1. electronic Long-Term Services & Supports (eLTSS) Initiative All-Hands Workgroup Meeting January 22, 2015 1

2. 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 2

3. http://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29 3 Reminder: Join the eLTSS Initiative 3

4. 4 Agenda TopicPresenter Welcome Meeting Reminders & Announcements eLTSS Roadmap Lynette Elliott Project Charter: Consensus VotingLynette Elliott Use Case: Development Process OverviewBecky Angeles Use Case Working Session: Draft Scope SectionsBecky Angeles / Community Next StepsLynette Elliott

5. All Hands Workgroup Meeting Structure Our Community Meetings are scheduled for one hour a week. We believe your time is valuable and appreciate your participation in this initiative. In order to make the most of our time together, we will start the meeting software for all community meetings at 12:25 pm Eastern. – This gives attendees time to log in to the WebEx and then dial in to the teleconference prior to the meeting start. We will begin the All Hands Meetings at precisely at 12:30 pm Eastern with administrative items and announcements. 5 Thank you for your participation and we look forward to working with you in the coming months.

6. Plan for the Coming Weeks All Hands Meetings will be held over the next several weeks to finalize the Project Charter – All Hands Meetings will be held Thursdays from 12:30 to 1:30pm Eastern – Next Meeting is January 29, 2015 – Meeting information can be found on the wiki: http://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29 http://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29 6 Meeting URLhttps://siframework2.webex.com/siframework2/onstage/g.p hp?t=a&d=662453276 Dial In1-650-479-3208 Passcode662 453 276 Attendee IDProvided by WebEx upon login REMINDER Please check the wiki for the latest meeting schedule. REMINDER Please check the wiki for the latest meeting schedule.

7. Upcoming Meetings ONC Annual Meeting – February 2-3, 2015 – The Office of the National Coordinator for Health IT (ONC) will hold the 2015 Annual Meeting in Washington, D.C. The two-day meeting will gather over 1,200 health IT partners for two days of plenaries and breakout sessions. Space is limited, so please register as soon as possible. Location – Washington Hilton ~ 1919 Connecticut Avenue ~ Washington, DC 20009 Webinar Registration Link – http://www.capconcorp.com/event/onc2015/registration/ http://www.capconcorp.com/event/onc2015/registration/ Agenda and additional details will be posted at the link below as they become available. Check back often: – http://www.healthit.gov/oncmeeting http://www.healthit.gov/oncmeeting 7

8. Concert Series Presentations 8 Organizations are invited to present on an existing project or initiative that is related to the eLTSS scope of work and/or will help inform the eLTSS target outcomes and deliverables These projects do not have to be technically-focused Criteria for consideration: Has solution, whether it is technical or process driven, been implemented in a one or more of the eLTSS settings: home and community-based setting or clinical setting? Does solution incorporate existing or emerging standards and/or other relevant guidance?

9. Concert Series Presentations: Logistics Presentations will be scheduled as part of the weekly eLTSS Community Meetings Duration: 15 to 20 mins webinar (or demo); 5 to 10 mins Q&A Presentations will occur following eLTSS Workgroup activities i.e. eLTSS workgroup will work on project charter review during first part of meeting; concert series presentation will occur during second half of meeting eLTSS Workgroup activities will always take precedence over concert series presentations If you have an interest in participating, please contact Evelyn Gallego (evelyn.gallego@siframework.org ) and Lynette Elliott (lynette.elliott@esacinc.com)evelyn.gallego@siframework.orglynette.elliott@esacinc.com A pre-planning meeting will be scheduled prior to any public demonstration 9

10. Upcoming Concert Series Presentations February 5 th : Project Health Design and ODLs March 5 th : Right Care Now Project 10

11. Timelines for Consideration: Two Pilot Phases, SDO Ballot Cycles eLTSS Initiative Roadmap Q3 ‘14Q4 ‘14Q1 ‘15Q2 ‘15Q3 ‘15Q4 ‘15Q4 ‘17 Phase 4: Pilots & Testing Pilot site readiness Implementation of solution Test User Stories and Scenarios Monitor Progress & Outcomes Utilize Requirements Traceability Matrix Phase 4: Evaluation Evaluate outcomes against Success Metrics and Criteria Update Implementation Guidance Develop, review, and finalize the Use Case and Functional Requirements Pre-Planning Call for Participation Conduct Environmental Scan Success Criteria Stakeholder Engagement Finalize Candidate Standards Standards Gap Analysis Technical & Standards Design Develop Requirements Traceability Matrix Develop Implementation Guide Launch initiative Review and Finalize Charter Review initial Candidate Standards 11 Initiative Kick Off: 11/06/14 Phase 1: Pre-Discovery Phase 2: Use Case Development & Functional Requirements Phase 3: Standards & Harmonization

