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Care Plan Team Meeting (As updated during meeting) André Boudreau Laura Heermann Langford 2011-02-09.

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Presentation on theme: "Care Plan Team Meeting (As updated during meeting) André Boudreau Laura Heermann Langford 2011-02-09."— Presentation transcript:

1 Care Plan Team Meeting (As updated during meeting) André Boudreau Laura Heermann Langford (1) HL7 Patient Care Work group NOTES: Action items can be found on slide 27 This document will be updated and polished over a few meetings.

2 Page 2 Participants- Meetg of Name Count ry YesNoNotes André Boudreau CAYes Laura Heermann Langford USYes Stephen No Peter No David No Adel Ghlamallah CA Yes William No Anneke No Ian No Charlie No Rosemary Kennedy u US Yes Jay Lyle USNo Margaret Dittloff USYes Walter Suarez USYes Peter Hendler USyes Ray Simkus CAYes Audrey Dickerson USYes Ian McNicoll UKYes

3 Page 3 Participants- Profile notes - 1 Name Count ry OrganizationNotes André BoudreauCA Boroan Inc. (Consulting) Chair, Individual Care SCWG No. 2 (pan Canadian Standards Collaborative Working Group); project manager – standards projects; HL7 EHR and PHR WG Laura Heermann Langford US Intermountain Healthcare RN PhD,: Nursing Informatics; Emergency Informatics Association, American Medical Informatics Association; IHE Stephen ChuAU NEHTA-National eHealth Transition Authority Lead Clinical Information Architect ; co-chair HL7 Patient care WG; vice-chair HL7 NZ Peter MacIsaacAU HP Enterprise Services MD; Clinical Informatics Consultant; IHE Australia; Medical Practitioner - General Practice David RowedAU Family medicine practiceMD; Adel GhlamallahCA Canada Health Infoway SME at Infoway (shared health record); past architect on EMR projects William GoossenNL 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 GoossenNL 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 TownendUK NHS Connecting for Health Health Informatics; Senior Interoperability Developer, Data Standards and Products; HL7 Patient Care Co-Chair

4 Page 4 Participants- Profile notes - 2 Name Count ry OrganizationNotes Charlie BishopUK iSOFTProduct Manager - Information & Integration ; HL7 Patient care WG Rosemary KennedyUS Thomas Jefferson University School of Nursing RN; Informatics; Associate Professor; HL7 EHR WG; HL7 Patient care WG; terminology engine for Plan of care; Jay LyleUS JP SystemsInformatics Consultant; Business Consultant & Sr. Project Manager Margaret DittloffUS The CBORD Group, Inc. RD (Registered Dietitian); Product Manager, Nutrition Service Suite; HL7 DAM project for diet/nutrition orders; American Dietetic Association Walter SuarezUS Kaiser Permanente MD, MPH; Director of Health IT Strategy; national priority for transition of care; WEDI- Workgroup for Electronic Data Interchange Peter HendlerUS Kaiser PermanenteMD; informatics; lead in KP convergent terminology; SNOMED CT Ray SimkusCA Brookswood Family Practice MD; Family medicine; EMR user; active meber various standards WG in Canada; on IHTSDO Contents Committee Audrey Dickerson 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. Ian McNicollUK Ocean Informatics Health informatics specialist; Formal general medical practitioner; OpenEHR; Slovakia Pediatrics EMR; Sweden distributed care approach

5 Page 5 Meeting(s) Objectives Agree on where we are and where we want to go Agree on the approach to get there Identify what is available and what is missing Identify tasks and develop realistic work plan Agree on roles and mechanics

6 Page 6 Agenda – (multiple meetings) Welcome and roll call Objectives of the meeting Care plan status update Objectives of this phase Methodology to be followed What has been done Gaps Team and roles Conclusion Next steps Next meetings


8 Page 8 Where we are We have a Care Plan DSTU We have an approved March 2010 Project Scope Statement Questions were raised and discussed regarding development processes, artefacts to be created and the types of ballots Use cases and storyboards have been collected Some are on the wiki and HL7 PC WG page Not standardized, not reviewed More would be available o Canada (Blueprint 2015) We have details on the methodology (see later) Ask William Goossen for more details (add on next page)

