FHIR Chat · Connectathon26 - Patient Request for Corrections

Stream: patient empowerment

Topic: Connectathon26 - Patient Request for Corrections

Virginia Lorenzi (Dec 15 2020 at 00:17):

New topic for use for the January 2021 Connectathon26.

Virginia Lorenzi (Dec 15 2020 at 06:12):

Learn more about the Patient Request for Corrections Track at Our Orientation this Thursday Dec 17th at 1Pm Eastern: https://confluence.hl7.org/display/PE/Patient+Request+for+Corrections+Connectathon+Orientation+Information

Sign Up for the Track Here:
https://confluence.hl7.org/display/PE/Connectathon+26+Patient+Request+for+Corrections+Participation+Sign-Up

Additional Details on Track: https://confluence.hl7.org/display/FHIR/2021-01+Patient+Empowerment%3A+Patient+Request+for+Corrections+to+their+Record

Review the IG: http://build.fhir.org/ig/HL7/fhir-patient-correction/index.html

We appreciate your insight and collaboration on this initiative.

Virginia Lorenzi (Dec 18 2020 at 08:32):

Recording and slides for Orientation now available: https://confluence.hl7.org/pages/resumedraft.action?draftId=97471515&draftShareId=a9085ca5-3c4c-4917-9823-bb2f8c8b8f00&

Virginia Lorenzi (Jan 05 2021 at 06:41):

We updated our schedule!

Tentative Schedule:

Pre-connectathon Spec Preparation Meetings:

Thursday December 3 @ 1 PM ET
Monday December 7 @ 3 ET
Tuesday December 8 @ 2 ET
Thursday December 10 @ 1 ET

Thursday December 17 @ 1ET (Track Orientation)
Orientation Recording Download Orientation PDF

Other pre-connectathon meetings - TBD

These dates and times are subject to change over the next few weeks but will be finalized before/at the connectathon.

Track Kickoff: Wednesday, January 13th, 3 PM Pacific Time (6 PM US ET)

Track Work: Thursday, January 14th, 8 AM -7 PM Pacific and Friday January 15th, 8AM - 4 PM Pacific

Status Check In Thursday: January 14 8AM Pacific (11 AM US ET) and 1 PM Pacific (4 PM Eastern) and 5 PM Pacific (8 PM Eastern)

Expert Guest Panel Thursday: January 14th, 2PM Pacific (5 PM Eastern)

Status Check In Friday: January 15 8AM Pacific (11 AM US ET) and 1 PM Pacific (4 PM Eastern)

Report Out Friday: Friday, January 15th, 3:00 PM Pacific (6 PM US ET)

Full track description here: https://confluence.hl7.org/display/FHIR/2021-01+Patient+Empowerment%3A+Patient+Request+for+Corrections+to+their+Record#id-202101PatientEmpowerment:PatientRequestforCorrectionstotheirRecord-Expectedparticipants

Dave deBronkart (Jan 13 2021 at 23:56):

Updating this to remove the past events and make this current:

Virginia Lorenzi said:

Track Work: Thursday, January 14th, 8 AM -7 PM Pacific and Friday January 15th, 8AM - 4 PM Pacific

Status Check In Thursday: January 14 8AM Pacific (11 AM US ET) and 1 PM Pacific (4 PM Eastern) and 5 PM Pacific (8 PM Eastern)

Expert Guest Panel Thursday: January 14th, 2PM Pacific (5 PM Eastern)

Status Check In Friday: January 15 8AM Pacific (11 AM US ET) and 1 PM Pacific (4 PM Eastern)

Report Out Friday: Friday, January 15th, 3:00 PM Pacific (6 PM US ET)

Full track description here: https://confluence.hl7.org/display/FHIR/2021-01+Patient+Empowerment%3A+Patient+Request+for+Corrections+to+their+Record#id-202101PatientEmpowerment:PatientRequestforCorrectionstotheirRecord-Expectedparticipants

Dave deBronkart (Jan 14 2021 at 00:03):

Here it is from the track kickoff :-)
image.png

Virginia Lorenzi (Jan 14 2021 at 01:20):

In case you missed our kickoff - here is the slide deck. It includes current state of clients and servers and tools: https://confluence.hl7.org/pages/worddav/preview.action?fileName=PatientCorrectionsConnectathon26Kickoff.pdf&pageId=97456948

Hitesh Jain (Jan 14 2021 at 01:39):

@Virginia Lorenzi - could you please send me a test patient (set up on HAPI test server)?
I'm building a test client reusing HAPI's test client code and can hit their server

Virginia Lorenzi (Jan 14 2021 at 08:19):

When you make a request to correct a record you need to reference a patient whose record is incorrect. Test Patient assignments and server URLs here: https://docs.google.com/spreadsheets/d/1Wai2wbkzZut1zg9Iz7O7f3KN0Rstc_81qUUHJDBIIEk/edit?usp=sharing
Let me know if you have trouble accessing or want more test patients for your organization. Also if you are not on the sheet and want a test patient let me or @Debi Willis know. All test patients are on the HAPI server.

