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Date  10:00 AEDT

Attendees:

@Andrew McIntyre (AMc – co-Chair)

@Michael Legg (MLe - co-Chair)

@Brett Esler (BE)

@Dalisay Giffard (DG)

@David McKillop (DMc)

@Eric Browne (EB)

@Jared Davison (JD)

@Jakub Sielewicz (JS)

@Kieron McGuire (KM)

@Michael Osborne (MO)

@Philip Wilford (PW)

@Tony Cruice (AC)

@Vincent McCauley (VM)

@Vanessa Cameron (VC - Secretariat)

Apologies:

@Angus Millar (AMi)

@Christian Holmes (CH)

@Danielle Tavares-Rixon (DTR)

@Scott Ferris (SF)

@Liam Barnes (LB)

@Robert Flatman (RF)


Meeting purpose: To discuss suggested updates to the Australian Diagnostics and Referral Messaging – Localisation of HL7 v2.4 Standard, with a focus on updates/concerns raised by ADHA members. 

Discussion items:

Versioning of the Standard: The version on the HL7 Australia O&O working group web page is to be utilised by O&O members to suggest changes and is for development purposes only.  The fixed, PDF rendering of the Standard is the reference document which should be utilised by regulatory bodies e.g. NPACC for accreditation surveys or inspection purposes; this was the document sent out to all for balloting and was published as HL7AUSD-STD-OO-ADRM-2018.1 in August 2018.  The Standard has its own space on Confluence and is ‘read only’ to all except BE.  Also noted, HL7 Australia Standards Development space lists all superseded, current and draft Australian Standards.  BE to update the link on the HL7 Australia O&O WG page accordingly.

HL7 website hasn’t been updated for some time due to new website being developed – release date TBA.

ADHA are currently reviewing the Standard as part of Secure Messaging Industry Offer; have created a profile to validate V2 messages, specifically REFI12 message, adding rules around mandatory and optional fields and querying ambiguous statements.  Have built conformance testing into clinical package validator tool from generic Messaging WorkBench XML file and cross-referencing v2.4 Standard.  Message samples on Confluence website were used to test messaging. 

REST Assured has developed an Open source testing harness to check messaging workflow, configured to any HL7 v2 profile desired, allowing you to set up scenarios where messages are sent back & forth with acknowledgements.  Suggest ADHA consider drafting a set of test messages, importing them and then having human review of display output would be of value re conformance testing, ensuring information is populated in correct areas of messages via screen shot review of rendering.

Agenda items:

2 Patient Administration for Pathology – 2.2.1.27 PID-27 Veterans military status (CE) 00130. Issue:  Should be a heading instead of plain text. Decision: Agreed to change text to heading.

2 Patient Administration for Pathology – 2.2.1.14 PID-14 Phone number ) - business (XTN) 00117.  Issue: ? should be ‘-‘.  Decision: Agreed to remove ? and add ‘-‘ .

 

2 Patient Administration for Pathology – PID-1 L7 Attribute Table Patient Identification.  Issue: PID-1 should be made mandatory to reflect narrative.  Decision:  Agreed to make field required and footnote added next to relevant item to denote Variance to HL7 International.

Australian Diagnostics and Referral Messaging - Localisation of HL7 Version 2.4.

1) 2.2.1 PID - patient identification segment.  Issue: In table, make PID-1 mandatory/required, not optional as the definitions states “it shall be one…” Decision: Agreed to make field mandatory and footnote added next to relevant item to denote Variance to HL7 International.

 2) 2.2.2 PV1 - patient visit segment.   Issue: In table, make PID-1 required (mandatory), not optional as the definition states “it shall be one…” Decision: Agreed to make field required and footnote added next to relevant item to denote Variance to HL7 International.

3) 7.3.2 Patient Referral  Issue : PRF1 field lengths for the following are too small:

  1. RF1-6 Field length of 30 is too small, should make it 250 (examples also are longer than 30)
  2. RF1-11 Field length of 30 is too small, should make it 250
  3. 7.3.2.6 RF1-6 Originating referral identifier  - also has statement “The first component is a string of up to 15 characters” etc - do we need to constrain the first field to 15 characters or change?  Decision: Agreed to change Explanatory note “The first component is a string that identifies an individual referral” etc.  Character limit increased from 30 to 250 characters, and footnote added next to relevant item to denote Variance to HL7 International.
  4. 7.3.2.11 RF1-11 External referral identifier – Character limit changed from 30 to 250 characters.

