List goals for this meeting (e.g., Set design priorities for FY19):
Review BPMN and DMN progress
Review CMN progress
Further ANF discussion, if possible
HPP/Sharable Clinical Pathways
Review confluence, GitHub, and shared work products
Discussion topics
Item
Presenter
Notes
Introductions
Keith et al
Penni is new to the team and everyone is providing introductions
BPMN Walkthrough
Linda
Overview of current version of In-Person Pre-Arrival BPMN
Need guidelines for Emergency/Escalation workflow
Potential rewording for Assess Patient Testing per VHA COVID-19 Guidelines
If assessed but chosen not to be tested - would there be a process or external protocol provided to patient (e.g., self-quarantine)?
Some items to consider are test availability, testing duration/wait-time, etc.
Stability should be a priority within the model, try and represent items such as self-quarantine via BPMN
Using Patterns for DMN (found in BPM+ Field Guide (Appendix))
Suggestion of returning a collection of antecedents that were found to be true, rather than simple true/false values
Specifically a list of COVID-19 symptoms found to be true (promoting richness in terms of DMN evaluation output)
Use case driven - how do represent general statements/queries to be used by DMN (engine); limitations
Pattern of asking specific interrogatives (pair of observation and values) as input to DMN backed BMPN task/activity
Observations need to be backed by great specificity via clinical concept codes
Inconsistency with terminological content can be confusing with the use finding (e.g., fever)
Pattern around setting default within DMN rules to have closure (e.g., avoiding scenario of no rule firing at all)
Next Meeting
Keith
2 pm ET / 11 am PT is suggested and works for group
Quick discussion on Terminology representation for clinical statements (models)
Keith
Via Solor Komet, reviewing inconsistencies from a statement clinical model perspective, regarding using data elements regarding Fever (in all its taxonomy representations)
Fever vs Fells hot/feverish is an example of error of omission
Need to create a Solor extension that harmonizes inconsistencies together which can more reliably retrieved in clinical statement models
SNOMED CT and LOINC fever (appropriate) concepts should be harmonized into a Solor extension(s)
There are representations temperature measuring procedures (overlap with LOINC) of SNOMED CT
Action items
Add action items to close the loop on open questions or discussion topics:
Schedule next meeting for 5/28 11am PT / 2pm ET Andrew Sills
New work will be conducted on Virtual Care clinical COVID-19 workflow Robert Lario (Linda)
Linda to gain/register for access to confluence page
Decisions
Type /decision to record the decisions you make in this meeting:
e4882761-cd83-42d0-8636-c8301f2876cec22d8240-be18-4d65-82cf-0ab05d813993DECIDEDIf patient is assessed and determined that no COVID-19 testing will be conducted there needs to be BPMN processes developed to hand appropriate protocols/guidance (e.g., self-quarantine) 28fe5f44-083b-4f33-964d-a5112cbc3914DECIDEDTerminological binding of clinical concepts/codes will be more specific than any limitations present within the terminology standards themselves (e.g., inconsistencies with “finding” in SNOMED CT)ca0e46d0-27d1-473d-aca4-cb8cdadf902cDECIDEDDMN pattern that generates a specific list (as a return value) of COVID-19 symptoms found to be true (promoting richness in terms of DMN evaluation output)eef79e81-724d-4345-98a2-328469721852DECIDEDDMN pattern that provides closure in scenarios where no rule would be fired via a “default” fired rule
If patient is assessed and determined that no COVID-19 testing will be conducted there needs to be BPMN processes developed to hand appropriate protocols/guidance (e.g., self-quarantine)
Terminological binding of clinical concepts/codes will be more specific than any limitations present within the terminology standards themselves (e.g., inconsistencies with “finding” in SNOMED CT)
DMN pattern that generates a specific list (as a return value) of COVID-19 symptoms found to be true (promoting richness in terms of DMN evaluation output)
DMN pattern that provides closure in scenarios where no rule would be fired via a “default” fired rule