Primary Goal: Cancer care is complex and crosses institutional boundaries many times. This story illustrates how innovations in interoperability for oncology and long term care can coordinate care and improve patient safety.

Key Points: • HL7 Consolidated Clinical Document Architecture standard (C-CDA)• DRAFT standards proposed for addition to C-CDA:

• Clinical Oncology Treatment Plan and Summary sponsored by The American Society of Clinical Oncology (ASCO) • Surrogate EHR Environment (SEE) Transfer of Care Implementation Guide sponsored by IMPACT (Improving

Massachusetts Post-Acute Care Transfers), an ONC grant-funded project• Full spectrum of data capture from document imaging to light weight editor to certified EHR to NLPMeaningful Use Relevance: Improving quality, safety, efficiency, and reducing health disparate. Improve care coordination .

Use Case 17

Care Theme: HIT InnovationsUse Case: Health Story: New Approaches for Coordinating Long-Term and Cancer Care

HL7 Resources:• HL7 Clinical Document Architecture (CDA) R2 Normative Edition 2005 • HL7 Implementation Guide for CDA Release 2: IHE Health Story Consolidation, Release 1.1 (C-CDA)• Clinical Oncology Treatment Plan and Summary – to be balloted (Spring 2013), proposed for C-CDA• Long Term Care Transfer Summary– to be balloted (Fall 2013), proposed supplement to C-CDA

Demonstration Participants:• Inofile: ChartMD• Lantana Consulting Group: SEE Tool• M*Modal: Fluency Direct and Catalyst • Verizon: Secure Universal Message Services (SUMS)• VitalHealth EHR• Oracle: Health Information Exchange

Clinical Workflow:

Care Theme: HIT InnovationsUse Case: Health Story: New Approaches for Coordinating Long-Term and Cancer Care

1. Patient visits PCP to review Mammogram Report. PCP scans the report into ChartMD and uses VitalHealth EHR

to produce and send C-CDA Referral and CCD to surgeon. (Inofile, VitalHealth, Verizon, Oracle)

2. Patient visits Surgeon, Oncologist; Diagnosis is made, surgery indicated, Mastectomy performed

3. Tumor Board reviews case and uses Fluency Direct and Catalyst to develop cancer Treatment Plan (M*Modal)

which is distributed to PCP and Home Health Agency

4. Visiting Nurse sees patient at home and uses prior documents and SEE Tool* to produce a Long Term Care

Transfer Summary (Lantana Consulting Group)

Access to the full chart, the Treatment Plan and Home Health reports surfaces potential problem

1- PCP 2- Oncology, Surgery 3- Tumor Board 4- Visiting Nurse

For more information visit: www.healthstory.com