Care Plan (CP) Meeting 90 minutes
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Transcript of Care Plan (CP) Meeting 90 minutes
Care Plan (CP) Meeting 90 minutes
André Boudreau ([email protected])
Laura Heermann Langford ([email protected])
Stephen Chu ([email protected])
2012-02-29 André to lead*Care Plan wiki: http://wiki.hl7.org/index.php?title=Care_Plan_Initiative_project_2011
HL7 Patient Care Work Group
To join the meeting:
Phone Number: +1 770-657-9270Participant Passcode: 943377# WebEx link (thanks to Canada Health Infoway): https://infoway-inforoute.webex.com/infoway-inforoute/j.php?ED=168011982&UID=494535562&RT=NCMxMQ%3D%3D
With meeting notes
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Agenda- Feb 29th (Lead: André)
• Agree on approach for modeling (Luigi)• Pediatric Allergy SB (20120201-RS on wiki) (Susan)
Review coordination of care section- Postponed• Stay Healthy SB - (final version 20120214 plus Appendix B on wiki)
(Carolyn)• Pediatric immunization (Susan)- next meeting• Perinatology SB - (complete version to be provided by Laura) (Laura) • Home Care SB - (2011-02-28 final version on wiki) (André) • Acute Care SB - (complete version to be provided by Kevin) (Kevin)
Postponed• Action plan to finalize SBs• Decide on consolidated format for SBs- Postponed• Review and augment draft of requirements (André)• Update work plan• Next meeting agenda
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Participants- Meetg of 2012-02-29 p1Name email Country Yes Notes
André Boudreau [email protected] CA YesCo-Lead- Care Plan initiative/HL7 Patient Care WG. B.Sc.(Physics), MBA. Owner Boroan Inc. Management Consultin. Chair, Individual Care pan Canadian Standards Collaborative Working Group (SCWG). Sr project manager. HL7 EHR WG.
Laura Heermann Langford [email protected] US Yes Co-Lead- Care Plan initiative/HL7 Patient Care WG. Intermountain Healthcare. RN PhD,: Nursing
Informatics; Emergency Informatics Association, American Medical Informatics Association; IHE
Stephen Chu [email protected] AU Yes NEHTA-National eHealth Transition Authority . RN, MD, Clinical Informatics; Clinical lead and Lead Clinical Information Architecture; co-chair HL7 Patient care WG; vice-chair HL7 NZ
Carolyn Silzle [email protected] US Yes American Dietetic Association
Susan Campbell [email protected] US Yes PhD microbiologist. Principal at Care Management Professionals. HL7 Dynamic Care Plan Co-developer
Margaret Dittloff [email protected] US The CBORD Group, Inc.. RD (Registered Dietitian); Product Manager, Nutrition Service Suite; HL7 DAM project for diet/nutrition orders; American Dietetic Association
Luigi Sison [email protected] US YesInformation Architect at LOINC and at HL7. Enterprise Data Architect at VA. Developing standard for Detailed Clinical Models (DCM), information models for Electronic Health Record (EHR) Diabetes Project, etc.
Peter MacIsaac [email protected] AU HP Enterprise Services. MD; Clinical Informatics Consultant; IHE Australia; Medical Practitioner - General Practice
William Goossen [email protected] NL Results 4 Care B.V. RN, PhD; -chair HL7 Patient Care WG at HL7; Detailed Clinical Models ISO TC 215 WG1 and HL7 ; nursing practicioner
Anneke Goossen [email protected] NL Results 4 Care B.V. RN; Consultant; Co-Chair Technical Committee EHR at HL7 Netherlands; Member at IMIA NI; Member of the Patient Care Working Group at HL7 International
Ian Townsend [email protected] UK NHS Connecting for Health. Health Informatics; Senior Interoperability Developer, Data Standards and Products; HL7 Patient Care Co-Chair
Rosemary Kennedy [email protected] US Thomas Jefferson University School of Nursing . RN; Informatics; Associate Professor; HL7 EHR WG; HL7 Patient care WG; terminology engine for Plan of care;
Jay Lyle [email protected] US JP Systems. Informatics Consultant; Business Consultant & Sr. Project Manager
Ian McNicoll [email protected] UK Ocean Informatics . Health informatics specialist; Formal general medical practitioner; OpenEHR; Slovakia Pediatrics EMR; Sweden distributed care approach
Maggie Gilligan [email protected] US Dietician; Owner, Senior Member , Nutra Tech Technology, LLC
Kevin Coonan [email protected] US MD. Emergency medicine. HL7 Emergency care WG.
Gordon Raup [email protected] US CTO, Datuit LLC (software industry).