Virginia Lorenzi (Jan 14 2021 at 08:20):

If you have an open server and it has support for CORS and transactions, I can load the same set of test patients there. Might also be able to do that if oauth is required with @David Hay help @Jeff Danford

Virginia Lorenzi (Jan 14 2021 at 17:00):

@John Moehrke noted that when a request is completed task.output should contain the amended document correspondence to the patient.

Virginia Lorenzi (Jan 14 2021 at 17:24):

@Debi Willis asked how the back and forth correspondence would work if provider needed more information from patient. We discussed and it seemed Task.businessStatus would be changed to denote that the Task is in the Needs more information state. Then we were trying to figure out how the provider would specify what was needed and how the patient app would supply it. It seems that we would need to use Task.output on provider side and Task.input on patient side. Would need codes for these. @Debi Willis can you put in a Propose for Change on the spec?

Virginia Lorenzi (Jan 14 2021 at 18:35):

@pam fleury @Hitesh Jain Hey there - I wanted to make sure you saw we assigned you test patients in the google sheets document: https://docs.google.com/spreadsheets/d/1Wai2wbkzZut1zg9Iz7O7f3KN0Rstc_81qUUHJDBIIEk/edit#gid=0

Hitesh Jain (Jan 14 2021 at 19:06):

@Virginia Lorenzi - ack

Virginia Lorenzi (Jan 14 2021 at 19:44):

@Natasha Kreisle @Cheng Liu I updated Sofia's correction request and based on our discussion with @Lisa Nelson rejected it.

Lisa Nelson (Jan 14 2021 at 19:52):

@Virginia Lorenzi I can see that task status was updated to rejected and we see your output type is "Denial Explanation", but this should be a codeableConcept according to the IG.

This does not seem to comply with what the IG says:
<output>
<type>
<text value="Denial Explanation"/>
</type>
<valueMarkdown value="We offer congratulations that you have quit smoking. We have not seen you at the clinic since January 5th, 2020 and we have no records stored on you after that time. According to our records, you were a smoker at that time so our records are correct. Please make sure to tell you doctor when you come in for a check up that you no longer smoke."/>
</output>
<output>
<type>
<text value="Explanation of Right to Disagree"/>
</type>
<valueMarkdown value="You have a right to provide a written disagreement to this Denial Decision. If you choose to provide a disagreement, it will be attached to your medical record."/>
</output>

pam fleury (Jan 14 2021 at 19:56):

Virginia Lorenzi said:

pam fleury Hitesh Jain Hey there - I wanted to make sure you saw we assigned you test patients in the google sheets document: https://docs.google.com/spreadsheets/d/1Wai2wbkzZut1zg9Iz7O7f3KN0Rstc_81qUUHJDBIIEk/edit#gid=0

thanks

Debi Willis (Jan 14 2021 at 19:58):

Thank you Lisa. @Virginia Lorenzi is taking a quick break and will get back to you soon.

Virginia Lorenzi (Jan 14 2021 at 22:03):

Expert Panel has now started. @Isaac Vetter @Josh Mandel @Micky Tripathi @Drew Torres @Lloyd McKenzie @Drew Torres @Jenni Syed @Vassil Peytchev @Cooper Thompson

Dave deBronkart (Jan 14 2021 at 22:22):

"Live blog" sorta:

#1 concern raised so far is the increased VOLUME of reported errors that provider orgs will be flooded with.

Natasha Kreisle (Jan 14 2021 at 22:27):

@Virginia Lorenzi Here's four tasks for your consideration of correction. Thanks! Task/1736634 Task/1736638 Task/1736643 Task/1736648

Virginia Lorenzi (Jan 15 2021 at 00:35):

@Natasha Kreisle which patient(s)? never mind found them

Virginia Lorenzi (Jan 15 2021 at 01:18):

@Natasha Kreisle @Lisa Nelson In discussions with HIM as well as our discussions at the kickoff, it would be more realistic at the point the correction is complete to send a document with the patient's request and proof that the data was amended - could you mock up one of those as a DocumentReference?

