form (camp form) – “away from home, emergency plan”. May not
be limited to emergency, capturing content outside of EMR, applies to all transition of care.
It is an expansible form.
What information needs to be in the form? Hard to decide which information needs to be in
the form. Perhaps build it for the most complex patient
There are ties here for the Care Plan effort, missing fear, anxiety, devices and how to deal
with this. In the VA, there have an effort that uses “Legos” where they are leveraging
reusable templates to support the information needs. It also can be used in adults.
CDA is hard to implement this but FHIR may be feasible, because of its extensibility. This
should also be able to be used in mobile devices, etc.
Pressure Ulcer DAM – contains concepts with tubes and drains.
Include Department of Health Special Health Care needs group - Chris Chytraus2
This document is different from others because it is contextual about patient’s specific
condition.
Basic info for this document:
1. Devices
2. Behavior and communication
3. Directives
US realm? We need international members.
Finalizing project scope statement (see document) involved narrowing the project scope
statement and defining roles of implementers and project sponsors.
Send the document tonight to the sponsoring groups and then
Goal is to have ballot ready by January 2015 WGM. Approve the PSS within next 2 weeks
and send it for electronic vote as soon as feasible. Hope that we have a distributable
project abstract to start working shortly.
January 22, 2014
Q1
Attendees: Mike Padula, Pele Yu, John Roberts, Alexander Henket, Anneke Goosen, Rick
Kuchan, Katherine Dubeau, Mark Janczewski
The status of the Child Health EHR Functional Profile (CHFP) was discussed. The CHFP
2
Include in discussions
passed the most recent ballot cycle for renewal. Members of the EHR WG provided an update
on Release 2 of the EHR Functional Model and highlighted a number of the differences about
the organization (structure) and tools (Enterprise Architect) used for editing/building functional
profiles. It is anticipated that the EHR FM R2 will be balloted in May 2014.
Given the recent AHRQ EHR Model Format for Child Health, which included substantive
content from HL7 CHFP, and no clear path for EHR certification for pediatric-relevant
functions, we discussed at length the value and utility for developing a revised version of the
CHFP that can be reconciled with release 2 of the EHR FM. Additionally, we have a draft of the
Neonatal Functional Profile as a derived profile of the CHFP R1 to detail specific functions
relevant to tertiary-level neonatal intensive care.
We discussed developing a scope statement for the CHFP R2 to include more content from
inpatient/ICU in addition to the ambulatory child health content. We will aim to revisit this next
meeting to flesh out a more precise timeline for this initiative, as well as work on mechanisms
to enlist the subject matter experts to support it. It was recognized that having an individual
familiar with the Enterprise Architect tool would be an important facet of the project. The desire
for a partial funding to support an individual in that role was expressed.
Immunization profiles, including examples from systems in the Netherlands, were also
discussed.
Q2
Attendees: John Roberts, Mike Padula, Pele Yu, Lura Daussat, Rick Geimer
Lura Daussat provided an update re: the Early Hearing Detection and Intervention
Implementation Guide that PHER has been developing.
Opportunities for projects relating to developmental screening were discussed.
Rick Geimer was kind enough to share his time and provide his take re: FHIR and highlight the
functionality, including the examples of where it seems it is most useful and where it is not (e.g.
narratives). Comparison with CDA functionality was discussed in greater detail.
Additional items for supporting planning and work group health (e.g., SWOT, 3 year plan,
webmeetings) were discussed as well.
Actions Items
1. Consider FHIR as potential solution for CH efforts
2. Plan for in between WGM calls
3. Submit PSS within next few weeks, as soon as feasible
4. Mike to share draft of PSS with Russ and Laura so they can edit and
send to PCWG and ECWG for input approval.
Next Meeting / Preliminary Agenda Items
Confirmed for Tuesday May 6th ((Q3 & Q4) and Wednesday May 7th (Q1 & Q2)
Agenda Items (Tentative):
 Project Work: Pediatric Developmental Screening Std (Cathy Rice)
 Portable Health Record with members of Emergency Care & PCC WGs joining
 EHR project: Update CHFP R2