Longitudinal Coordination of Care (LCC) Workgroup (WG) LCC All Hands Meeting June 4, 2013 1.
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Transcript of Longitudinal Coordination of Care (LCC) Workgroup (WG) LCC All Hands Meeting June 4, 2013 1.
Longitudinal Coordination of Care (LCC) Workgroup (WG)
LCC All Hands Meeting
June 4, 2013
1
Meeting Etiquette
• Remember: If you are not speaking, please keep your phone on mute
• Do not put your phone on hold. If you need to take a call, hang up and dial in again when finished with your other call o Hold = Elevator Music = frustrated speakers and
participants• This meeting is being recorded
o Another reason to keep your phone on mute when not speaking
• Use the “Chat” feature for questions, comments and items you would like the moderator or other participants to know.o Send comments to All Participants so they can
be addressed publically in the chat, or discussed in the meeting (as appropriate).
From S&I Framework to Participants:Hi everyone: remember to keep your phone on mute
All Participants
Agenda
• Summary of LCC WG Accomplishments for May 2013
• LCC WG Timeline
• LCC Use Case 2.0
• HL7 Ballot Tiger Team
• eLCC – CDA IG Development
• Next Steps
3
Summary of LCC WG Accomplishments• Continued development LCC Use Case 2.0 focused on
Interoperable Care Plan Exchange• LCC HL7 Tiger Team
– Aligning the Patient Care WG Care Plan DAM to LCC
• HITPC MU3 SWG Meetings– Agreement to reference IMPACT ‘Transfer of Care’ dataset:
consult note, transfer summary and consultation request– Reviewing LCC Care Plan Recommendations for MU3
• Lantana C-CDA Revisions Project (HL7 ToC Implementation Guidance development)– HL7 Project Scope Statement approved by HL7 Structured
Documents WG– ‘Transfer of Care’ dataset harmonization activities currently
being reviewed with LTPAC SWG– ‘Care Plan/HHPoC’ harmonization activities to start in June
• Reorganized LCC WG Structure and Meetings
Summary of LCC WG Accomplishments (cont’d)• Continued LCC Stakeholder & Pilot Engagement
Activities– Call for Pilot Participation!– Outreach to Vendors (Caradigm, GetRealHealth)– Outreach to State HIE Grantees: MD, CT, TN– Outreach to IDNs: Wellmont Health System (TN), Life Centers of
America– HIMSS Analytics: Care Coordination Model– VA / DOD: HHPoC alignment
Longitudinal Coordination of Care
Workgroup
Longitudinal Coordination of Care
Workgroup
Patient Assessment
Summary (PAS SWG
LTPAC Care Transition SWG
Longitudinal Care Plan SWG
• Engage directly with HL7 to establish the standards for the exchange of patient assessment summary documents
• Inform the development of the Keystone Beacon PAS Document Exchange
• Identify the key business and technical challenges that inhibit LTC data exchanges
• Define data elements for long-term and post-acute care (LTPAC) information exchange using a single standard for LTPAC transfer summaries
• Identify standards for an interoperable, longitudinal care plan* which aligns, supports and informs person-centric care delivery regardless of setting or service provider
6
LCC Sub Workgroups (SWG)
*Care Plan standards will enable providers to create, transmit and incorporate care plans and needed content for the benefit of medically complex and/or functionally impaired individuals, their families and caregivers.