9 Page 9 Where we are (William?)

10 Page 10 Notes from Jay Lile – INFORMATION: The DAM should inform a constrained model (DIM/DMIM/RMIM), which is then used as the basis for specifications (CDA, message, etc.). If we build a DAM, we'll presumably use it to update the Care Provision DIM. The updated DIM should be in the list of balloted deliverables. (This is much clearer in PSS 4d, but the sections should be in harmony.) 2.SCOPE ISSUE: We will also need to determine whether the DAM scope should be restricted to the care plan or should reverse-engineer the entire Care Provision DIM. 3.PSS (Project Scope Statement) UPDATE: The Scope section (4a) discusses semantic scope, but it does not lay out the scope of work. I'd suggest that the text currently in 2a be removed from 2a, expanded, and added to 4a. 4.GUIDELINE: The term "DSTU" is being used to refer to deliverables. I find that confusing: DSTU is a status, not an artifact. It would be clearer to me if artifacts were referred to as messages, cda documents, DAMs, and DIMs, and ballot status were used to modify those artifacts. E.g., "the purpose of this project is to develop a Care Plan CDA document, with all necessary antecedent artifacts [list them], and to ballot this document as DSTU." 5.DELIVERABLES: Modeling the information space will almost certainly be useful, but I'm still in the dark about the use cases. Under what circumstances is it necessary to communicate a care plan? For what business purpose are organizations paying their employees to volunteer and develop this standard? 6.PSS UPDATE: External collaboration (6) could use more detail. That would also make it less necessary to mention this slightly distracting information in previous sections.


12 Page 12 Objectives of this phase Get more familiar with HL7 chain of deliverables (HDF) Consolidate and clarify business and clinical requirements Under what circumstances is it necessary to communicate a care plan? Include clinical guidelines Distributed care planning as in Sweden: meta data needed For what business purpose are organizations paying their employees to volunteer and develop this standard? Scope: decide whether the DAM scope should be restricted to the care plan or should reverse-engineer the entire Care Provision DIM Assemble use cases and analyze ?Develop DAM Update objectives once we have a better handle on our methods

13 Page 13 Deliverables (to be updated after a few weeks of travel…) NB: Care Plan wiki to be used for all documents Laura and André to manage? See HDF Domain Analysis- later Project Scope Statement Eventually… DAM storyboard, use cases, structural models, dynamic models Care Plan CDA? Care Plan v3 message?


15 Page 15 Guidelines Use approved HL7 methods: HDF- DAP All agree We need to familiarize ourselves with the approach Resources HDF_1.5.doc (Jan 2010) CIC DAM Development Guide HL7 PC Cambridge 2010.pptx Format for use cases, storyboards, activity diagrams and interaction diagrams - HL7Wiki.mht Examples EMS Domain Analysis Model VOORBEELD.pdf

16 Page 16 HDF- Domain Analysis Overview Source: HDF_1.5.doc, page 37


18 Page 18 What do we have (assets) Approved PSS that needs revision when we are ready Use cases and storyboards (next page) Glossaries: HL7, EHR WG CEN Continuity of care P1 and P2 CEN docs are published Information model and processes and workflow Care plan DSTU of 2007 IHE models of the PPOC (Patient Plan of Care) To be updated with a good inventory (see next page) NB: we need all the assets in one location (or at least links to other locations would be found in that spot)

19 Page 19 Use Cases and Storyboards on Hand Care Plan Storyboards - HL7Wiki.mht Care Plan Use cases - HL7Wiki.mht CarePlanPneumoniaStoryboard.doc Goossenetal2004Jamia-nursingprocessHL7-186.pdf Care coordination usecases v-9 IHE Australia.doc CarePlanTopicUseCasesDiabetesCare doc IHE-PCC_Profile- Proposal_Chronic_Care_Coordination-1-AU.doc To be updated


21 Page 21 Gaps

22 Page 22 Workplan High level here, comprehensive on Excel There was a work plan PC CarePlanTopic Planning & Controllist_v02.xls


24 Page 24 Team and Roles (WIP) Name RoleNotes André Co-Lead Laura Heermann Langford Co-Lead Stephen ChuAUWG Co-Chair Peter MacIsaacAU David RowedAU Adel GhlamallahCA William GoossenNLWG Co-Chair, DCM Anneke GoossenNL Ian TownsendUK Charlie BishopUK Rosemary KennedyUS Jay LyleUS ETC. To be augmented

25 Page 25 Team and Roles- Notes Resource issue - the need to fill the roles of HL7 modeling and vocab facilitators to progress the works


27 Page 27 Concluding notes Approach is OK Have 1 or 2 or 3 more calls to sort ourselves out Weekly calls at 17h00 ET

28 Page 28 Issues/Questions as of No.DateIssue NameCommentsOwnerStatus

29 Page 29 Action Items as of No.Action ItemsBy WhomFor WhenDone 1.Clarify procedure and obtain rights for André/Laura to update CP wikiWilliam? 2.Do an inventory of use cases and storyboard on hand Laura (student) 3.Ask William for an update (add in a diff colour to the appropriate pages)André 4Prepare summary of the steps from HDF to produce the DAMAndré 5Obtain and share the published version of the CEN Continuity of care P1 and P2Audrey

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