care plan (cp) team meeting notes (as updated during meeting)

Care Plan (CP) Team Meeting Notes(As updated during meeting)

André Boudreau ([email protected])

Laura Heermann Langford ([email protected])

2011-05-04 (No. 12)Care Plan wiki: http://wiki.hl7.org/index.php?title=Care_Plan_Initiative_project_2011

HL7 Patient Care Work Group

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

Agenda for May 4th

• Preparation for WGM in Orlando• Care plan situations update (Susan)• MU material (Susan)• Care Plan elements from KP, Intermountain, VA, etc. (Laura)• Storyboards

Feedback on Chronic care Plan storyboard New storyboard for acute care (Danny)

• Modeling resource: Luigi: agrees to be our modeler: use case, data, process, UML EA Vs Eclipse: EA is preferred by many

• Next meeting agenda

• For a future meeting: Business requirements: summary of key aspects since February (André) EA or Eclipse Overarching term to use (Ian M.) Care Plan Glossary

Agenda for May 11th

• Storyboards (Laura, Danny, Susan, André)• Requirements (André)

Include processes (Stephen’s work) Include key functionalities (diabetes case)

• Comparison of care plan contents (Ian) To inform the information model Start of spreadsheet

• Finalization of Orlando WGM agenda (All)• Next meeting date and agenda

• Later EA or Eclipse Overarching term to use (Ian M.) Care Plan Glossary

Participants- Meetg of 2011-05-04 p1Name email Country Yes Notes

André Boudreau [email protected] CA Yes Co-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 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

Peter MacIsaac [email protected] AU HP Enterprise Services. MD; Clinical Informatics Consultant; IHE Australia; Medical Practitioner - General Practice

Adel Ghlamallah [email protected] CA Canada Health Infoway. SME at Infoway (shared health record); past architect on EMR projects

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 Yes 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 Yes JP Systems. Informatics Consultant; Business Consultant & Sr. Project Manager

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

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.

Ian McNicoll [email protected] UK Ocean Informatics . Health informatics specialist; Formal general medical practitioner; OpenEHR; Slovakia Pediatrics EMR; Sweden distributed care approach

Danny Probst [email protected] US Intermountain Healthcare. Data Manager

Kevin Coonan [email protected] US MD. Emergency medicine. HL7 Emergency care WG.

Gordon Raup [email protected] US CTO, Datuit LLC (software industry).

Susan Campbell [email protected] US Yes PhD microbiologist. Principal at Care Management Professionals. HL7 Dynamic Care Plan Co-developer

Elayne 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

Participants- Meetg of 2011-05-04 p2Name email Country Yes Notes

David Rowed [email protected] AUCharlie Bishop [email protected] UKWalter Suarez [email protected] USPeter Hendler [email protected] USRay Simkus [email protected] CALloyd Mackenzie [email protected] CA LM&A Consulting Ltd.Serafina Versaggi [email protected] US YesSasha Bojicic [email protected] CA Lead architect, Blueprint 2015, Canada Health Infoway

Agnes Wong [email protected] CARN, BScN, MN, CHE. Clinical Adoption - Director, Professional Practice & Clinical Informatics, Canada Health Infoway

Cindy Hollister [email protected] CA RN, BHSc(N), Clinical Adoption -Clinical Leader, Canada Health Infoway

Valerie Leung [email protected] CA Pharmacist. Clinical Leader, Canada Health Infoway

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.

ORLANDO WGM

Orlando WGM Topics

• Thursday May 19th, Q1, 9h00 to 10h30• Duration 1.5 hour• Who to lead: Laura• Potential Topics, to be finalized next week

Status of Care Plan DAM project Identifying key material from other Patient Care work (Pressure

Ulcer, DCM) and other WG (Emergency Care, Care Provision, Care Statement, Structured Document, CDA consolidation, etc.)

Requirements, include inventory of existing material and standards Storyboard review Identifying clinical resources that would review future storyboards Modeling work required

CARE PLAN SITUATIONS

Care Plan Situations

• See document prepared by Susan Campbell: Care Management Concept Matrix-v2-20110427a.xls

• Identifies different types of care management and for each, presents characteristics from a provider and payer perspective as well as from a patient perspective

• Matrix has some elements that are US specific. Some columns could be added so that other country

specific terms/types could be added• Next steps: postponed (Susan)

Add explanations and brief descriptions for the various types and characteristics (second worksheet added)

Add if possible another worksheet with vendors and roles

MEANINGFUL USE MATERIAL

MU Material (Susan)

• MU aspects Demonstrate that providers and institutions have EHR that have been

certifiedo Have all patient records electronico Interoperability can be verifiedo EHR can be used meaningfully to report

Health conditions that are most common are the ones targeted for the first phaseo Use evidence based care to lower costs and improve patient outcome

• 3 phases Ph1: population health

o By attestation that they can send the measures, one test to CDC; Use certified SW and have e-record

