Care Plan (CP) Meeting Wednesday, July 25, EDT Laura Heermann Langford Stephen Chu *C are Plan wiki: HL7 Patient Care Work Group To join the meeting: Phone Number: Participant Passcode: # With meeting discussion notes

Page 2 July 25, 2012 Agenda/Minutes  Agenda Review – update as needed  Linking vs nesting Storyboard review  Modeling work update

Page 3 Participants- Meeting of Name Country YesNotes Laura Heermann Langford US x 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 x 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 USx American Dietetic Association Susan Campbell US PhD microbiologist. Principal at Care Management Professionals. HL7 Dynamic Care Plan Co-developer Kevin Coonan US MD. Emergency medicine. HL7 Emergency care WG. Nancy Wilson RomanUS Enrique Meneses US Serafina Versaggi USClinical Systems Consultant John Farmer USx Chris White US Luigi Sison US 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.

Page 4 Linking vs Nesting Care Plan Discussion Notes  Stephen reviewed work done on multi-morbidities-chronic-conditions- CarePlan-UseCase  Team discussion o The need for a glossary identified (to include care plan, care paths, protocols, …) o A diagram of how care plans relate to each other may be helpful (context associations, express the relationship of multiple care plans) o Need to look at HL7 and ISO definition of care plans o Need to look at the “across-specific point care plans” impacts, in bound and out bound risks

Page 5 Modeling Discussion Notes  Luigi and Enrique were able to meet face to face  Models done to date were reviewed and exchanged  Possible approaches to complete were reviewed and discussed  Determined to follow the narrative storyboard -> use case-> process model -> information model approach  Luigi and Enrique will be splitting the work according to storyboards for the above stated process. o (Luigi = home care, acute care) o (Enrique = pediatric, Perinatal, stay healthy)  Requesting next meeting be 1.5 hours devoted to modeling work

Page 6 Other Discussion Notes Susan mentioned work done by Marshfield clinic re: the use of data for quality improvement – dsahboard, drill down into underlying data etc. Marshfield Clinic (Wisconsin) homegrown E.H.R. that is quality data driven. 2Fframe%2Fg.do&apiname=lsr.php&renewticket=0&renewticket=0&actappname=ec0605ld&entappname=url0107ld&needFilter =false&&isurlact=true&entactname=%2FnbrRecordingURL.do&rID= &rKey=bc14120d8f6fb9a1&recordID= &r nd= &siteurl=fedgov&SP=EC&AT=pb&format=short CMS Page listing coordinated care model source information Susan/Laura agreed to update team on work occurring at the US ONC S&I Framework 2 meetings from now. update from Susan  The ONC group working on this is located at:  LTPAC and Longitudinal Care Plan are the two most related. LTPAC has the data elements. LCP is basically beating around the bush to do what we are trying to do in this group in HL7. We are currently working on a white paper to try do describe what a longitudinal care plan is. Unfortunately, it doesn’t work from first principles and grow logically. Instead it uses the Home Care Plan of Care as the starting point because that is what CMS wanted.

Page 7 FUTURE MEETINGS Conference calls between now and September 2012 – see wiki 90 min., Wednesday 5-6:30pm US Eastern, fortnightly (every week) Will be using Mikogo for screen sharing Next meeting August 8, 2012

Page 8 Next meeting – Aug 8 (Lead: Laura) Agenda for Aug 8, 2012  Modeling work Agenda for Aug 22  Update on US ONC S&I Framework Other topics: o Follow up on documents related to requirement work done by Andre is needed. o Stephen/Laura will look to see if Andre’ has posted his documents and if not will contact him to obtain copies. Schedule TBD o Requirements Definition o Stephen Hufnagel: EHRS FIM on Care Plan Items

Page 9 APPENDIX

Page 10 Past Participants- Name Country YesNotes André Boudreau CA 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 X 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 X 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 USX American Dietetic Association Susan Campbell USX 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 US 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 x 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 11 Past Participants- 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 Steve HufnagelUS 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 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.