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Longitudinal Coordination of Care (LCC) Workgroup (WG) HL7 Tiger Team Patient Care WG Care Plan DAM July 19, 2013 1.

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Presentation on theme: "Longitudinal Coordination of Care (LCC) Workgroup (WG) HL7 Tiger Team Patient Care WG Care Plan DAM July 19, 2013 1."— Presentation transcript:

1 Longitudinal Coordination of Care (LCC) Workgroup (WG) HL7 Tiger Team Patient Care WG Care Plan DAM July 19,

2 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

3 Agenda Goals Schedule Discussion of Team Members association with and level of involvement for Health Concerns, Interventions, Goals Discussion of how to represent Team Members relationship to the Patient Next Steps 3

4 4 For this Tiger Team: Alignment of HL7 artifacts with LCC artifacts to support care plan exchange HL7 CCS provides Service Oriented Architecture Care Plan DAM provides informational structure LCC Implementation Guides provide functional requirements Ongoing comments can be submitted and viewed on wiki: Goals

5 Schedule – July 2013 SUNDAYMONDAYTUESDAYWEDNESDAYTHURSDAYFRIDAYSATURDAY AM ET Discussion Plan Activity Data Element Attributes AM ET Discussion Team Member Relationship to Patient :30 PM ET Continued Discussion Team Member Relationship to Patient AM ET Discussion TBD AM ET Discussion TBD

6 Work Group Schedules LCC WG SWG MeetingLCC LeadsDate/ TimeProjects LTPAC SWGLarry Garber Terry O'Malley Weekly Mondays, 11-12pm EST C-CDA: Transfer Summary, Consult Note, Referral Note LCC HL7 Tiger Team Russ LeftwichWeekly Wednesdays, pm EST LCC WG comments for HL7 Care Plan DAM LCP SWGBill Russell Sue Mitchell Jennie Harvell Weekly Mondays and Thursdays 5-6pm EST C-CDA: Care Plan, HomeHealth Plan of Care HL7 WG SWG MeetingHL7 LeadParticipating LCC Members Date/ TimeProjects HL7 Patient Care WGRuss Leftwich Elaine Ayers Stephen Chu Michael Tan Kevin Coonan Susan Campbell Laura H Langford Lindsey Hoggle Bi-weekly Weds, 5 - 6pm EST Care Plan DAM Care Coordination Services (CSS) HL7 Structured Documents WG Bob Dolin Brett Marquard Sue Mitchell Jennie Harvell Weekly Thursdays, 10-12pm EST CDA (various) HL7 SOA WG CCS ProjectJon Farmer Enrique Meneses (facilitators) Stephen Chu Susan CampbellWeekly Tuesdays 5 - 6pm EST Care Coordination Services (CSS) HL7 Patient Generated Document Leslie Kelly HallWeekly Fridays, 12- 1pm EST Patient-authored Clinical Documents

7 7 Continued discussion of how to represent Team Members association with and level of involvement for the following data elements (to align with LCC Use Case 2): Health Concerns Interventions Goals New discussion of how to represent Team Members relationship to the Patient Is this represented in current model? Does it need to be? Is it the individual involved in care planning process, do they have a role in updating the care plan, or do they simply have access to the Care Plan? Tiger Team Discussion Points

8 8 How to represent Team Members association with and level of involvement for the following data elements: Health Concerns Interventions Goals How to represent these associations Primary, secondary, Tertiary High, Medium, Low, None High – involved – need to be communicated Decision: High, Medium, Low seem to be better designators – Primary can be a loaded term that we want to avoid Team Member Responsibility Discussion

9 9 Identify Team Members association with and level of involvement for Health Concerns Care Giver In general they should be associated with all health concerns, but the model should allow for specification Designate consent when it comes to certain Health Concerns and communication around them. This would enable payment in a fee for service world (for Health Concerns this might not be applicable – but would make sense for Interventions) Also would enable accountability Want to be associated with Health Concern, but there are certain parameters that must exist This may cross the line into Policy rather than what should be in an Information Model Team Member Responsibility – Health Concerns

10 10 Identify Team Members association with and level of involvement for Interventions Level of Involvement (may not be applicable) Same as prior slide – High, Medium, Low, None Association with Whos responsible for implementing the intervention Ensure this intervention is brought to goal – the steward of the intervention Role/Participation Propose, order, track, perform, etc) Team Member Responsibility – Interventions

11 11 Identify Team Members association with and level of involvement for Goals Team Member Responsibility – Goals

12 12 New discussion of how to represent Team Members relationship to the Patient Is this represented in current model? Does it need to be? Is it the individual involved in care planning process, do they have a role in updating the care plan, or do they simply have access to the Care Plan? Example: A patient might see a specialist (any care team member in a specialized domain – behavioral health, nutrition, physical therapy, etc.) once, or it might be intended that the patient will see the specialist only as needed, at intervals from years to days. Such a specialist seen only once or at intervals of years apart would not likely be involved in care plan updates or in all information exchange about the patient. Team Member Relationship to Patient

13 13 What attributes should be captured? PCP, specialist acting as PCP, independent consultant, task specific care team member Intensity or level of engagement – one time, as needed, specified intervals frequent or infrequent Relationship to other care team members? Date of last encounter? Needed, but probably exists elsewhere – this may lead to duplicate and inaccurate data Status – Active, Inactive, Reconciliation of care plan components Care plan governance or read only access Communications separate from governance? Team Member Relationship to Patient

14 14 New discussion of how to represent Team Members relationship to the Patient Is this represented in current model? Does it need to be? Is it the individual involved in care planning process, do they have a role in updating the care plan, or do they simply have access to the Care Plan? Team Member Relationship to Patient

15 Proposed Next Steps Hope to have an updated DAM by next weeks call Next Touch Point meeting with PCWG is July 24 Update discussion schedule Finalize LCCs Comments well before August 4, 2013 for submittal as part of September Ballot (HL7 PCWG needs time to incorporate any comments)

16 16 Contact Information Were here to help. Please contact us if you have questions, comments, or would like to join other projects. S&I Initiative Coordinator Evelyn Gallego Sub Work Group Lead Russ Leftwich Program Management Lynette Elliott Becky Angeles


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