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])

2012-03-14 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

http://wiki.hl7.org/index.php?title=Care_Plan_Initiative_project_2011

https://infoway-inforoute.webex.com/infoway-inforoute/j.php?ED=168011982&UID=494535562&RT=NCMxMQ==

https://infoway-inforoute.webex.com/infoway-inforoute/j.php?ED=168011982&UID=494535562&RT=NCMxMQ==

Agenda- March 14th (Lead: André)

• Review changes to Pediatric immunization SB (Susan)• Review Coordination of care concepts (Susan)• Review Care Plan BPMN first results (Luigi)• Review Care Plan Class Model first results (Luigi)

William’s Guidelines for DAM Information Modeling

• Next meeting agenda

• If time permits: Postponed• Review and augment draft of requirements (André)

Coordination of care Care management matrix Do a few past meetings

• Update work plan

Participants- Meetg of 2012-03-14 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 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] USNIH 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

Participants- Meetg of 2012-03-14 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] UK

Steve Hufnagel US Yes

Peter 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] USHIMSS. 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.

REVIEW OF STORYBOARDS • Reference file from the wiki:

Chronic-Conditions_Care-Plan-Storyboard_V0-5_Revised_2012-01-06.docx

Changes to Pediatric Immunization SB (Susan)

• See Pediatric_Immunization_Care_Plan_Storyboard_v0_4_201203

06.doc (available on wiki)• The SB was simplified• We have to look at immunization beyond pediatrics• Influenza immunization• Part of preventive care• See the various notes and general comments in the

updated version (on the wiki) Pediatric_Immunization_Care_Plan_Storyboard_v0_5_201203

14a.doc

Coordination of Care (Susan)

• See document by Susan: Coordination of Care using a Care Plan- refinements-SEC-20120229.docx Available on the wiki (Ref Material section)

• Focus should be on supporting the process of care planning, not on the static plan

• There are many different roles in care management Nurse case manager Social case manager Disease case manager Care coordinator Care navigator

• Care coordination may be viewed as just logistical in some contexts but it is more than just logistical. It is about the proper execution of the workflow, combining people and machine actions

• In our Requirements statement, we need to document this range of complexity

• Our Glossary needs to clarify the meaning that we want to give to these various terms. Semantics vary by culture and language

CARE PLAN DAM MODELING• Luigi

BPMN Model (Luigi)

• Enterprise Architect SW (EA) is used• Review of a first draft of the BPMN for the

encounters A and B of the Chronic care SB• We use roles, not individuals or systems in the

model• The other 2 encounters will be added in the next

round

Class Model (Luigi)

• Discussion• We need good definitions (Glossary of terms)• The class model is being built in parallel to the

BPMN model in Enterprise Architect SW (EA)

FORWARD PLAN

Status of 7 SBs – 2012-03-14

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 done

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

Ongoing and Future Work, and Outstanding Items- as of 2012-03-14

• Acute Care SB to be completed - (Kevin)• Care Plan DAM Requirements (André and Care Plan Group)• BPMN models including information exchange (Luigi and CP Group)• Information model and glossary (Luigi and CP Group)• Business rules and triggers (TBD)• Action plan for balloting (CP Group and Co-Chairs)

Target:

William’s Guidelines for DAM Information Modeling (2012-03-07)• See example from CIC/PC on Diabetes

Use expression of data elements instead of a glossary with a list of words

Diabetes: data element name, definition, permissible values, permissible values definitions, reference, and optional items

• For the DAM, develop a class diagram with just names. For example, if we encounter a scale: give the scale a class name

and stop. Next create a DCM for the scale that can hold all knowledge, data elements, coding, data types, meta information and so on

DCM: variable, value set, description, example, data type, vocabulary, code for variable, code for value, comments

• CP Group discussion (2012-03-14) We will still build a Glossary to clarify the meaning of our terms/

concepts We will give example of value sets to illustrate meanings

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


Process Flow


Information Model (Analysis)


Glossary


«optional»Business Rules Description


Business Trigger Analysis


DAM Approv al

Publish DAM

ProjectApproved

Business Requirements

«outcome»«outcome»

Source: HDF_1.5.doc, page 37

Last updated: 2011-02-09

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

Next meeting Agenda- March 28th (Lead: André)

• EHRS FIM on Immunization profile (Steve)• Review Care Plan BPMN (Luigi)• Review Care Plan Class Model (Luigi)• Next meeting agenda

• If time permits• Review and augment draft of requirements (André)

Coordination of care Care management matrix Analyze a few past meetings

• Update work plan

APPENDIX

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

CARE PLAN REQUIREMENTS

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

http://wiki.hl7.org/index.php?title=EHR

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

Care Plan (CP) Meeting 90 minutes

Documents

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