Care Plan (CP) Meeting 90 minutes André Boudreau Laura Heermann Langford Stephen Chu André to lead *C are Plan wiki: HL7 Patient Care Work Group To join the meeting: Phone Number: Participant Passcode: # WebEx link (thanks to Canada Health Infoway): With meeting notes

Page 2 Agenda- Feb 29th (Lead: André) Agree on approach for modeling (Luigi) Pediatric Allergy SB ( RS on wiki) (Susan)  Review coordination of care section- Postponed Stay Healthy SB - (final version plus Appendix B on wiki) (Carolyn) Pediatric immunization (Susan)- next meeting Perinatology SB - (complete version to be provided by Laura) (Laura) Home Care SB - ( final version on wiki) (André) Acute Care SB - (complete version to be provided by Kevin) (Kevin)  Postponed Action plan to finalize SBs Decide on consolidated format for SBs- Postponed Review and augment draft of requirements (André) Update work plan Next meeting agenda

Page 3 Participants- Meetg of p1 Name Country YesNotes André Boudreau 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 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 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 USYes American Dietetic Association Susan Campbell USYes PhD microbiologist. Principal at Care Management Professionals. HL7 Dynamic Care Plan Co-developer Margaret Dittloff 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 USYes Information 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 AU HP Enterprise Services. MD; Clinical Informatics Consultant; IHE Australia; Medical Practitioner - General Practice William Goossen 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 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 UK NHS Connecting for Health. Health Informatics; Senior Interoperability Developer, Data Standards and Products; HL7 Patient Care Co-Chair Rosemary Kennedy 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 US JP Systems. Informatics Consultant; Business Consultant & Sr. Project Manager Ian McNicoll UK Ocean Informatics. Health informatics specialist; Formal general medical practitioner; OpenEHR; Slovakia Pediatrics EMR; Sweden distributed care approach Maggie Gilligan US Dietician; Owner, Senior Member, Nutra Tech Technology, LLC Kevin Coonan US MD. Emergency medicine. HL7 Emergency care WG. Gordon Raup US CTO, Datuit LLC (software industry). Elaine Ayres 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 Rob Savage US CDC Immunization

Page 4 Participants- Meetg of p2 Name Country Yes Notes David Rowed AU MD. Family GP.; Was chair, 2005, Electronic Communications Working Group of the AU General Practice Computing Group Charlie Bishop UK Walter Suarez US Peter Hendler US Ray Simkus CA Practicing Family GP, Vancouver, BC. User of EMR. Intense interest and involvement in EHR and EMR standards, functionality and terminology Serafina Versaggi USClinical Systems Consultant Brett Esler AUPen Computer Sys Catherine Hoang USVA Hugh Leslie AU a General Practitioner ; Chief Medical Officer, Ocean Informatics Seam Heard Thomson Kuhn US Sr. Systems Architect at American College of Physicians Russell Leftwich US Md, Allergist, internal medicine; Chief Medical Informatics Officer, Office of eHealth Initiatives, State of Tennessee Michael Tan NL Publishing Facilitator, Care Provision, PC WG; Senior Project manager, Nictiz, NL Corinne Gower NZ Senior Business Analyst at NZHIS; Senior Advisor at Ministry of Health New Zealand Susan 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 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. Gaby Jewell 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 US Member of HL7 since Co-Chair, HL7 Template WG; Shafarman Consulting Inc.

Page 5 CARE PLAN DAM MODELING APPROACH

Page 6 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 model o 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 7 BPM Example (from EA)

Page 8 Class Model Example (from EA) Without the green part and without data types Key: have good definitions

Page 9 The Class diagram captures the logical structure of the system - the Classes - and things that make up the model. It is a static model, describing what exists and what attributes and behavior it has, rather than how something is done. Class Diagram Example (from EA)

Page 10 REVIEW OF STORYBOARDS Reference file from the wiki: Chronic-Conditions_Care-Plan-Storyboard_V0-5_Revised_ docx

Page 11 Pediatric Allergy SB- Coordination of care (Susan) See  Pediatric Allergy Care Plan Storyboard RS_SEC.doc  Pediatric Allergy Care Plan Storyboard References SEC.docx See new doc by Susan Postpone the discussion to next meeting Also send the list of sources. Updated

Page 12 Stay Healthy SB (Carolyn) See  Stay_Healthy_Health_Promotion-_Care_Plan_SB-_final docx  Stay Healthy Health Promotion Appendix B info exchanged docx Updated version Need clear links inside the SB to Appendix B Updated

Page 13 Perinatology CP SB (Laura) Complete version provided by Laura See new version. Consider complete!! Updated

Page 14 Home Care SB (André) See  Home Care Care Plan Storyboard V0_4a- Final a.docx Review add-ons Ask permission to load NYeHC doc to wiki (André) Updated

Page 15 New York eHealth Collaborative Extract from Developing Interoperability Standards for Homecare Plan of Care: Use Case Version F1 - December 21, 2011

Page 16 Acute Care SB (Kevin) Previous notes  2 encounters to document at the end: ICU, psychiatry  Also key thoughts on coordination of care in this case should be added Complete version to be provided by Kevin Postpone? We have enough to start modeling Not done

Page 17 STATUS AND PLAN FOR ALL STORYBOARDS

Page 18 Status of 7 SBs – OwnerSB NameStatusDate for Complete Draft PCCP Final review Kevin CoonanAcute ConditionDraft 1 completed Second draft pending ???Pending André Boudreau Home CareUnder external review DoneFeb 15th Stephen ChuChronic ConditionsReviewed. Third draft completed DoneFeb 29th Susan Campbell -Pediatric Allergy -Immunization Reviewed. Second draft of both Immunization Allergy done March 14 Feb 29 th Laura Heermann Langford PerinatologyReviewed. Second draft Final: pending DoneFeb 29 th Carolyn SilzleStay healthy/ health promotion Draft 1 completed Final draft distributed DoneFeb 29th Updated

Page 19 CARE PLAN REQUIREMENTS

Page 20 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  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 21 FORWARD PLAN See Spreadsheet

Page 22 HDF- Domain Analysis Overview Source: HDF_1.5.doc, page 37 Last updated:

Page 23 Forward Plan Discussion Notes 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

Page 24 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. 1 st Webex supplied by Canada Health Infoway

Page 25 Next meeting Agenda- March 14 th (Lead: André) Pediatric immunization SB (Susan)- was forgotten on Feb. 29th Review Coordination of care concepts (Susan) Review Care Plan BPMN first results (Luigi) Review Care Plan Class Model first results (Luigi) Review and augment draft of requirements (André)  Coordination of care  Care management matrix  Do a few past meetings Update work plan Next meeting agenda

Page 26 APPENDIX