<div dir="ltr">Just to level-set, there are three links in the current use case to sources that describe potentially interesting data (though not directly how they map to FHIR, as far as I can see):<div><ul><li><a href="https://bitbucket.org/openid/heart/wiki/Alice_Shares_with_Physicians_and_Others_UMA_FHIR" target="_blank">Use case</a></li><ul><li><a href="https://www.healthit.gov/policy-researchers-implementers/patient-generated-health-data" target="_blank">PGHD</a></li><li><a href="https://www.healthit.gov/sites/default/files/commonclinicaldataset_ml_11-4-15.pdf" target="_blank">Common Clinical Data Set</a></li><li><a href="https://www.wedi.org/home/virtual-clipboard-to-improve-patient-data-collection" target="_blank">Virtual clipboard</a> (<a href="http://www.wedi.org/docs/default-document-library/virtual-clipboard-definition-and-design-document.pdf?sfvrsn=0" target="_blank">this link</a> is actually more helpful -- I've changed it in the use case)</li></ul></ul><div>And based on one of our telecon conversations, we provided this list right in the use case, where the first item might possibly encompass some of the others by definition:</div></div><div><div><ol><li>Virtual clipboard<br></li><li>Basic patient profile /Patient)<br></li><li>Medication history (/MedicationDispense, /MedicationAdministration)<br></li><li>Immunizations (/Immunization.vaccineCode , /Immunization.status)<br></li><li>Allergies (/AllergyIntolerance)<br></li><li>Problem list /Condition.code, /Condition.status)<br></li><li>Labs (/DiagnosticReport.code - LOINC /DiagnosticReport.codedDiagnostics - SNOMED)<br></li><li>Basic insurance info? EOB?<br></li><li>(what else? Keep it simple)<br></li></ol></div></div><div>Here was my guess about directions, given that a use-case-based definition of this resource set is meant to encompass baseline information before a first visit.</div><div><br></div><div>First, we want to keep firmly in our minds that Alice's motivation to share this information at all is as a convenience vs. sharing it in a more onerous, brittle fashion (e.g., having to keep updating her meds list later, spending time printing forms, arriving early to the first appointment...). So we don't "win" if we don't hit that mark.</div><div><br></div><div>Second, labs and EOBs look like the "odd items out" on that list for a first visit. Am I right? And what's missing? And what's the "FHIR concordance" for all this? Can one actually be done?</div><div><br></div><div>Third, there would be some kind of a "matrix of requesting-side appropriateness" for what is to be shared:</div><div><ul><li><b>Payment info:</b> E.g., there's a particular type of insurance infrastructure in the US, but in Canada, it would look different. So the "insurance info" reference in #8 would need to vary or be missing per jurisdiction.<br></li><li><b>Provider services:</b> There <i>may</i> be a fundamental mismatch between the nature of health information available and what the provider can even do. When it comes to, say, chiropractic, is there an appropriateness or privacy concern about providing meds/allergy information? It's a complex technical question to imagine leaving this info out per provider type (akin to the segmentation challenges discussed on the recent thread titled "Patient Consent", so perhaps we decide to put it out of scope in favor of time constraints on usage, notifications of what's missing, usage constraints, etc.), but I'm listing this for discussion completeness.</li></ul><div>Finally, I'm assuming that for interoperability and attractiveness of standardization, we'd want to say that (barring the above concerns if solved) if a data item is <i>available</i> in the record, and Alice chooses to share it as part of the "virtual clipboard" resource set context, then it <i>must</i> be included. In technical terms, this would equate to the resource server supporting an API call that extracts out a bunch of potentially disparate data fields and provides them, because it supports the use case (i.e., provides a lot of value). We could separately think about whether extensibility is okay or not in the context of HEART.</div></div></div><div class="gmail_extra"><br clear="all"><div><div class="gmail_signature" data-smartmail="gmail_signature"><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr"><div><div dir="ltr">
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<br><div class="gmail_quote">On Tue, Jul 19, 2016 at 4:51 AM, Debbie Bucci <span dir="ltr"><<a href="mailto:debbucci@gmail.com" target="_blank">debbucci@gmail.com</a>></span> wrote:<br><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex"><p dir="ltr"> Now that we agree the RPT is essentially an suthorization to release ... changing thread to focus on resource set. <br></p>
<p dir="ltr">>>Can you elaborate a little on what you're thinking in terms of defining a resource set? I imagine that the "clipboard" resource set would vary quite a bit based on the provider and their specialty. Are you suggesting that we attempt to define a universal set of fields that everyone would need as a baseline?</p>
<p dir="ltr">Really need someone that knows FHIR in great detail to weigh in but ....</p>
<p dir="ltr"> it seems to me that there are general classes to authorize (meds allergies etc) that could generally be placed in the resource set to allow specific implementations to gather the info needed within those classes throttled by the classification code. </p>
<p dir="ltr">I was going to look at a few examples but as I recall - with exceptions to specialty specific questions much of the paper form are the exact same questions from provider to provider</p>
<p dir="ltr"> >>Or are you thinking that we should just acknowledge the existence of something called a clipboard resource set, and let implementors decide for themselves what that means?</p>
<p dir="ltr">Believe there needs to be some consistency but ack need for extensions <br>
</p>
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