Decision: Agreed to make all proposed changes and footnote added next to relevant item to denote Variance to HL7 International.

6 Identifiers

Issue a: Table 6.1 - Examples for Department of Veterans Affairs - Key is wrong. DVG card type incorrect DVA card type: DVG = white; DVO = orange; DVG = gold.  Decision: Agreed to change card type DVW = white.

Issue b: User-defined Table 0363 – Assigning Authority - Are these examples correct?  How many other codes will be allowed in this table? E.g. |7654321^^^RMH^MR| and  |34567890^^^QLD^DL| . 5 values currently listed in Table 0363 are Australian national content.  HL7 International Standard v2.4 has 19 additional values, however HL7 FHIR Table 0363 indicates all values in this table have been deprecated.  Decision: Suggest implementers produce a warning, not an error when other Assigning Authorities are referenced as Assigning Authorities.

Appendix 8 Simplified REF profile - There may be multiple identifiers in the PractionerRole identifier list. It is important to map the routable identifiers in the order specified in the directory entry. Note that HL7v2 systems often will consider only the first repeat of this field.  Issue: The current AU-FHIR-PD profile does not support ordering of identifiers; hence the order cannot be guaranteed. Decision: No changes made since the secure messaging vendor determines the order in their data being served, and the message producer must follow this.

Appendix 5 Conformance Statements (Normative) PRD-7 must have at least 1 repeat (for providers receiving electronic communication). PRDs exist for each practitioner involved in the treatment of the patient, some of these may not be intended to receive a copy electronic electronically.

Appendix 5 Conformance Statements (Normative)Issue: Ensuring the uniqueness of the Entity Identifier (EI) in OBR-2 (Placer Order Number) for a request identifier across different organisations, the Entity identifier (first component) in addition to the Namespace ID (second component) and/or Universal ID (...Address ‘and/or’ issue by removing optionality.  Decision:  Agreed to align HL7au:000003 with HL7au:000004.1 (r2) and HL7au:000002 - When field exists, EntityIdentifier AND Namespace ID AND Universal ID AND Universal ID type must be specified.  Also, HL7au:000003 remove optionality of UniversalID,UnversalIDType to make consistent with ORC in HL7au:000005,6,7.

7 Patient Referral – 7.3.3 PRD-7 – Provider Data segment.  Decision: Should be made mandatory to align with conformance point HL7au.00104 7.0 (r2) which states that PRD-7 must have at least 1 repeat (for providers receiving electronic communication).


New Meeting actions:

  • 16. JD – Add links to published Standard onto HL7 O&O workspace
  • 17. BE - Update links to all Standards on the HL7 Australia O&O WG page
  • 18. VC – Add new agenda item re Table 1.1 Length re 7.3.3 PRD-7 does increasing field length from 100 to 250 pose a problem as it is repeatable?  Needs clarification statement to be included in Introduction
  • 19. VC – Schedule meeting for 24 March 2020, preferred time 10:00 AEDT

Outstanding Meeting actions:

  • 5. VM – Follow up with BE re providing input to FHIR & Pharmacy group HL7 International including Connectathons – Pending.  VC send reminder to VM  - Complete 18.06.2019.
  • 9. VC – Contact BE to obtain login/access to Confluence to update meeting dates, agendas, minutes & related documents – Complete.  VC to sign up to obtain login rites for Confluence – Complete.  JD to assist VC with Confluence once access provided – Complete 06.08.2019.
  • 10. MLe – Speak with eHealth NSW at their Quad meeting – Complete 18.06.2019.
  • 12. MLe – Suggest October 2019 workshop in Syd/Melb to BE and Jason Steen– Complete (but not actioned).
  • 13. VC – Chase AMi for MyHR information on OBR4 with priorities and total numbers – Complete.
  • 14. MLe – Write to RANZCR re new Standard & welcoming their participation –  Complete.
  • 15. VC – Contact BE and Jason Steen re uploading all HL7 AU workshop presentations to website  – Complete 03.10.2019 (but not actioned). VC – Contact BE & HL7 AU Secretary for delegate list + representative organisations – Complete (but not actioned).




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