Findings Notification Brief Profile Proposal for 2013/2014 presented to the IT Infrastructure Planning Committee

Patient Care Coordination Planning Committee The Problem The problem of tracking and notifying the appropriate providers about findings continues to have large impacts on patient outcomes.The problem of tracking and notifying the appropriate providers about findings continues to have large impacts on patient outcomes. There are significant proprietary product offerings in several domains to resolve these issues.There are significant proprietary product offerings in several domains to resolve these issues. The proprietary products do not interoperate well and the vendors are interested in having a way to share their across disciplines, and across enterprisesThe proprietary products do not interoperate well and the vendors are interested in having a way to share their across disciplines, and across enterprises

Patient Care Coordination Planning Committee Use Case The use cases are described in the draft whitepaper.The use cases are described in the draft whitepaper. One important sticking point is clarifying and defining the distinction between an alarm and a finding.One important sticking point is clarifying and defining the distinction between an alarm and a finding. –Alarms range from a signal “patient wants a pillow” through a signal “monitor device reports patient is not breathing”. The physical and administrative scope of alarms tends to be localized. –Findings are a diagnostic conclusion that in the opinion of the diagnosing provider requires follow up. These range from a radiologist report of a suspicious lesion on an image to a diagnosis of a dissecting aorta. Findings are often cross enterprise, e.g., the emergency department needs to inform the patient’s primary care provider about an incidental finding made during treatment.

Patient Care Coordination Planning Committee Proposed Standards & Systems The existing profiles for HPD and PWP will be used to provide information needed about how to contact providers.The existing profiles for HPD and PWP will be used to provide information needed about how to contact providers. PCD has an alarm management profile that overlaps with this work.PCD has an alarm management profile that overlaps with this work. Various proprietary offerings exist, mostly in the radiology marketplace, although some also address pathology and laboratory markets. These do not presently interoperate.Various proprietary offerings exist, mostly in the radiology marketplace, although some also address pathology and laboratory markets. These do not presently interoperate. The PEQ effort from Japan will complement this work because it can aid in finding the patient when an urgent or critical finding arises.The PEQ effort from Japan will complement this work because it can aid in finding the patient when an urgent or critical finding arises.

Patient Care Coordination Planning Committee Discussion There have been discussions but not progress in coordinating with the PCD Alarm management work.There have been discussions but not progress in coordinating with the PCD Alarm management work. Proposal is to proceed with defining an infrastructural set of transactions that can then be customized with domain specific additions if needed.Proposal is to proceed with defining an infrastructural set of transactions that can then be customized with domain specific additions if needed. –Specifically request participation/representative membership from the interested domains RadiologyRadiology CardiologyCardiology LaboratoryLaboratory PathologyPathology PCDPCD Any other interested domainAny other interested domain –We have received interest from non-IHE domains of Emergency Medicine, Anesthesiology and ICU care to participate. ICU is aware of the PCD Alarm management and wants to complete the work with a findings management. –The mismatch between schedules and workloads of the different domains that should work together will be a problem.

Patient Care Coordination Planning Committee Schedule RSNA and work conflicts will make the next two months difficult for the major contributors. This may also give us time to get contributions from those who are interested and new. January and February should be much more productive, with a publication ready draft ready for review at our meeting in March, 2013.