Minutes - FHIR Validation Group 2022-10-27

Thursday, 27th October 2022, 10:00 CET

Agenda

• Allergy type update
• Status of activities:
  • Business templates
  • WG Population Health
  • WG Infrastructure
  • Medication
  • Core changes
  • WG Payment and Insurance
  • Lab WG
    • Request for reuse of Lab profiles for tests for transfusion
    • Logical model
    • Lab Observation
  • Technical re-publication of existing profiles
• Terminology template
• Visualization tool and how it would be added to the process
• Any Other Business

Participants

• Bart Decuypere
• Anne Nerenhausen
• Filoretta Velica
• Hanne Vuegen
• Veerle Michiels
• Nik Silverans
• Karlien Erauw
• Isabelle Pollet
• Jean-Michel Polfliet
• José Costa Teixeira

Minutes

AllergyIntolerance

Blocking point - Allergy Type Stage 0: We our Allergy Intolerance types was diverging from HL7 FHIR International (we had 3 types, HL7 had 2 - Blocking!) Stage 1: We can now consider Allergy Intolerance type to be a CodeableConcept - but we need a BE Extension. Stage 2 (when R5 is released and we have an R4 profile): We can pre-adopt the R5 element as a different extension Stage 3 (when R5 is released and we have an R5 profile): We drop the extension and use the core element.

We are in stage 0. After the release of R5 we can move to stage 2 or 3

Alternative 1

We can skip stages 1 and 2, and simply wait for R5 to be released and at that time we adopt the new value set.

• • Advantages: Less releases, no extensions
  • Disadvantages: We must wait until R5 release to do this - ETA mid 2023, but there may be delays AND we must migrate in Belgium. And we will not capture the data on non-allergic hipersensitivities until that happens

Alternative 2

We can skip stage 2, add an extension to hold the data until R5 is released and at that time we drop the extension. We will NOT drop the existing .type element and we will provide guidance for implementers to use those. We will emphasize that this is not a deviation from the standard, it is a technical pre-adoption of a known evolution of the standard.

• • Advantages: No worries about R5 timeline. We can adopt it whenever we want. No loss of data until then.
  • Disadvantages: One more extension, requires a release.

• • We will inform the HL7 Working Group Patient Dossier that we prefer the Alternative 2 as a way to meet the business needs.**
  • We will ask the Working Group to consider this recommendation and approval. Given the consensus on the Validation Group and the ease and viability to approve this, ideally this approval can be done quickly without requiring a meeting**
  • The Project (INAMI) can propose the enhancement to validate in the group**

Business Templates

• First meeting today. Discussions are ongoing and will continue in next meetings
• ETA is to have a first release of the templates by end December

Population Health

• Meetings are ongoing, work is as expected

Infrastructure and Security

• Target participants have been identified
• Meetings are not planned yet
  • Important to ensure RSW/Isabelle and Vitalink/Brecht and RSB/Filoretta to ensure timely planning and participation
• Topics:
  • Adding of metadata (security labels) to every FHIR results
  • Support of PoCT to existing profiles?
  • Handling of mHealth....

Medication

• Vidis has proposed a FHIR analysis to HL7 - which takes time, so we must prepare in advance
• Meetings are ongoing, publication of current development version is currently blocked because of a technical issue with rendering ExampleScenarios with are used a lot in the IG.

Core profile changes

• There are 6 topics open for the Core profiles : https://github.com/hl7-be/core/issues
• For clarity, **we shall maintain the table with the WGs and profiles** - eHealth / José will make a proposal
• In this meeting, we will clarify that the core profiles must be handled with extreme care for continuity etc. The facilitator of the group SHALL be an volunteer to avoid preponderance of any influence and guarantee that the results do not depend on who's chairing.
• We should convene the Core Profile WG **We will ask Karlien to ask**

Payment and insurance

• Meetings are planned

Lab WG

• Request for using lab profiles for transfusion
  • Bart reached out to the technical authors and to the Belgian project manager
  • We will continue reaching to the BE project manager to see if/when we have topic for a new Proj Proposal
• Logical model : Bart has volunteered to reverse engineer the current lab stuff. José has co-volunteered.
  • The fact that Logical Models are rendered in exactly the same visual format as FHIR resources is confusing.
  • We can work on ways to make a clear distinction between logical models (which can be Informative) and the technical specification
    • We can change the colors / background between functional (requirements, logical models,..) to be different from the technical specification
    • We can also change the logical model DEFAULT visualization into a UML diagram or something so that it does not show immediately as a FHIR resource
• Bart and José to come up with a proposal and example to a future Validation meeting.
• Lab Observation - remark on the request to add Category on BeLabObservation - the WG should be aware that they are not only devoted to one project, but to the standards. Ardon will present a new use case for the group to discuss.

Technical re-publication of the existing profile

• A technical change - will be discussed offline (Bart and José)

Terminology template

• Template is there - do we want to give it a deadline? No, we can use the current template.
  • We had no feedback until now. We can use the current template as a V1 of a template to request ValueSets.
  • We can use this template in the Lab WG.