Minutes - Patient Dossier WG 2022-01-06

Thursday, 9th December 2021, 09:00 CET

Attendees

• Anne Nerenhausen
• Bart Decuypere
• Brecht Van Vooren
• Dominique Bastille
• Félix De Tavernier
• Isabelle Pollet
• Jan Lenssen
• José Costa Teixeira
• Karlien Erauw
• Kris Deceunynck
• Marleen Martens
• Michaël Cauchie
• Stijn Longin
• Walter Bollaert

Excused

• Clément Brasseur
• Filoretta Velica
• Geert Top
• Jean-Michel Polfliet
• Pablo d'Alcantara
• Tatiana Pereira

Agenda

• Review and work on open issues

Minutes

• Looking at issue log here: https://github.com/hl7-be/hl7-be-patient-dossier/projects/1

• Belgian valueset for vaccincodes
• migration to BE dossier
• difference b/wdossier
• target disease bei ng mandatory - valueset needed
• create valueset for product code
• document use cases: do we need more on the existing ones

• some issues need input
• any issues missing ?
• valueset vaccincodes

• vaccinnet needed to provided a valueset, will be arriving soon, 52 vaccincodes currently used
• goal it to create one list for vaccincodes, preferably in Snomed CT
• list can be created without values, a minimal set will be necessary asap (for covid f.e.)
• there is a group of diseases for which there are vaccins in Belgium
• a list with initial values will be composed, RIZIV will contact NRC for validation, including if Snomed CT can be used - it must be stressed that this is urgent, especially the covid vaccincode

• valueset for product codes

• administered product today is a reference, not a code
• there are 3 technical choices possible:

• 1: a reference does not have to be to a full resource, url is not necessary, identifier can be used - using a logical reference
• 2: putting a reference to a resource chat is contained in the immunization
• 3: change this from being a reference to a codable concept or a reference to a medication - most complex

• old
• The most pressing issues are those with ValueSets. The issues have been prioritized in the Issues Board

• There are 3 different concepts, each with a slight different meaning and each with a possibly different Value Set:
  • Vaccination (type): The type of vaccination, corresponding to a set of diseases that are targeted with one action. For example MMR, DTaP,...
  • Disease code - this is the code for the actual disease that is targeted, and may correspond N:1 to the vaccine code. For example DTaP has 3 diseases
  • Product Code - this is the actual product code, which can be using ValueSets such as CNK, or classes such as ATC...

• In FHIR, the VaccineCode is mandatory, and the Patient Dossier Group does not feel it's adequate to convey ambiguous meaning there - i.e. we believe that the VaccineCode should have the Vaccination (type) Code, while Product code is a different element.

• The first priority is to create a ValueSet for VaccineCode. Given the fact that this cannot be empty, there needs to be a value for Vaccinet / eVax to put something there without needing to transcode the products into vaccination types.

• Anne (RIZIV) has provided a document with a value set, which is forwarded to the people in the meeting.

• We concluded to add a code for "Unspecified Vaccine code" to the ValueSet that we'll use in Belgium for VaccineCode. This avoids free text entry, and ensures that systems can proceed accordingly when receiving such information.

• An email is being sent out to the group to validate the concepts - the codes will be assigned later - and the group will come forward with any objections or gaps before the 23rd December.

Meeting adjourned at 10:06

Next meeting Thursday 20 Jan at 9AM