HL7AU - FHIR WG : Meeting SM TWG 2018-06-14

Created by Brett Esler, last modified on 14 Jun, 2018

14 Jun 2018

Agenda

HealthcareService roles
Other Business

Minutes

Reuben: scope of the HealthcareService.specialty is only health care with the subset http://build.fhir.org/ig/hl7au/au-fhir-base/ValueSet-snomed-healthcareservice-role.html will need other types of server
- manage through NCTS for additions
- could use refsets - implicit valuesets; maybe in the future
- other service types are needed
Reuben: how will we govern the content of the valueset - good question.
Propose we use SNOMED-CT AU have a valueset for specialties including concept is-a 224891009 (Healthcare services) for HealthcareService.specialty : agreed
Jared: perhaps a separate field for (Healthcare professional) specialties provided by HealthcareService 0..*
Jaco: look at HealthcareService.type bindings HI-taxonomy + ANZIC as a AU base concern
CI build is coming back shortly
Proposal: constrain all Address.state use in PD profile to be bound to abbreviation code from a defined ValueSet nominally https://healthterminologies.gov.au/fhir/ValueSet/australian-states-territories-2 (excluding OTHER) - so all search and result content will use the state code values : group agrees
State codes are not entirely sufficient : Brett to follow up on content

Action items

- Brett: following up on IG build issues
- Brett: updates re Address states as above
- Brett + Jaco: reasons for NCTS processing SNOMED Healthcare Service type terminology
- Brett: set up up a public servers page for reference

Attachments:

image2018-6-10_9-23-9.png (image/png)

Comments:

Hi Brett, TWG Members,

I may only be able to join half-way through the meeting this morning - so posting my comments to support the discussion.
- should we be changing these terminologies in AU-PD profiles, we should just be cognisant of the AU-BASE CodeSystems earmarked for implementation at this time - it would be very beneficial to keep these in sync as much as possible.
- where AU-BASE designates ANZSIC for HealthcareService.type

as per point [1.c.ii] HCS.specialty
- the HI-Service taxonomy is not really the taxonomy to use for specialties (it is designated for Service Types & Categories)

When you look closer to http://hl7.org/fhir/stu3/codesystem-service-type.html (as per noted HealthcareService.type / HealthcareService.category)
- this CodeSystem is aligned to HI-Service, with extensions added to cover key non-health service types (this CodeSystem was obtained from the NHSD, it has been aligned to HI-Service over the past years)
The benefit with using this HI-Service based CodeSystem for the HealthcareService.type, it has the necessary granularity to classify the HealthcareService.type to support a detailed/accurate search result (noting the SNOMED gaps to classify Service Types at this time)

HCS.specialty is defined under http://hl7.org/fhir/valueset-c80-practice-codes.html as a larger group term for the type of "Practitioner-Provider Services/Specialties" offered at the service.
- it does not define the HealthcareService Type or HealthcareService Category - and I am confident that it should not be the service type.

Recommendations:
Worthy Note: SNOMED will require a some effort to cover the majority of Service Types (best approach, but will require time to finalise)
- HealthcareService.category:
-- recommend to use http://hl7.org/fhir/stu3/codesystem-service-category.html
-- improvement to me made to the codesystem for Australian use - (AU-BASE), instead of using the FHIR international codes (1,2,3,4) - the concepts should be presented by the ANZSIC and where extended the HI-Service Codes
--- General Practice (eg. 17 to be and 8511 - thus ANZSIC and HI-codes aligned)
* the above allows reasonable compatibility between existing needs in the industry/health sector and what is provided by existing Australian codeSystems/taxonomies

- HealthcareService.type:
-- recommend to use http://hl7.org/fhir/stu3/codesystem-service-type.html
-- improvement to me made to the codesystem for Australian use - (AU-BASE), instead of using the FHIR international codes (1,2,3,4) - the concepts should be presented by the ANZSIC and where extended the HI-Service Codes
--- General Practice (eg. 124 to be 8511 - thus ANZSIC and HI-codes aligned)
--- Neurosurgery (eg. 216 to be 8512-16.2 - thus ANZSIC and HI-codes aligned)
-- HealthcareService.type is a MUST implement and MUST support for AU-BASE and AU-PD
* the above allows reasonable compatibility between existing needs in the industry/health sector and what is provided by existing Australian codeSystems/taxonomies

In reference to the above (category & type)
http://hl7.org/fhir/stu3/codesystem-service-type.html had concepts added over the years (eg. NDIA) which do not have representative codes in both ANZSIC/HI-Service - these could be prefixed with "X" to denote the extension which is not aligned to the base CocdeSystems/Taxonomies.
- The NHSD is able to provide valuable insights into this as we have done most of the ground-work already.
- Parallel conversations should still be had with NCTS/ADHA to ensure these Service Types are made available in SNOMED for future use, however is not critical to the immediate FHIR implementation.

- HealthcareService.specialty:
-- as per recommendation and FHIR INT: use the CodeSystem http://hl7.org/fhir/valueset-c80-practice-codes.html
-- however, HCS.specialty should not be a core attribute to make use of when finding services, I see this more as an optional. HealthcareService.type is the KEY search parameter.

Posted by jaco.olivier at 14 Jun, 2018 10:55