Longitudinal Coordination of Care Pilots WG Monday, October 28, 2013

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 Panelists 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 Panelists

3 Reminder Join the LCC WG & Complete Pilot Survey ** If your contact information has recently changed, please send your updated information to Becky Angeles at

TopicPresenter Welcome & AnnouncementsEvelyn Roll Call – IntroductionsBecky Open Forum Q&ACommunity Next Steps Agenda 4

Meeting Reminders S&I Framework Hosted Meetings: LCC Pilot WG meetings are Mondays from 11:00– 12:00 pm Eastern –Focus on validation and testing of LCC Standards for Transitions of Care & Care Plan exchange LCC All Hands WG meetings are Mondays & Thursdays from 5:00– 6:00 pm Eastern –These meetings are facilitated in partnership with Lantana and will focus on discussion and review of HL7 C-CDA Care Plan Ballot Comments HL7 Structured Documents WG Meetings Wednesdays from 10:00 – 11:00am Eastern WebEx: Dial In: ; Access Code: Focus on ballot reconciliation of HL7 C-CDA Ballot comments Thursdays from 10:00 – 12:00pm Eastern –WebEx: –Dial In: ; Access Code: –Focus on block voting of HL7 C-CDA Ballot comments

Meeting Reminders HL7 Patient Care WG Meetings Care Plan every 2 nd Wednesday from 5:00 – 6:30pm ET (4:00 in Nov) –Focus on Care Plan DAM Ballot Reconciliation –Next meeting scheduled for Oct. 30 th –Phone: , Participant Code: NEW* Patient Care Health Concern Topic Meetings every 2 nd Thursday from 4:00 – 5:00pm Eastern Next meeting scheduled for Nov. 7th Phone: , Participant Code: Care Coordination Service Meetings every Tuesday 5:00 - 6:30 pm ET (4:00 in Nov) CCS ballot reconciliation, new CCS ballot for Jan 2014

LCC Pilot WG Timeline: Aug 2013 – Sept 2014 Aug-Sept 13Oct- Nov 13Dec- Jan 14Feb- Mar 14Apr- May 14Jun- Jul 14Aug- Sep 14 Milestones Updated HL7 C- CDA IG Complete HL7 Fall Ballot Close LCC Pilot Monitoring & Evaluation LCC Pilot Proposal Review HL7 Ballot Publication LCC Pilots Close HL7 Ballot & Reconciliation LCC Pilot WG Launch IMPACT Go-Live NY Care Coordination Go-Live HL7 C-CDA IG Revisions LCC Pilot Wrap-Up LCC Pilot Test Spec. Complete HL7 Ballot LCC Pilot WG

Purpose –Provide tools and guidance for managing and evaluating LCC pilot Projects –Create a forum to share lessons learned and best practices –Provide subject matter expertise –Leverage existing and new partnerships Goals –Bring awareness on available national standards for HIE and care coordination –Real world evaluation of parts of most recent HL7 C-CDA Revisions Implementation Guide (IG) –Validation of ToC and Care Plan/HHPoC datasets Pilot Work Group Purpose and Goals 8

Iona Thraen, Director of Patient Safety for Utah Department of Health Christol Green, Wellpoint Cindy Levy, CPHIMS Advisor for Shape Hitech Diane Evans, Senior Advisor for Impact Advisors Gordan Raup, Chief Technical Officer for Datuit Janel Welch, Academy of Nutrition and Dietetics/Nutrition sub- committee Laura Heerman-Langford, United Health Care Les Keepper, community member interested in secure platforms to pass MU Susan Campbell, Brockdale Neighborhood Health Center Terry OMalley, LTPAC co-lead, LCC lead, Associate PI on IMPACT Project Jennie Harvell, HHS Office of the Assistant Secretary for Planning and Evaluation Roll Call and Introductions 9

Are there any issues you would like to address? –How the new CCD standards relate to MU and whether the current standards support MU1 and MU2 requirements rather than MU3 –How the LCC Pilot Program ties directly already published standards –How NIEM relates to the LCC/HL7 effort What type of partners/organizations are you looking for? –Provider organizations that focus on patient interaction to improve outcomes –Integrated delivery systems that exchange among health care providers, long term service and support providers, and patients Open Forum Q&A 10

What is the current level of HIT/HIE adoption in your organization? –General consensus said adoption is either in early stages or has not yet happened and is hindered by the focus on efforts to meet basic requirements for MU1 and 2 Do you have a vendor partner? If not, are you willing to help us let you find one? –Attendees expressed interest in assistance with finding a vendor partner Other topics/comments for future discussion? –Alignment at the organizational level Open Forum Q&A 11

Sample Pilot Options 12 User ScenarioS&I Use Case 1.Exchange of CCDToC Use Case 2.Exchange of Transfer Summary LCC Use Case Exchange of Consultation Request LCC Use Case Exchange of Consult Note LCC Use Case Exchange of Test/Procedure Report LCC Use Case Exchange of Test/Procedure Request LCC Use Case Exchange of HHPoCLCC Use Case 2.0 User ScenarioS&I Use Case 8.Exchange of Care PlanLCC Use Case Exchange of Patient GoalsLCC Use Case Exchange of Advance Directives LCC Use Case Exchange of Pre-Test Screening Process LCC Use Case Exchange of Care Plan components for Patient Centered Value Management LCC Use Case Concordance- the extent to which the patients goals, interventions, concerns, outcomes match to the providers prioritization LCC Use Case Exchange of Transfer of Care (Discharge and ED Consult request) LCC Use Case 2.0

Homework Assignments: –Complete Pilot Survey –Sign up as an LCC Committed Member –Submit Pilot Documentation Proposals Available on the LCC Pilot SWG Wiki: to Lynette Elliott Next Steps 13

LCC Leads –Dr. Larry Garber –Dr. Terry OMalley –Dr. Bill Russell –Sue Mitchell LCC/HL7 Coordination Lead –Dr. Russ Leftwich Federal Partner Lead –Jennie Harvell Initiative Coordinator –Evelyn Gallego Project Management –Pilots Lead: Lynette Elliott –Use Case Lead: Becky Angeles LCC Initiative: Contact Information 14 LCC Wiki Site: