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Date:  11:00 AEST

Attendees:

Apologies:

Meeting purpose: To continue reviewing suggested updates to the Australian Diagnostics and Referral Messaging – Localisation of HL7 v2.4 Standard not discussed in Meeting 9 on 07 April 2020

Agenda items:

*Note: Raising items - 1) make inline comment on draft standard as can be tracked easily and resolved electronically (preferred) 2) email Vanessa Cameron

With the current COVID-19 pandemic scenario there are increased demands for electronic pathology, radiology and pharmacy requesting. The ability for a service provider to receive an electronic order generally  requires a unique identifier, e.g. barcode, which is sent via Security field in message header 2.1.9.8 MSH-8 Security (ST) 00008. Problem exists in that the identifier must be generated in a proprietary message format which can be printed as a barcode by pharmacy etc e.g. Message – prescription exchange – identifier – print barcode. Basic REST API: Requesting Service (GP) –> (HTTP request) -> Providing service (Pharmacy eRX) which communicates with itself. Not aware of any current HL7 message standard for security information for barcode.  With placer group numbers tending to be incremental (with/without check digit), they are easily predictable, therefore a security risk for pharmacy medications.  Andrew McIntyre to develop draft offline and circulate prior to next meeting.

3 Datatypes - HL7 Vocabulary Committee published Table 0396 (FHIR-centric & V2) initially to inform users what was currently available and then once they began using it, they could specify/recommend other code systems for use. Purple text within Table 0396 removed and content revised for international code system reference.

NOTE 1: These are the more commonly used code systems in the Australian context.  For the international code systems available refer to http://www.hl7.org/special/committees/vocab/table_0396/index.cfm

Some organizations that publish code sets author more than one. The coding system, then, to be unique is a concatenation of the name of the coding authority organization and the name of its code set or table. When an HL7 table is used for a CE data type, the name of coding system   component is defined as HL7nnnn where nnnn   is the HL7 table number. Similarly, ISO tables will be named ISO nnnn, where nnnn is the ISO table number.

This table is not exhaustive and other non-standard coding schemes may be used.

NOTE 2: HL7 message validation tools should raise a warning when a code from a coding system above cannot be resolved from their respective terminology data source. Similarly, code systems encountered not found in this table should also raise a warning.

7 Patient Referral – Coding systems updated in Table HL70396 to include EAN, MIMS-GENCODE, AMT, MIMS-FORM, IS and units of measurement code updated to include MIMS-UNITS

 

Appendix 5 Conformance Statements (Normative) – Reference to HL7au:00044.11.1.7 Receivers updated: Receivers must understand that a LOINC code of 74028-2 (Report Template ID) signifies the identifier of the report template used to structure the data and not render as patient data.

Appendix 8 Simplified REF profile –Initially PV-1 was optional, but now mandatory. Referral message individual provider/recipient PRD IR provider should be duplicated into PV1-9 to match intended recipient. Some time has passed since MSIA report. There may be valid instances where PV1-9 consulting doctor is desired to be used for its original purpose. Also, ADHA have contract with message producers and receivers to conform with the spec in its current form.

Appendix 6 Example Messages – Examples provided referenced outdated LOINC code (60572-5), now updated with LOINC code 74028-2.

7 Patient Referral – inline comment updated to new LOINC code 74028-2: Patient referrals containing structured HL7v2 VMR information should contain an OBX as follows which acts as a header. Note that the OBX-4 sub-ID field is the dotted decimal root value that structured child elements must belong. In the example below this is 1 but may be another number. The LOINC value "74028-2^^LN" in OBX-3 Observation Identifier indicates that this OBX is defining the report template ID which can be found in OBX-5 Observation Value (RP).

 

7 Patient Referral – example in 7.4.1 VMR header updated with valid LOINC code 74028-2 OBX|1|RP|6057274028-5^^LN2^^LN|1|HL7V2-VMR.v1^HL7V2 VMR&99A-9AAC5A649D18B6F2&L^TX^Octet-stream||||||F
 

4 Observation Reporting – no need to add 74028-2 to VMR template as no template currently specified for HL7 VMR

Suggested new chapter required for ACK messages e.g. Chapter 8. Acknowledgments. Will also need Conformance points to assist users understand ACK messages rather than hiding crucial conformance statements within Introduction. International Standard has Acknowledgements are covered off in Chapter 2 Control. Action: Anthony Cruice and Jared Davison to develop draft offline and circulate prior to next meeting on 26 May 2020.

New Meeting actions:

  • 25. Andrew McIntyre – Develop draft re proprietary barcode messaging via 2.1.9.8 MSH-8 Security (ST) 00008


Outstanding Meeting actions:

Next meeting – Tuesday 26 May 2020

LOCATION

TIME

NSW / ACT / VIC / TAS / QLD

11:00 AEST

SA / NT

10:30 ACST

WA

09:00 AWST

Auckland NZ

13:00 NZST


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