Ph2: similar but data reporting of the measures (80% of population) Ph3: individual health: longitudinal measures for outcomes

• Issue: finding common measures for all the segments• Document: HIT POLICY COMMITTEE MEASURE CONCEPTS • Document: Notes from Oct 20, 2010- Policy Committee meeting on

Meaningful Use Phase 2

MU Material

• See SHIPPS DAM ballot material (Serafina, CBCC WG) NQF E-Measures Relation to Care Plan? Identify specific items relevant to CP (Serafina, with Susan)

• Care Plan has not entered yet the quality measures A very key area of communication for quality care Needs to be able to surveying ‘care plans’

• Important in the development of the Care Plan reference model

• S&I Transition of Care initiative can influence our work and vice-versa

CARE PLAN MATERIAL FROM VARIOUS ORGANIZATIONS

Care Plan Material from Various Organizations• Laura: will contact KP• Info to ask for:

Care plan processes, guidelines (disease treatment models) Criteria that a patient must exhibit in order to trigger the CP

process Key care plan contents /data elements Data exchange between providers

• PPOC summary in the CP comparison diagram is incomplete Ask Ian to enrich it

Care Plan Scope Question

• The whole care perspective?• VS care plan communications among providers• Bottom up approach vs top down• Top down: EHR FM• Field approach: storyboards• Need to complete the storyboards• Restructure? Test our set of storyboards at the end

with the following: 3 age groups: newborns, adults, seniors Types of care: chronic, acute, palliative, mental,

behavioural, stay healthy, others?

STORYBOARDS

Feedback on Chronic Care Plan Storyboard• Want to ensure

Readability Clinical accuracy, validity Coverage (focus on the 80%, not the exceptions) Remember: storyboards get improved over time, as the

project advances• By clinicians• As we progress in the progress• Ask the PC list/members

Storyboards- Next week if possible

• Acute Care Plan Storyboard: Danny In progress

• Home Care: André• Perinatology: Laura• Pediatric and Allergy/Intolerance: Susan• Stay healthy: Laura

MODELING TOOL- EA OR ECLIPSE

Modeling Tool to Use• Responses from Lloyd Mackenzie and Jean Duteau

Both use Enterprise Architect (EA)• Response from Andy Stechishin, HL7 Tooling and V3 Publishing co-chair

First, there is an active Tooling project (called MAX) to export information from EA using MIF, the HL7 official interchange format.

Second, at the WGM in Sydney, Sparx gave each attendee a license for EA. Third, during my tenure as a co-chair of Publishing, most DAMs that have been submitted for ballot

have been developed (or at least published) using EA. It seems to me that a convergence is occurring and EA seems to at least be the tool of choice for

many.• Eclipse is a platform for doing many different things using specific plug-ins

Recommended by HL7 Open Source but not as intuitive as Enterprise Architect (which costs some 100$ for a desktop

version) However, choosing which tool and plug-in (for UML) to install is difficult for non technical folks (vs

the easy-to-use EA) We would need some coaching to allow a quick start

o Adel agreed to help us thereo André will find a resource

• The tool will be used to do: Use cases Activity and workflow diagrams Interaction diagrams Class models

Includes post-meeting notes

CONCLUSION

Action Items as of 2011-05-04

No. Action Items By Whom For When Status

2. Do an inventory of use cases and storyboard on hand Laura (Danny) Active: Underway

3. Ask William for an update (add in a diff colour to the appropriate pages) André Outstanding - Request made

5 Obtain and share the published version of the CEN Continuity of care P1 and P2; obtain ok from ISO

Audrey/Laura Outstanding

9 Draft a new PSS and review with project group André Deferred

10 Complete a first draft of requirements André Started

12 Complete storyboards Multi

13 Prepare Orlando WGM

14

NB: Completed action items have been removed.

APPENDIX

Storyboard: what is it?

• Narrative of business (clinical; administrative) processes on domain/area of interest

• Non technical (conceptual in nature)• Describes:

• Activities, interactions, workflows• Participants• High level data contents feeding into or resulting from

processes• Provides inputs for:

• Activity diagrams• Interaction diagrams• State transition diagrams• High level class diagrams

Stephen Chu12 April 2011

Storyboards

• 5 to 10 max See list on wiki

• Identify actors and understand their roles• Understanding the care planning processes will help

understand the needs for info exchange E.g. query for resource availability vs the care plan needs for

patient X• 3 types of requirements

Functions to be carried out, workflow, processes Static semantics: info model, glossary, vocabulary Functions to be carried out by the system: EHR FM, PHR FM, etc Interactions between systems: interoperability

• Include meaningful use items that are universal in perspective

REQUIREMENTS

care plan (cp) team meeting notes (as updated during meeting)

Documents

care plan wiki

individual care

phd chair hl7 patient

care plan glossarypage

plan of carejay

hl7 nursing practicioneranneke

hl7 international ian

hl7 netherlands member