12. Goals for the eLTSS Initiative Identify key client assessment domains and associated data elements to include in an electronic Long-term Services & Supports (eLTSS) plan Create a structured, longitudinal, person-centered eLTSS plan that can be exchanged electronically across and between community- based information systems, clinical care systems and personal health record systems. We will use Health IT to establish a person-centered electronic LTSS record, one that supports the person, makes him or her central to the process, and recognizes the person as the expert on goals and needs.* * Source: Guidance to HHS Agencies for Implementing Principles of Section 2402(a) of the Affordable Care Act: Standards for Person-Centered Planning and Self-Direction in Home and Community-Based Services Programs 12

13. eLTSS Project Charter Review Schedule 13 DateAll Hands WG Meeting TasksHomework (Due Wednesdays by COB) Nov 13 Project Charter Orientation Background Section & Challenge Statement Review: Background Section, Challenge Statement Nov 20 Scope StatementFinalize: Background Section/Challenge Statement Review: Scope Statement Section Nov 27Thanksgiving Holiday: NO MEETING Dec 4 Value StatementFinalize: Scope Statement Section Review: Value Statement Dec 11 Target Outcomes and Expected Deliverables Standards and Other Reference Materials Concert Series Presentation #1 (CMS/ACL Person- Centered Planning Policies) Finalize: Value Statement; Review: Target Outcomes and Expected Deliverables, Standards and Other Reference Materials; Stakeholders and Other Interested Parties Dec 18 Stakeholders and Other Interested Parties Potential Risks Consensus Voting Orientation Finalize: Standards and Other Reference Materials; Review: Stakeholders and Other Interested Parties, Potential Risks Dec 25 Jan 1 End of Year Holiday: NO MEETINGS Jan 8 Potential Risks Consensus Voting Orientation Finalize: Potential Risks Review: All Project Charter Sections Jan 9 – 13 th End to End Review Project Charter Jan 15 th Finalize Project Charter; Present eLTSS Glossary Concert Series Presentation: KOR Health Jan 20 – 26th Consensus Voting

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15. Consensus Voting Refresher Voting period January 20 – 26 We will be asking Committed Members of the initiative to vote on the electronic Long-Term Services and Supports Charter: – Yes A Yes vote does not necessarily mean that the deliverable is the ideal one from the perspective of the Initiative Member, but that it is better to move forward than to block the deliverable – Yes with comments If a Consensus Process attracts significant comments (through Yes with comment votes), it is expected that the comments be addressed in a future revision of the deliverable. – Formal Objection Must provide comments indicating a path to address the objection in a way that meets the known concerns of other members of the Community of Interest. "Formal Objection" vote without such comments will be considered Abstain votes. A Formal Objection means that the objector cannot proceed with the project unless the objections are met. It is acceptable and expected to use a Formal Objection in a first consensus round to communicate a point of view or process issue that has not been addressed in the drafting of the initial deliverable. Should a Consensus Process attract even one "Formal Objection" vote with comments from an Initiative Member, the deliverable must be revised to address the "Formal Objection" vote (unless an exceptional process is declared). – Abstain (decline to vote) Note: Each Organization, no matter the number of Committed Members, only receives 1 Vote. If there are multiple committed members from your organization please verify your collective vote with them.

16. Verifying your Commitment Level To verify you are a committed member go to the Members section of the eLTSS Wiki page: http://wiki.siframework.org/eLTSS+Jo in+the+Initiative#Members http://wiki.siframework.org/eLTSS+Jo in+the+Initiative#Members Search for your name Verify your “Role” If you want to be a committed member and see that you are not please re-join or re sign up for the initiative indicating your new role: http://wiki.siframework.org/eLTSS+Jo in+the+Initiative http://wiki.siframework.org/eLTSS+Jo in+the+Initiative 16 Example Member List

17. Submitting your Vote (All votes due by January 26 th at 8pm ET / 5pm PT) 1.Review the eLTSS Charter (either using the Word document posted on the wiki or reading the Wiki page itself. Both are the same): http://wiki.siframework.org/electronic+L ong- Term+Services+and+Supports+%28eLTSS %29+Charter http://wiki.siframework.org/electronic+L ong- Term+Services+and+Supports+%28eLTSS %29+Charter 2.Complete the Voting Form on the wiki: – NOTE: You must be a Committed Member to Vote Yes Yes with comments. Formal Objection Abstain (decline to vote) 3.Submit your Vote 4.A message is displayed verifying your vote was recorded 17 2 2 3 3 4 4 Project Charter Section To participate in the Consensus for Data Provenance please do the following : 1 1

