Minutes - Referral WG 2020-04-02

First meeting

Meeting Minutes – by Karlien Erauw & Robin Bosman

Attendees:

• Will Van Norel, Cerner
  
• Philip Sidgwick, CIN
  
• Robin Bosman, eHealth Platform, convenor of this Working Group
  
• Karlien Erauw, Agoria, secretary of HL7 Belgium
  
• Arnaud Lippert, RIZIV/NIHDI/INAMI
  
• Anne Nerenhausen, RIZIV/NIHDI/INAMI
  
• Erwin Bellon, UZ Leuven
  
• Nick Hermans, UZ Leuven
  
  

Agenda:

• Roll call
  
• Present HL7 Belgium wiki pages
  
• WG's mission
  
• Presentation RIZIV/NIHDI/INAMI
  
• Next meeting schedule
  
  

Meeting Minutes:
The convenor gives a short introduction:

• Importance of mission statement: please review for next time
• As the time is limited, the group decides to give a maximum amount of time to and to start with the input from the RIZIV/NIHDI/INAMI.

The NIHDRIZIV/NIHDI/INAMI experts give an overview of their project and based on the first extensive drafts they already realized for the logical datamodel. (Their input is shared with the group)

• As a side note, the group notes it is important to use the word 'referral prescription' ('RP') when referring to this workgroup, as this aligns on the general understanding.
• The RP contains the following:
  • Patient SSIN identifier
  • Prescriber NIHDI identifier
  • Date creation
  • 0…* NIHDI identifiers of signing healthcare parties (for validity of the RP in certain cases) with dates
  • 1…* NIHDI identifiers that will perform the RP
  • 1 Period or date for performing the RP
  • 1 Status with date
  • 0.. * Structured data linked to the specific model of RP
  • 0.. * Not structured data linked to the specific model of RP
  • 1 Reference ID

• Clarifications concerning the above:
  • In some cases, extra signing healthcare parties are needed for the validity of the RP. This is linked to the overall validity period of the RP. These extra parties are not the parties that will perform the RP but RIZIV/NIHDI/INAMI will need to be able to check these parties signed in the right period. (This normally is 15 days) For diagnostic imaging, these extra signing parties are normally not needed.
  • In some cases, multiple healthcare parties will perform the RP.e.g. multiple kinesists or nurses.
  • The datamodel presented already contains many types/subtype. It will need to be defined whether each can be fully structured.
    • Not all types are already cleared out in the model.
    • This workgroup can work on the further development of the logical model using the business input that was gathered.
  • It is noted a radiologist can divert from the RP with the right of substitution. In that case he will have to create a new RP that will be part of/linked to the original RP and be shared with NIHDI.
    • The RIZIV/NIHDI/INAMI will have to check whether the new one is reimbursable.

Although the group does not see itself as the authority to define the architecture to use this, it is acknowledged certain choices might have an impact on how the FHIR resources will be modelled.

• e.g. encryption expectations might influence the choice whether certain information is modelled in separate FHIR resources or when it should be possible a certain list is consulted, it might have an influence on availability of the right parameters.
• In general the group agrees its primary role is working towards the logical datamodel and its expression in FHIR resources and all of this is use case driven. As such, the group shall steer away from concrete discussion around how or where data is actually storaged in what format etc.

The group considers some general topics of importance:

• Concerning codification (e.g. SNOMED-CT) it is confirmed this was not in the inititial gathering mission of the NIHDI but it will be looked at internally how we might proceed in this.
• The three main priorities for the RIZIV/NIHDI/INAMI are kine, imaging and nursing.
• The group notes we do have experts in our group for imaging but not on the other topics. This means our group should be extended with more stakeholders.
  • It is a risk if we only look at use cases that are in line with our current expertise in this group.
• Based on the information we have as-is there are already investigations this group can do towards FHIR e.g. how to model the multiple signers.

Next meeting: Thursday April 16, 1PM - Karlien will send out an invite for a call every other Thursday.