Elaine Ayres [email protected] US NIH National Institutes of Health. MS, RD; Deputy Chief, Laboratory for Informatics Development, NIH Clinical Center ; Project manager for BTRIS (Biomedical Translational Research Information System), a Clinical Research Data Repository
Rob Savage [email protected] US CDC Immunization
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Participants- Meetg of 2012-02-29 p2Name email Country Yes Notes
David Rowed [email protected] AU MD. Family GP.; Was chair, 2005, Electronic Communications Working Group of the AU General Practice Computing Group
Charlie Bishop [email protected] UKWalter Suarez [email protected] USPeter Hendler [email protected] US
Ray Simkus [email protected] CA Practicing Family GP, Vancouver, BC. User of EMR. Intense interest and involvement in EHR and EMR standards , functionality and terminology
Serafina Versaggi [email protected] US Clinical Systems Consultant Brett Esler [email protected] AU Pen Computer Sys
Catherine Hoang [email protected] US VA
Hugh Leslie [email protected] AU a General Practitioner ; Chief Medical Officer, Ocean Informatics
Seam Heard [email protected]
Thomson Kuhn [email protected] US Sr. Systems Architect at American College of Physicians
Russell Leftwich [email protected] US Md, Allergist, internal medicine; Chief Medical Informatics Officer, Office of eHealth Initiatives, State of Tennessee
Michael Tan [email protected] NL Publishing Facilitator , Care Provision, PC WG; Senior Project manager, Nictiz, NL
Corinne Gower [email protected] NZ Senior Business Analyst at NZHIS; Senior Advisor at Ministry of Health New Zealand
Susan Matney [email protected] US Medical Informaticist at 3M Health Care; Chair Elect of the SNOMED CT Nursing Special Interest Group at IHTSDO; Vocab Facilitator for Patient Care TC at HL7 Standards
Audrey Dickerson [email protected] US HIMSS. RN, MS; Standards Initiatives at HIMSS; ISO/TC 215 Health Informatics, Secretary; US TAG for ISO/TC 215 Health Informatics, Administrator; Co-Chair of Nursing Sub-committee to IHE-Patient Care Coordination Domain.
Gaby Jewell [email protected] US Senior strategist at Cerner Corp,
Ken Rubin US Co-Chair, HL7 Service Oriented Architecture Work Group; Chief Architect, Federal Healthcare Portfolio, HP Enterprise Services
Mark Shafarman [email protected] US Member of HL7 since 1992. Co-Chair, HL7 Template WG; Shafarman Consulting Inc.
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CARE PLAN DAM MODELING APPROACH
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Proposed Modeling Approach
• Two streams of parallel modeling• From Storyboards to Business Process Modeling (BPM)
One single model, using the chronic care SB Modeling focused on Patient movement and interchange of care plan data No details on care activities at a given site (e.g. hospital, physician office,
etc.)• From Storyboards to UML Class Model / Entity-Relationship Diagram)
Focused on care plan information Identification of other relevant information without detailed modeling (e.g.
patient demographics, local organization policies and rules) Include good definitions of concepts Tie to the PC data element specifications Take advantage to existing definitions
o e.g. ISO CONTSYS modelo HL7 Vocabulary: patient, care plan,
Build definitions as we move forward• Laura: How will we capture different coordination of care processes:
care manager, primary care physician; simple vs complex care
Updated
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BPM Example (from EA)
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Class Model Example (from EA)
Without the green part and without data types
Key: have good definitions
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• The Class diagram captures the logical structure of the system - the Classes - and things that make up the model. It is a static model, describing what exists and what attributes and behavior it has, rather than how something is done.
Class Diagram Example (from EA)
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REVIEW OF STORYBOARDS • Reference file from the wiki:
Chronic-Conditions_Care-Plan-Storyboard_V0-5_Revised_2012-01-06.docx
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Pediatric Allergy SB- Coordination of care (Susan)• See
Pediatric Allergy Care Plan Storyboard 20120229-RS_SEC.doc Pediatric Allergy Care Plan Storyboard 20120228- References
SEC.docx
• See new doc by Susan• Postpone the discussion to next meeting• Also send the list of sources.
Updated
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Stay Healthy SB (Carolyn)
• See Stay_Healthy_Health_Promotion-_Care_Plan_SB-_final
20120214.docx Stay Healthy Health Promotion Appendix B info exchanged-
20120214.docx• Updated version• Need clear links inside the SB to Appendix B
Updated
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Perinatology CP SB (Laura)
• Complete version provided by Laura• See new version.• Consider complete!!
Updated
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Home Care SB (André)
• See Home Care Care Plan Storyboard V0_4a- Final- 2012-02-
28a.docx• Review add-ons• Ask permission to load NYeHC doc to wiki (André)
Updated
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New York eHealth Collaborative
• Extract from Developing Interoperability Standards for Homecare Plan of Care: Use Case
• Version F1 - December 21, 2011
Plan Of Care (POC) Approval Process: Future Flowchart
Homecare EMRUser Physician EMRTransport
(direct EMR-EMR or via HIE/RHIO)
User
2 (11, 13)User
documents assessments
and/or updates to
POC
3 (12, 14)Generates POC(Initial, Update,
Recert)
No
No
7.1 Signs as is?
7.3Not My
Order/No Longer My
Patient
7User reviews
and processes
POC
*7.2 Signs with Changes?