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19. ONC Standards and Interoperability (S&I) Framework Lifecycle Our Missions – Promote a sustainable ecosystem that drives increasing interoperability and standards adoption – Create a collaborative, coordinated, incremental standards process that is led by the industry in solving real world problems – Leverage “government as a platform” – provide tools, coordination, and harmonization that will support interested parties as they develop solutions to interoperability and standards adoption. 19 Tools and Services Use Case Development and Functional Requirements Standards Development Support Standards Development Support Certification and Testing Harmonization of Core Concepts Implementation Specifications Pilot Demonstration Projects Reference Implementation Architecture Refinement and Management

20. S&I Framework Phases 20 PhasePlanned ActivitiesPotential Output Pre-Discovery Development of Initiative Synopsis Development of Initiative Charter Definition of Goals & Initiative Outcomes Environmental Scan Project Charter Discovery Creation/Validation of Use Cases, User Stories & Functional Requirements Identification of interoperability gaps, barriers, obstacles and costs Review of Vocabulary Use Case Candidate Standards Inventory Implementation Evaluation of candidate standards Development of Standards Solution Plan Creation of Implementation Guidance Implementation Guide Companion Guide (‘how to guide’) Exchange Profiles Code Packages/Reference Implementation Pilot Validation of aligned specifications, testing tools, and reference implementation tools Revision of documentation and tools Development and presentation of Pilot Proposals Pilot Demonstration Plan EvaluationMeasurement of initiative success against goals and outcomes Identification of best practices and lessons learned from pilots for wider scale deployment Identification of hard and soft policy tools that could be considered for wider scale deployments Pilot Evaluation Pilot Lessons Learned/‘Open House’ YOU ARE HERE

21. Use Case Background Foundation for identifying and specifying standards required to support data exchange, reference implementations and tools – Ensure consistent and reliable adoption of data exchange standards Gives contextual background of why eLTSS standards are necessary Explains benefits of standards Describes detailed Scenarios and User Stories which serve as examples of how enhanced technical capabilities will improve task at hand – Scenarios are accompanied by diagrams which provide pictorial representations of the processes, actors involved and the sequence of the information exchange 21

22. Use Case Development Objectives Engage Stakeholders as Committed Members, Invite Experts, or Interested Parties in the creation of a Use Case Identify Scenarios and User Stories that address real-world problems Keep it simple Focus on the business and functional requirements: Focus on “what” the requirements should be rather than “how” Create a finalized Use Case that demonstrates value and supports the proposed goals and success criteria for the Initiative Publish a finalized Use Case that contains necessary content, supported by artifacts, to enable Harmonization and subsequent S&I Framework efforts to occur Establish Use Case and supporting artifacts in a reusable fashion to support future health information interchange Initiatives 22

23. Use Case Development Approach 1.Incorporate Challenge Statement, Value Statement and Scope Statement from Project Charter – Foster discussion with the workgroup providing introductory context 2.Develop the Scenarios – Organizes the Use Case into logical components 3.Develop the User Stories – Provide real life application examples of the improved technology that the Use Case is meant to support 4.Define the Actors – Derived from User Stories 5.Identify the Assumptions, Pre-Conditions and Post Conditions – Lay the foundation for creating the Functional and Dataset Requirements – Act as inputs for the standards harmonization activities 6.Develop the Diagrams – Use Case, Context, Activity, Sequence diagrams represent the interaction between systems 23

24. Use Case Development Approach (cont’d) 7.Develop the Functional Requirements – Identify the capabilities a system in a role must have in order to enable interoperable exchange of the healthcare data of interest – Provide a detailed breakdown of the requirements in terms of the intended functional behaviors of the application – Includes System Requirements and Information Interchange Requirements 8.Develop Dataset Requirements – A table representing the data elements and data element sets that will be available within the message or document. 9.Finalize Issues, Risks and Obstacles – Compiled throughout the Use Case development process 10.Achieve consensus on the Use Case Package 24

25. Use Case Outline Tailored for each Initiative 25 1.0 Preface and Introduction** 2.0 Initiative Overview – 2.1 Initiative Challenge Statement** 3.0 Use Case Scope – 3.1 Background** – 3.2 In Scope – 3.2 Out of Scope – 3.3 Communities of Interest** 4.0 Value Statement** 5.0 Use Case Assumptions 6.0 Pre-Conditions 7.0 Post Conditions 8.0 Actors and Roles 9.0 Use Case Diagram 10.0 Scenario: Generic Provider Workflow – 10.1 User Story 1, 2, x, … – 10.2 Activity Diagram o 10.2.1 Base Flow o 10.2.2 Alternate Flow – 10.3 Functional Requirements o 10.3.1 Information Interchange Requirements o 10.3.2 System Requirements – 10.4 Sequence Diagram 11.0 Risks, Issues and Obstacles 12.0 Dataset Requirements Appendices – Related Use Cases – Previous Work Efforts – References ** Leverage content from Project Charter

