© 2015 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. FHIR Workflow Overview / status / decisions

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Process 2 conference calls/week since November, 2015 Generally people per call Worked through a document listing “Workflow Issues” Lately have been spending lots of time testing the specification against use-cases 2

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. DECISIONS / RECOMMENDATIONS For endorsement/approval at this meeting (where consensus) 3

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Plan for Q3 Run through the slide deck once  Will not pause for questions Most of the answers will be on subsequent slides Context will help in crafting responses Run through the slides again  Will pause for questions/discussion (but time-box) Will vote to endorse what we can where there’s consensus Will decide what issues to work in in Q4 4

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Request resources E.g. DiagnosticOrder, ProcedureRequest, CarePlan Represent an authorization/plan/intent Do not represent a fulfillment request Can be a many-to-may relationship between a request resource and fulfillment requests To request fulfillment can:  Post resource with a tag  Use an Operation or Message  Use Task 5

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Request pattern NameFlagsCard.TypeW5Description & Constraints identifierS0..*Identifierid Business identifier for request/order basedOnS0..*Reference() Request fulfilled by this request requisitionS0..1Identifier Composite request this is part of status!S1..1codestatus draft | active |suspended | category!S1..1CodeableConcept class proposal | plan | orig. order | encoded + codeS0..1 CodeableConcept whatWhat’s being requested/ordered subjectS 1..1 Reference(Patient | Group? | ??) who.focusIndividual the service is ordered for contextS0..1Reference(Encounter | EpisodeOfCare) contextEncounter or Episode during which request was created 6

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Request pattern cont’d occurrence[x]S0..1 dateTime| Period| Schedule? when.plannedWhen service should occur authoredS0..1dateTimewhen.recorded When the request transitioned to being actionable requesterS0..1 Reference(Device | Patient | Practitioner | RelatedPerson | Organization?) who.author Who/what is requesting service performerType S0..1CodeableConceptwho.performer Desired type of performer for service performer S0..1 Reference(Practitioner | Organization | Patient | Device | RelatedPerson) who.performerDesired performer for service reason[x]S0..1 CodeableConcept | Reference(??) whyWhy is service necessary? supportingInfo 0..*Reference(Any) Additional information to be used in fulfilling request note 0..*Annotation Comments made about the service request 7

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Key relationships 8

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Statuses Request statuses entered-in-error draft active suspended stopped completed cancelled Task statuses entered-in-error draft requested received accepted rejected ready in-progress on-hold failed completed 9

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Response resource pattern 10 Name Flag s Card.TypeW5Description & Constraints identifierS0..*IdentifieridBusiness identifier for event record basedOnS0..*Reference() Request fulfilled by this event ParentS0..*Reference() Part of this occurrence status!S1..1codestatus draft | active |suspended | completed codeS0..1 CodeableConcept whatWhat was done subjectS 1..1 Reference(Patient | Group? | ??) who.focusIndividual the service is done for contextS0..1 Reference(Encounter | EpisodeOfCare) context Encounter or Episode during which event occurred occurrence[x]S0..1 dateTime| Period| Schedule? when.occurredWhen service occurred occur performer S0..1 Reference(Practitioner | Organization | Patient | Device | RelatedPerson) who.performerPerformer of service reason[x]S0..1 CodeableConcept | Reference(??) whyWhy is service necessary? note 0..*Annotation Comments made about the service request

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Task Order & OrderResponse will be removed  Superseded by Task Task will support:  Please fulfill  Please deal with this change of state  Please make some change in the future 11

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Task 12

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Definition resources Will try to combine notions of Protocol and OrderSet  Latter may be a profile on the former Request resources will not be used as part of Protocol  Will have a separate DefinedActivity resource that supports definition of all clinical activity 13

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Additional comments Standardize ‘request’ resource names  NutritionOrder->NutritionRequest  MedicationOrder->MedicationRequest  DiagnosticOrder->DiagnosticRequest Composition for “events”, but not requests  Use “basedOn” or “requisition” 14

© 2016 HL7 ® International. Licensed under Creative Commons. HL7 & Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Outstanding work Discuss how Task is used with compensating actions (e.g. transaction reversal) If/how does Task get used for Messaging & Operations Overlap of SupplyRequest, DeviceUseRequest, VisionPrescription Mappings from Task states & properties to WS- HumanTask “Best practice” IGs on how to implement workflow in different business patterns 15