Can Martin Gardner’s work to represent episodes as XML documents be incorporated into a wider piece of work to define a framework for intra-operative care. FHIR resources can be represented as XML docs so how can his work be aligned with the much more general FHIR profiles. Answer seems to be = not easily 😞
Session 1 : Modelling and the output of the HL7-FHIR Anesthesia Working Group
Suggestions for projects/activities for the weekend.
Notes from the Meeting
GF gave an overview of the purpose of the group which is to bring together like-minded clinicians involved in PoM and contribute to the modelling work of the HL7 Anesthesia group, but more widely to help define and refine the resources/archetypes that may be used to build a framework for peri-operative care.
General discussion around the current state of the nation in terms of UK sites using systems that incorporate elements of OpenEHR/FHIR. IM mentioned Ade Byrne in Southampton.
Presentation from MH on DAM for Anesthetic Record(slides to follow)
AD highlighted the paradigm of Access-Author(record)-Process-Interpret in relation to Observations and how this can be handled in the model.
Discussion of how to represent the anaesthesia record - MH suggested CDA is an appropriate format to consider. AD asked about how it fits with PRSB document naming standard.
MH demonstrated some of the activity diagrams from the model and there was discussion about maximal vs mandatory recording of e.g. configuration of lumens in a central line. It was agreed that we should be able to define a device e.g. a needle in as much detail as possible but in implementation, it could be reduced to a very basic set of properties.
In looking at examples of positioning, there was some discussion about the relative merits of recording SNOMED concept IDs(SCIDs) vs the convention of SCID | Description against the enumerations of e.g. arm position. A further question is around licensing. Large-scale publication of SNOMED termsets is prohibited under licensing arrangements. It was suggested that we stick to a few examples.
Next steps - produce a short, human-consumable summary of the model for the RCoA(e.g. 10-slide presentation), highlighting it’s submission to the HL7-FHIR community in May 2019.
Jamie Strachan suggested as first recipient. GF to coordinate with AN for dual submission to AAGBI and group that led the project to define a national anaesthesia record for the UK.
(? Richard Griffiths).
Presentation on SNOMED-CT(AN)
(slides to follow)
AD to send slides on SNOMED-CT training.
Deterioration following surgery - how observations are captured. Discussion around relevant SNOMED concepts.
IM demonstration of RESET - archetype for recording clinical observations around fluid balance.