Minutes - Referral WG 2021-11-16

Attendees

• Alexis Van Zeveren (arrived late)
• Dr Alain Derom
• Bart Decuypere
• Benny Verhamme
• Frédéric Istace
• Frederik Lenaerts
• Hans De Keersmaecker
• Jean-Michel Polfiet
• Joost Van Averbeke
• Jos Bellen
• José Costa Teixeira
• Karlien Erauw
• Kristof Jaubin
• Nick Hermans
• Nico Vannieuwenhuyze
• Peter Laridon
• Robert Nicolas (Medispring)
• Thibault Mahieu
• Tom Tollenaere
• Stefan Waegemans
• Toon Schiemsky

Excused/Not present

• Frederik De Kegel
• Mieke Buckinx
• Olivier Lothaire
• Paul Neyens
• Richard Francken
• Theo Schumacher
• Tom Fiers

Agenda

• Rework on issues resulted from the pilot phase

Minutes

• Updates of the pilot phase of the Lab result project, see presentation here - by Jean-Michel Polfliet

• goal of the pilot: implementation proof documentation for the project
• 5 pilot participants (2 GP softs + EPD soft + 2 LIS) + 2 biologists
• tracking of issues is done in github
• testcases will be used in the future for the end-to-end solution

• List of issues is here: https://github.com/hl7-be/hl7-be-fhir-laboratory-report/projects/1
• Today we will deal with the issues having as status "To Be Validated by WG"
• Issue #18 Every bundle needs a unique identifier - how will be deal with this at national level, do we want to standardise this ? yes

• combination of system and value has to be unique
• Medina will remove the lab prefix : lab riziv number + unique number for the lab (f.e. riziv request number)
• HL7 Belgium has to work on naming system : HL7 Belgium will set this up in the way "this is the approved url as agreed" - it will be the identifier of the bundle, not the unique ID
• please note: one request cannot have 2 bundles as outcome

• The Bundles have to be unique, any reference identifiers in the bundle do not have to be unique ? They only have to be unique within the same bundle

• Issue #26 "Multilevel titles on protocols"

• a lab protocol has titles and none or multiple subtitles and each level can have results
• need for agreement on way of encoding

• proposal: using "hasMember" as this has been created to have hierarchy

• Issue #38 is almost the same issue "Subtitles and panels"

• nuance of narrative generation
• is there a need for a dummy narrative to a panel ?
• Conclusion: if you have a child you have to use "hasMember"

• Narrative: the receiving party needs to be able to rebuild the protocol

• Macsys wants to leave the narrative empty - is this against the HL7 FHIR standard mandatory guidance ? Macsys will create plain text in the narrative
• copy of the protocol could be sent as a blob, not in the narrative

• Issue 34 about coding system to include in the observation

• can we use multiple ones ?
• link to coding system : FHIR allows Loinc, Albert or lab codes
• should we not determine how we have to identify lab coding systems - will Medidoc, Medigest codes be identified ?
• is there a repository page of the used lab coding systems ? needs to be created & option to be re-validated by this WG
• a terminology server could be an option for the future

Action items

• HL7 Belgium to make up naming system for identifier for bundles
• HL7 Belgium to make up repository page of the used lab coding systems
• HL7 Belgium to update status of discussed items

Next Meeting: additional meeting on Thursday Nov 25 at 1PM to make progress