COMMUNITY-LED INITIATIVE
HL7 Tiger Team SWG
• Educate the LCC Community on related HL7 processes, framework and evolving standards relevant to LCC
• Gather and generate comments for HL7 Care Plan related evolving standards (Care Coordination Services & Care Plan Domain Analysis Model (DAM))
Work Group SchedulesLCC WG
SWG Meeting LCC Leads Date/ Time Projects
LTPAC SWG Larry GarberTerry O'Malley
Weekly Mondays11am - 12pm EST
C-CDA: Transfer Summary, Consult Note, Referral Note
LCC HL7 Tiger Team
Russ Leftwich Weekly Wednesdays 11am - 12pm EST
LCC WG comments for HL7 Care Plan DAM
LCP SWG Bill RussellSue MitchellJennie Harvell
Weekly Thursdays 5pm - 6pm EST (starting June 6)
C-CDA: Care Plan, Home Health Plan of Care
HL7 WGSWG Meeting HL7 Lead Participating LCC
MembersDate/ Time Projects
HL7 Patient Care WG Russ LeftwichElaine Ayers Stephen Chu Michael Tan Kevin Coonan
Susan Campbell Laura H Langford Lindsey Hoggle
Bi-weekly Weds5pm - 6pm EST
Care Plan DAMCare Coordination Services (CSS)
HL7 Structured Documents WG
Bob DolinBrett Marquard
Sue MitchellJennie Harvell
Weekly Thursdays10am - 12pm EST
CDA (various)
HL7 SOA WG CCS Project Jon Farmer Enrique Meneses (facilitators) Stephen Chu
Susan Campbell Weekly Tuesdays 5pm - 6pm EST
Care Coordination Services (CSS)
HL7 Patient Generated Document
Leslie Kelly Hall Weekly Fridays12pm - 1pm EST
Patient-authored Clinical Documents
LCC WG Timeline: Mar 2013 – Dec 2013
Mile
ston
es
Pilot Site Identification & Engagement
Care Plan IG Complete
Lantana Contract Awarded for
Development of ToC IG
HL7 Project Scope Statement Due
HL7 Intent to Ballot Due
HL7 Fall Ballot Open
NY Pilots Monitoring
LCC Care Plan Use Case 2.0 Development & Consensus
IMPACT ToC Pilot Monitoring
IMPACT Care Plan Pilot Monitoring
HL7 Ballot Publication
ToC IGs Development (Transfer Summary, Referral Note, Consult Note)
ToC IGs Complete
HL7 Final Ballot Due
LCC Stakeholder Engagement: Lantana, IMPACT, ASPE, NY, CMS
Care Plan/ Home Health Plan of Care IG Development
HL7 Ballot Package Development
HL7 Ballot & Reconciliation
FACA LCC WG Briefings
LCC & HL7 Care Plan Coordination
IMPACT Go-Live
NY Care Coordination Go-Live
Lantana Contract Awarded for Care
Plan IG Development
LCP SWG LCC Use Case 2.0 –
Interoperable Care Plan Exchange
Use Case 2.0 – Interoperable Care Plan Exchange• Focus on the functional requirements for an
Interoperable Care Plan exchange– Will feed into the Care Plan component of the work Lantana is doing for
the Aug/Sept HL7 Ballot
• This work is being performed under the LCC Longitudinal Care Plan (LCP) SWG
– Meetings are held on Thursdays from 5pm-6pm ET
• LCC Use Case 2.0 Wiki Page (http://wiki.siframework.org/LCC+WG+Use+Case+2.0)
– We have a comment form to provide feedback on UC sections (http://wiki.siframework.org/LCC+Use+Case+2.0+Comments)
10
LCC Use Case 2 Development Schedule
Date Item
Feb 2013 10.1 User Stories
Mar 2013 10.0 Scenario (Base Flow, Alternate Flow)
3.0 Use Case Scope (In Scope / Out of Scope)
3.4 Communities of Interest
Apr 2013 5.0 Use Case Assumptions
6.0 Pre-Conditions
7.0 Post Conditions
8.0 Actors and Roles
11.0 Risks, Issues, and Obstacles
May 2013 9.0 Use Case Diagrams
10.4 Sequence Diagram
10.3 Functional Requirements
Appendices
12.0 Dataset Requirements
Jun 2013 12.0 Dataset Requirements
End-to-End Review (Includes 1.0, 2.0, 4.0)
Consensus Period and Voting
• 1.0 Preface and Introduction**
• 2.0 Initiative Overview– 2.1 Initiative Challenge Statement**
• 3.0 Use Case Scope– 3.1 Background**– 3.2 In Scope– 3.3 Out of Scope– 3.4 Communities of Interest
• 4.0 Value Statement**
• 5.0 Use Case Assumptions
• 6.0 Pre-Conditions
• 7.0 Post Conditions
• 8.0 Actors and Roles
• 9.0 Use Case Diagram
Use Case Outline
•10.0 Scenario: Generic Provider Workflow– 10.1 User Stories– 10.2 Activity Diagram
o 10.2.1 Base Flowo 10.2.2 Alternate Flow
