Minutes - Referral WG 2020-10-09

Attendees (#27)

• José Costa Teixeira, HL7 Belgium
• Karlien Erauw, Agoria/HL7 & IHE Belgium
• Pieter Devolder, IHE Belgium
• Robin Bosman, eHealth Platform
• Jos Bellen, UZ Brussel
• Jamie Verelst, UZ Brussel
• Paul Neyens, UZ Leuven
• Kristof Jaubin, UZ Leuven
• Filip Migom, MIPS
• Thibault Mahieu, MIPS
• Alexandre Schiltz, MIPS
• Andries Dumont, Intersystems
• Hans De Keersmaecker, Corilus
• Philippe Cauchie, CHU Charleroi
• Frederik Lenaerts, Amaron
• Dieter De Gruyter, Amaron
• Mieke Buckinx, NexuzHealth
• Peter Laridon, eHealth Platform
• Filip Jacobs, UZ Gent
• David Van Praet, UZ Gent
• Benny Verhamme, UZ Gent
• Frederic Istace, CGM
• Theo Schumacher, CGM
• Olivier Lothaire, CGM
• David Levêque
• Dr Alain Derom
• Frank Vandewiele, Xperthis

Excused

• Nick Hermans, UZ Leuven

Agenda

• Context
• HL7 FHIR as technical standard
• Related HL7 published guidelines
• Approach of HL7 Belgium
• Action items

Minutes

• Karlien Erauw welcomes the audience and introduces briefly HL7 Belgium and the purpose and way of working of its working groups
• Context:

• The eHealth platform has prioritized the structured exchange of laboratory reports. Goal is to implement by end of July 2021.
• As such, there's a need to have a clear view on our use of content standards by the end of October/early November.
• HL7 FHIR has been chosen as the technical standard in this project. This means that the standardization effort involves FHIR profiling and guidance. This is the scope of this new HL7 FHIR working group within HL7 Belgium.

• Setting the scene by Robin Bosman

• Important remark: architectectural concepts are not the scope of this WG
• To define the technical FHIR standard for the laboratory result, a draft Implementation Guide has been set up on this address
• General guidelines on how to use the laboratory report leveraging FHIR resources are described on the ‘Guidance’ page
• Three technical profiles have been created to deal with the laboratory report, they can be find on the ‘Artifacts’ page

• These concern profiles on

• the DiagnosticReport
• Observation and
• Specimen resource

• Examples are here

• Some discusscions

• use of codes to express the results : Loinc > Albert > own code + text field > text field only

• When a code is absent, the lab is supposed to ask its creation a the Belgian ReTAM-Lab group (Tom Fiers or Philippe Cauchie)
• Belgian LOINC Subset: a new extraction should be available November 1

• What about dynamic lab testing ?

• there is a FHIR extension, will be adressed in later meetings

• What about micro biology testing ?

• there are good examples at HL7 international

• Syntax of diagnostic report is at maturity level 3 in FHIR. This means that there is already some testing done.
• There is a ifference between FHIR profiling and FHIR extensions. Extensions can cause interoperability issues, profiling not.
• FHIR has plenty of libraries available, see here. For a FHIR server there is no difference betweenw json or xml and you get exactly the same result. This is the advantage of FHIR. Client and server have all of the libraries. Functionality does not change.
• How are we going to be interoperable with outside of Belgium, in Europe (~Z segment)
• Microbiology is not developed in Retam, nor in Loinc

• The logical model will have to be composed, first draft to be expected in upcoming weeks
• Structure definition: see here

• note: the differential table shows the difference between the (international) profile and the Belgian profile

• Action items

• Please review the guidance
• If you are familiar with FHIR: start looking at the examples here and here

• to check if all elements of a lab report are mapped in the implementation guides

• For HL7 FHIR beginners, check out the free FHIR workshops offered on November 3 and 4 during the eHealth plugathon
• If Loinc items are missing, please reach out to Philippe Cauchie

Next meeting: Monday, October 19 at 4PM

• Contact Karlien Erauw for the dial-in details if you have not received the meeting invite