2020-05-27 Meeting notes

Owned by Andrew Sills
Last updated: May 27, 2020
2 min read

Date

May 27, 2020

Participants

  • @Andrew Sills

  • @Keith Campbell

  • @Robert Lario

  • Linda Wedemeyer

  • @Penni Hernandez

Goals

  • 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

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

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)
Review and identify ANF representation for In-Person Pre-Arrival DMN table @Keith Campbell@Penni Hernandez@Andrew Sills
Linda to gain/register for access to confluence page

Decisions

  1. 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)
  2. 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)
  3. 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)
  4. DMN pattern that provides closure in scenarios where no rule would be fired via a “default” fired rule