7.2.1Files signed POC in
patient's recordwith changes
identified
8Returns POC
(Signed with or without changes,
or unsigned)
7.1.1Files signed POC in
patient's record
7.3.1Does not sign,
captures reason why
15Medical Provider
Initiates POC Update
15.1User opens most
recent POC
See * aboveand follow process for
Signed with changes
- Requires ability to view most
current POC as a whole
15.2User updates
POC
Yes
No
No
Yes
Yes
10.2.1Files POC in
patient's record with changes
identified
10.3.2User identifies
correct provider and process
repeats
10.1Signedas is?
10.3Not My
Order/No Longer My
Patient
10.2Signed with Changes?
- User Action
Ongoing and Recertification
Yes
Yes
Yes
1Receives
Referral/Verbal order to provide
homecare
5Transport
5.1 -Via Direct protocols or HIE/RHIO
5.2 – Will address:- Delivery
timeframes- ACK/NACK
- Patient matching
4Sends POC
4.1 - Assembles export file to POC standard for exchange
4.2 - Transmits POC to receiving entity
66.1 - Receives POC based
on new POC standard6.2 - Directs POC to patient's
provider's Inbox
10Receives POC based
on new POC standard
9Transport
-Via Direct protocols or HIE/RHIO
– Will address:- Delivery
timeframes- ACK/NACK
- Patient matching
10.1.1Files POC in
patient's record
10.2.2Notify Clinician
of changes
10.3.1Display reason why not signed
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Acute Care SB (Kevin)
• Previous notes 2 encounters to document at the end: ICU, psychiatry Also key thoughts on coordination of care in this case
should be added• Complete version to be provided by Kevin
• Postpone?• We have enough to start modeling
Not done
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STATUS AND PLAN FOR ALL STORYBOARDS
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Status of 7 SBs – 2012-02-29
Owner SB Name Status Date for Complete Draft
PCCP Final review
Kevin Coonan Acute Condition Draft 1 completedSecond draft pending
??? Pending
André Boudreau
Home Care Under external review
Done Feb 15th
Stephen Chu Chronic Conditions Reviewed.Third draft completed
Done Feb 29th
Susan Campbell
-Pediatric Allergy-Immunization
Reviewed.Second draft of both
Immunization
Allergy done
March 14
Feb 29th
Laura Heermann Langford
Perinatology Reviewed.Second draftFinal: pending
Done Feb 29th
Carolyn Silzle Stay healthy/ health promotion
Draft 1 completedFinal draft distributed
Done Feb 29th
Updated
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CARE PLAN REQUIREMENTS
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Discussion- Requirements Structure/Approach
• See new structure EHR-S FM R2 contents integrated
o For EHR-S FM R2 December 2011 ballot package, see EHR WG wiki http://wiki.hl7.org/index.php?title=EHR
Agree that it will become a collector of all our thoughts regarding the care plan
We will take a bit if time at each meeting to review notes from the past and enrich the requirements
Updated
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FORWARD PLAN• See Spreadsheet
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HDF- Domain Analysis Overview act 3: Domain Analysis Ov erv iew
Analyze Business Context
(from 3.4.1 Business Context Analysis)
Analyze Use Cases
(from 3.4.2 Use Case Analysis)
Analyze Process Flow
(from 3.4.3 Process Analysis)
Analyze Information Exchanged
(from 3.4.4 Information Analysis)
Analyze Business Rules
(from 3.4.5 Business Rules Analysis)
Story board
(from 3.7 Artifacts)
Use Case Analysis
(from 3.7 Artifacts)
Process Flow
(from 3.7 Artifacts)
Information Model (Analysis)
(from 3.7 Artifacts)
Glossary
(from 3.7 Artifacts)
«optional»Business Rules Description
(from 3.7 Artifacts)
Business Trigger Analysis
(from 3.7 Artifacts)
DAM Approv al
Publish DAM
ProjectApproved
Business Requirements
«outcome»«outcome»
Source: HDF_1.5.doc, page 37
Last updated: 2011-02-09
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Forward Plan Discussion Notes 2012-01-19 WGM• Suggestion from William – WRT HDF processes: good to follow
But do not use glossary Capture data definitions/metadata as data element specification William to send standard examples of data element specification
to the group- André to follow-up• Work plan discussed as per work plan excel file contents:
Itemised deliverable components, need to work on and agree on deliverable dates
Target DAM ballot date: possible September 2012 To be discussed and confirmed in next conf calls Feb 1
• Good storyboards will make the mapping and modelling of process flows a lot easier
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FUTURE MEETINGS• Conference calls between now and May 2012 – see wiki
• 90 min., Wednesday 5-6:30pm US Eastern, fortnightly (every 2 weeks)• Starting Feb. 1st
• Webex supplied by Canada Health Infoway
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Next meeting Agenda- March 14th (Lead: André)
• Pediatric immunization SB (Susan)- was forgotten on Feb. 29th• Review Coordination of care concepts (Susan)• Review Care Plan BPMN first results (Luigi)• Review Care Plan Class Model first results (Luigi)• Review and augment draft of requirements (André)
Coordination of care Care management matrix Do a few past meetings
• Update work plan• Next meeting agenda
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APPENDIX