Virginia Lorenzi (Jan 15 2021 at 01:20):

@Natasha Kreisle @Lisa Nelson @Debi Willis We envisioned that Task.description would contain a description of what the patient wanted corrected with the input fields not necessarily being needed. However in your examples, the server can only understand what is needed by processing the DocumentReference in input. Just pointing that out.

Dave deBronkart (Jan 15 2021 at 01:31):

Hey all - if you were in today's amazing Expert Panel, you heard repeatedly from the different experts that it's NOT "corrections" we're correcting, precisely - patients can request AMENDMENTS to the record. Should we rename this project "Patient Requests for Amendments"?

Example: in 2003 a chest x-ray report identified me as a woman. I was appalled when they said they're not allowed to CORRECT THE MISTAKE so it said "53-year-old man." What I didn't fully understand until today is that EMR entries are legal business records (with all kinds of legal implications), and just as in accounting, you can't just go back and change something - you have to keep the original and note that you changed it. The attached screen capture is what they did with me.

So: should we rename the project?

A downside is that "corrections" is far more blunt about the important reality of ERRORS in the chart. And nobody who reads today's project name will get the wrong impression.

Debi Willis (Jan 15 2021 at 01:43):

Dave deBronkart said:

So: should we rename the project?

A downside is that "corrections" is far more blunt about the important reality of ERRORS in the chart. And nobody who reads today's project name will get the wrong impression.

I agree...there is no mistake of what we are doing when they read the project name. I think communicating the idea with the word "correction" is more important than stepping in line with the way the clinics handle it (amend verses correction). The name of the project is "Patient request for corrections" (though we did sometimes take a short cut and just say "patient corrections"). The patient really is asking for a correction. If the clinic handles it as an amendment, then that is OK. We are focusing on "the ask". I doubt patients will be requesting "an amendment". They will likely point out something that is wrong and ask them to correct it. I vote to leave the name as it is.

Virginia Lorenzi (Jan 15 2021 at 04:47):

Please log all your ideas - comments, questions, changes to JIRA: https://jira.hl7.org/projects/FHIR/issues/FHIR-29376?filter=allopenissues
1) Create an Issue by selecting CREATE button
2) Set Project to FHIR Specification Feedback
3) Set Specification to Patient Corrections (FHIR)
3) Set Issue Type to either Change Request, Question, or Comment - your choice.

image.png

Lloyd McKenzie (Jan 15 2021 at 05:51):

Note: You can name the guide "Patient corrections" and still explain in the intro to the IG that the corrections will be processed as 'amendments' (and why).

Virginia Lorenzi (Jan 15 2021 at 07:12):

Yes - we do that.

Virginia Lorenzi (Jan 15 2021 at 07:37):

In Europe its not corrections either - its rectifications. I like that corrections is like generic brand.

Virginia Lorenzi (Jan 15 2021 at 08:17):

@Natasha Kreisle @Lisa Nelson I updated alot of your tasks, simulating a provider - 1736638, 1736643, 1736648, and 1735868

Virginia Lorenzi (Jan 15 2021 at 18:30):

Sample letter of denials to patients: https://www.lsuhsc.edu/administration/cm/cm-53/AttachmentE-SampleLetter.pdf
https://www.downstate.edu/physicians/documents/U.Patient.Amendment.Notice.of.Denial.Letter.Form.pdf

Virginia Lorenzi (Jan 15 2021 at 18:37):

This has examples of both the amendment accepted letter and the denial letter: https://hipaacow.org/wp-content/uploads/2013/03/Lettersforamendmentofhealthinformation2-1-13.doc

Virginia Lorenzi (Jan 24 2021 at 07:48):

Reminder @Debi Willis @Dave deBronkart @Natasha Kreisle @Lisa Nelson @Abigail Watson @Matt Blackmon @Timon Grob @Erik Schaefer @John Moehrke @Jeffrey Danford @Maria D Moen @Ron Jawanda Thank you for attending the Patient Empowerment - Patient Request for Corrections Connectathon Track. PLEASE PROVIDE YOUR FEEDBACK:

Virginia Lorenzi: Please log all your ideas - comments, questions, changes to JIRA: https://jira.hl7.org/projects/FHIR/issues/FHIR-29376?filter=allopenissues
1) Create an Issue by selecting CREATE button
2) Set Project to FHIR Specification Feedback
3) Set Specification to Patient Corrections (FHIR)
3) Set Issue Type to either Change Request, Question, or Comment - your choice.