– 10.3 Functional Requirementso 10.3.1 Information Interchange Requirementso 10.3.2 System Requirements
– 10.4 Sequence Diagram
•11.0 Risks, Issues and Obstacles
•12.0 Dataset Requirements
•Appendices
– Related Use Cases– Previous Work Efforts– References– Glossary
12
** Leverage content from Charter
Draft sections complete
Content available for review
LCC HL7 Tiger Team SWG Update
Lead: Dr. Russ Leftwich
Overview
• Tiger Team Objectives
• Importance of LCC Engagement with HL7
• Establish artifacts and ballot comments
• Harmonize Care Plan DAM
• Schedule
Tiger Team Objectives
• Educate the LCC Community on the HL7 processes and framework
• Educate the LCC Community on the HL7 Ballots relevant to LCC
• Generate comments to the Care Coordination Service and Care Plan Domain Analysis Model (DAM) Ballots for May and September 2013 to align LCC Objectives with HL7 Work Products
Importance of LCC and HL7 Coordination
• Care Plan Domain Analysis Model September Ballot (HL7 Patient Care WG)
– Shared glossary of terms– Alignment of the various care plan components between LCC
and HL7 (Risks, Barriers, Relationships, Prioritization, etc)
Establish Tiger Team Artifacts and Ballot Comments
• Comments in MS Excel Ballot Package
• Presentations for updates to HL7 Workgroups
• HL7 Care Plan Domain Analysis Model ballot artifacts are due for submission on August 4
18
• The Domain Analysis Model (DAM) was created by the HL7 Patient Care WG (PCWG)
• The goal of LCC is to review the DAM and provide input from a provider perspective and to harmonize elements that overlap with LCC efforts around care plan exchange and workflow• LCC Tiger Team is presenting recommendations and
comments during PCWG meetings prior to when the DAM goes to ballot in September
Harmonize Care Plan DAM
19
• Define differences between Risks and Health Concerns, make recommendations on how to designate/categorize them
• Define Barriers, make recommendations on how to designate/categorize them
• Define Goals, Interventions, Outcomes and Assessments and make recommendations on how to designate/categorize them
• Past Meeting Artifacts available on the LCC Wiki:http://wiki.siframework.org/LCC+-+Meeting+Artifacts
Discussions To-Date
20
• Discuss methods of prioritization and who prioritizes
• Discuss how to assign Care Team Members to prioritized Goals, Concerns and Interventions
• Discuss how to reconcile differing prioritizations
• Discuss mitigation of irrational patient choices
• Align terminologies, definitions and Use Cases between PCWG and LCC
Continuing Discussions
Schedule – May 2013SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
1 2 3 411 AM ET Overview of HL7 LCC Domain
Analysis Model
5 6 7 8 9 10 1111 AM ET HL7 LCC DAM: Risks, Health Concerns, Barriers,
Preferences
12 13 14 15 16 17 1811 AM ET HL7 LCC DAM: Risks, Health Concerns, Barriers,
Preferences
5 PM ET Touch Point with PCWG
19 20 21 22 23 24 2511 AM ET HL7 LCC
DAM: How to designate and/or
model Prioritizations
26 27 28 29 30 3111 AM ET: HL7 LCC DAM: Assignment
of Care Team Members to
Prioritizations
Schedule – June 2013SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
2 3 4 5 6 7 8
11 AM ET: Discussion
Prioritization
9 10 11 12 13 14 1511 AM ET
Discussion cont’d Prioritization
5 PM ET Tentative Discussion with
PCWG (TBD)
16 17 18 19 20 21 2211 AM ET
Discussion TBD
23 24 25 26 27 28 2911 AM ET
Discussion TBD
30
Participate in the Tiger Team
• If you are interested in joining the LCC HL7 Ballot Tiger Team, please:– Participate in the Wednesday meetings at 11:00am EST– Check out the wiki:
http://wiki.siframework.org/LCC+HL7+Tiger+Team+SWG
LTPAC SWGeLCC CDA IG Development
Leads: Mike Tushan & Zabrina Gonzaga (Lantana)
25
Objective
• Develop national data standards for information exchange of a Longitudinal Coordination of Care Dataset.
