Stream: Advance Directives
Topic: Connectathon 27
Corey Spears (Mar 20 2021 at 18:53):
Connectathon 27 Advance Directive Interoperability stream
@Lorraine Wickiser @Lisa Nelson @Dave Hill @Matt Elrod @Jan Oldenburg @Jessica Skopac @Maria D Moen @Tina Wilkins
Cecilia Wong (Mar 20 2021 at 21:18):
Has there been any more discussion regarding AD other than DNR? I'm seeking for suggestion of which resource is best used for AD other than DNR which we are going to use Flag.
Maria D Moen (Mar 22 2021 at 13:34):
We have three types of content we are building the FHIR resources to handle: advance directives/personal advance care plans are type 1, episodic patient instructions are type 2, and portable medical orders for life-sustaining treatment are content type 3. DNR falls into content type 3, and we are examining all of the derivatives of this content type as part of our work. COntent type 1 is our first release, closely followed by contents types 2 and 3. Did that help?
Cecilia Wong (Mar 22 2021 at 19:14):
Maria, thanks for your response.
Are these content intended as part of R5?
Corey Spears (Mar 23 2021 at 04:23):
Our current work is an Implementation Guide built on R4.
Corey Spears (Mar 23 2021 at 15:13):
The current proposed Connectathon 27 track can be found here: https://confluence.hl7.org/display/FHIR/2021-05+PACIO+Advance+Directive+Interoperability
Corey Spears (May 17 2021 at 18:17):
Hi All, The FHIR server addresses seemed to have been loaded into the Connectathon Manager. You can visit the Server page and search for PACIO to find the right one.
http://conman.clinfhir.com/connectathon.html?event=con27
Corey Spears (May 17 2021 at 18:18):
The ADVault Open FHIR R4 Endpoint is https://qa-rr-fhir2.maxmddirect.com
The patient FHIR ID is 3e0a479f-375c-46ba-857b-9ed4cca7db9f
Nancy Lush (May 17 2021 at 18:45):
While the IG works on the MiHin server, it is not working on the Advault server for patient id = 3e0a479f-375c-46ba-857b-9ed4cca7db9f.
We are still diagnosing the cause, but it does not include any observations or goals. We are also expecting a bundle, could that be missing in the Advault FHIR server?
Nancy Lush (May 17 2021 at 18:48):
Is there any difference between the two Mihin patient ids? 14603 and 14630
Nancy Lush (May 17 2021 at 19:00):
More feedback for Advault: o A bundle is returned, but observations and goals are not included. The bundle includes the Composition resource itself, Patient, Organization (custodian), and Device. No observations or goals. RelatedPerson resources are also missing from the bundle.
Corey Spears (May 18 2021 at 04:48):
MITRE ADI Server is up and should be available to white listed IP addresses. The sample data for Betsy Smith-Johnson is available for testing.
Patient FHIR ID: 153 (http://34.226.8.102/mitre-iqies-api/fhir/Patient/153)
Composition FHIR ID: 152 (http://34.226.8.102/mitre-iqies-api/fhir/Composition/152/$document)
Corey Spears (May 18 2021 at 05:53):
The MITRE Client Reference Implementation can be found here: https://snf-pseudo-ehr.herokuapp.com/
Make sure you click on the "Advance Directives Compositions" menu item at the top after connecting to a server.
I am currently working to see if I can get it connected to the MITRE RI Server.
Vladimir Prihodko (May 18 2021 at 15:09):
Corey Spears said:
MITRE ADI Server is up and should be available to white listed IP addresses. The sample data for Betsy Smith-Johnson is available for testing.
Patient FHIR ID: 153 (http://34.226.8.102/mitre-iqies-api/fhir/Patient/153)
Composition FHIR ID: 152 (http://34.226.8.102/mitre-iqies-api/fhir/Composition/152/$document)
Are URLs correct? On my side, the server is not responding to both requests (Patient 153 and Composition 152)
Vladimir Prihodko (May 18 2021 at 15:15):
Also, the browser blocks requests:
image.png
Is the https endpoint available?
Forrest White (May 18 2021 at 15:37):
Vlad, I just tried this URL in Postman and received success 200 status: http://34.226.8.102/mitre-iqies-api/fhir/Composition/152
Matt Elrod (May 18 2021 at 16:08):
ADVault patient ID: Patient/3e0a479f-375c-46ba-857b-9ed4cca7db9f
Vladimir Prihodko (May 18 2021 at 16:21):
Matt Elrod said:
ADVault patient ID: Patient/3e0a479f-375c-46ba-857b-9ed4cca7db9f
Goals and Observations are not included in bundle.
Vladimir Prihodko (May 18 2021 at 16:23):
Matt Elrod said:
ADVault patient ID: Patient/3e0a479f-375c-46ba-857b-9ed4cca7db9f
Also, compositions have nested sections. The section nesting is not expectable per IG.
Nancy Lush (May 18 2021 at 17:45):
This is the source of the problem reading the IG data from the advault server: The profile is missing for all resources.
Vladimir Prihodko (May 18 2021 at 17:47):
https://qa-rr-fhir2.maxmddirect.com/Composition/9710734f-e383-40b4-aa08-f473c02cca5c/$document - profile is missing for all resources
Matt Elrod (May 18 2021 at 18:25):
Profile is not required but has been added to resources
Matt Elrod (May 18 2021 at 18:27):
Vladimir Prihodko said:
Matt Elrod said:
ADVault patient ID: Patient/3e0a479f-375c-46ba-857b-9ed4cca7db9f
Also, compositions have nested sections. The section nesting is not expectable per IG.
The issue with nested sections has been corrected in ADVault and is per IG
Vladimir Prihodko (May 18 2021 at 18:41):
https://api.interop.community/PacioSandbox/open/Composition/14602/$document - the custodian is missing
https://api.interop.community/PacioSandbox/open/Composition/14705/$document - the custodian included, but the profile is missing, so our app is not displaying any ADI
Corey Spears (May 18 2021 at 19:42):
We will likely neeed to add some more guidance on the $document operation. Base FHIR standard definition is here:https://www.hl7.org/fhir/composition-operation-document.html
Forrest White (May 18 2021 at 20:27):
FYI - The Altarum PACIO AD FHIR Server: https://fhirconnect.altarum.org/hapi-fhir-jpaserver-AD-SMART/fhir/ data was updated at about 3:50pm EST.
Vladimir Prihodko (May 19 2021 at 16:37):
There is an issue with the MOLST observation in the current Advault data (https://qa-rr-fhir2.maxmddirect.com/Composition/31291b24-d699-417f-8f0e-4a2260f03ca6/$document): it has a profile of Autopsy.
Matt Elrod (May 19 2021 at 17:51):
Vladimir Prihodko said:
There is an issue with the MOLST observation in the current Advault data (https://qa-rr-fhir2.maxmddirect.com/Composition/31291b24-d699-417f-8f0e-4a2260f03ca6/$document): it has a profile of Autopsy.
Thank you for the feedback. The identified issue is resolved. Please let us know if you are having any other issues. Also their have been a few updates to the resources, the most recent composition id= d3d562d0-3328-4a31-a95a-2b71cc84e7d8
Last updated: Apr 12 2022 at 19:14 UTC
