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With meeting notes. To join the meeting: Phone Number : +1 770-657-9270 Participant 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. - PowerPoint PPT Presentation
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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
Page 2
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
Page 3
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
Page 4
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.
Page 5
REVIEW OF STORYBOARDS • Reference file from the wiki:
Chronic-Conditions_Care-Plan-Storyboard_V0-5_Revised_2012-01-06.docx
Page 6
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
Page 7
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
Page 8
CARE PLAN DAM MODELING• Luigi
Page 9
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
Page 10
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)
Page 11
FORWARD PLAN
Page 12
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
Page 13
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:
Page 14
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
Page 15
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
Page 16
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
Page 17
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
Page 18
APPENDIX
Page 19
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
Page 20
CARE PLAN REQUIREMENTS
Page 21
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
Page 22
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