• Expand on the document types and templates to include HL7 Implementation Guides (IGs) for new and enhanced document types:
• New: Transfer Summary
• New: Consultation Request
• Enhanced: Consult Note
26
Background
• Improving Massachusetts Post Acute Care Transfer (IMPACT) project
• Resulted in a Transfer of Care Dataset: 500 data elements that are necessary during a patient transfer of care
• Data set is organized into 5 groups:
• Transfer of Care
• Consultation Request
• Shared Care Encounter Summary
• Care Plan
• Home Health Plan of Care
27
Stakeholders and Participants
• NYeC: New York eHealth Collaborative
• CCITI NY: Continuum of Care Improvement Through Information New York
• Healthix, Inc
• ONC S&I Framework
• IMPACT Project team
• HL7 International Structured Documents Work Group/ Patient Care WG
• ASPE (Care Plan)
28
Deliverables
• Project Scope Statement (approved by Structured Docs WG)
• Functional Specification
• Templates: create up to 30 new CDA templates
• Sample Files: sample files to accompany each document type
• Schematron: validation rules
• HL7 CDA IG(s): final implementation guide(s) for DSTU*
• HL7 Ballot Package
• HL7 Ballot Reconciliation
• Published HL7 CDA IG
*Draft Standard for Trial Use
29
Project Timeline
AprTask 1: Background
Analysis• S&I stakeholder meetings• Identify relevant precedentTask 2: Functional
Specifications/Setting Specific Rules
• S&I stakeholder meetings• Develop mapping sheet• Define setting specific
rules
May Jun Jul Aug Oct Nov DecSep
Task 4: Templates• Develop templates
Meetings
Deliverables
LEGEND:
Task 6: Ballot Material• Produce schematron
validation rules• Develop IG• Review IG with Tiger Team• Deliver IG to S&I• Update and submit IG and
materials for ballotTask 7:
Reconciliation/Publication
• Develop ballot comment tracking table
• Lead reconciliation meetings
• Publish IG
HL7 Reconciliation meeting frequency and dates TBD
DraftDraft
Next Steps
• Lantana to continue work on eLCC CDA Implementation Guide for ToC
– Care Plan/HHPoC IG development scheduled to start in June
• Monitor IMPACT Project Go-Live in July
• Continue outreach to key LCC Stakeholder groups
– Professional Associations, EHR vendors, CMS Care Planning Programs
– Coordination with other Care Plan Initiatives: DoD/VA, HIMSS
• Develop/Execute on Pilot Engagement Plan (Call for Participation!)
– MA and NY entities have committed to pilot pre-balloted LCC standards before end of year
– Engage TN LTPAC Entities and Life Centers of America
• Develop and submit Tiger Team Recommendations to HL7 WGs
• Continue participation in HITPC SWG MU3 #3 Care Coordination
• Participate in LTPAC HIT Summit (June)
30