26. Review of Key Use Case Sections Assumptions, Pre-Conditions, Post-Conditions Assumptions – Outlines what needs to be in place to meet or realize Use Case requirements – Functional in nature and state broad overarching concepts related to the Initiative – Serve as a starting point for subsequent harmonization activities Pre Conditions – Describes the state of the system, from a technical perspective, that must be true before an operation, process, activity or task can be executed – Lists what needs to be in place before executing information exchange as described by Functional Requirements and Dataset requirements Post Conditions – Describes the state of the system, from a technical perspective, that will result after the execution of the operation, process activity or task 26

27. Review of Key Use Case Sections Defining the Actors Outlines business actors who are participants in information exchange requirements for each scenario – A business actor is a person or organization that directly participates in a scenario Business actor must use a system to perform functions and participate in the information interchange – The system or system actor has roles (send, receive, publish, subscribe or in some cases display) and actions which involve exchanging content. Example 27 ActorSystemRole PCPEHR SystemSender SpecialistEHR SystemReceiver PatientPHR SystemReceiver

28. Review of Key Use Case Sections Use Case Context Diagram Conceptually represents business actors interacting with Use Case and User Stories Provides a pictorial representation of environment where exchange takes place Characterizes types of interactions that an actor has with a specific system Shows the association and interaction between business actors and Use Case Provides an overview of actors (users or external systems) and interactions between them 28 DRAFT EXAMPLE

29. Review of Key Use Case Sections Scenarios A comprehensive description of actors, interactions, activities, and requirements associated with information exchange Pertain to supporting the health information exchange and describing key flows Scenarios are supplemented by User Stories Example: Specialist requests a patient’s Clinical Care Summary from Primary Care Provider (PCP) Scenario 1 User Story 1 User Story 2 Scenario 2 User Story 1User Story 2 29

30. Review of Key Use Case Sections User Story Describes real world application as an example or instantiation of a Scenario Summarizes interaction between Use Case actors, and specifies what information is exchanged from a contextual perspective Interactions are further described in subsequent sections – Historically, user stories have been utilized to provide clinical context Example Scenario (from previous slide): Specialist requests a patient’s Clinical Care Summary from Primary Care Provider (PCP) Example User Story: A Specialist receives a referral and requires more information to treat the patient properly at the point of care. Using an EHR System, the Specialist sends a request to the PCP for the patient’s Clinical Care Summary. The PCP successfully receives the requests, understands the requests, and sends the patient’s Clinical Care Summary back to the Specialist via the EHR System. The Specialist successfully receives the patient information, understands it, and makes an informed decision that can provide better quality of care to the patient. 30

31. Review of Key Use Case Sections Activity Diagram A form of a state transition diagram in which all or most of the states are activity states or action states Illustrates Use Case flows graphically, and represents flow of events and information between actors – Displays the main events/actions required for data exchange and the role of each system in supporting the change 31

32. Review of Key Use Case Sections Functional Requirements Identify capabilities a system in a role must have to enable interoperable exchange of healthcare data Provide a detailed breakdown of the requirements in terms of the intended functional behaviors of the application Functional Requirements include: Information Interchange Requirements define the system’s name and role Specify actions associated with actual transport of content from the sending system to the receiving system System Requirements include requirements internal to the system necessary to participate successfully in the transaction Detail workflow that is essential to the Use Case 32

33. Show interactions between objects in sequential order of occurrence – Communicates how exchange works by displaying how different components interact – Primary use of diagram is the transition from requirements expressed as use cases to more formal level of refinement NOTE: Horizontal lines identify specific activity between systems Review of Key Use Case Sections Sequence Diagram 33

34. Dataset Requirements Include data elements and data element sets within message or document Each data element included is necessary for some aspect of Use Case; however, requirements do not specify exactly how they may be used together All data element sets may contain multiple data elements unless otherwise stated Identification of data elements forms the foundation for harmonization activities Data elements identified in Use Case set constrain the contents of documents and messages Issues Risks and Obstacles Concerns that might interfere with meeting requirements of Use Case NOTE: Take into consideration risks outlined in Project Charter Review of Key Use Case Sections Dataset Requirements & Issues, Risks & Obstacles 34

35. Week Target Date (2015) All Hands WG Meeting Tasks Review & Comments from Community via Wiki page due following Tuesday by 8 P.M. Eastern 11/22 Use Case Kick-Off & UC Process Overview Introduce: In/Out of Scope Review: In/Out of Scope 21/29 Review: In/Out of Scope Introduce: Context Diagram & User Stories Review: Context Diagram & User Stories 32/5Review: Context Diagram & User StoriesReview: Continue Review of User Stories 42/12 Review: Finalize User Stories Introduce: Assumptions & Pre/Post Conditions Review: Assumptions & Pre/Post Conditions 52/19 Review: Assumptions & Pre/Post Conditions Introduce: Activity Diagram & Base Flow Review: Activity Diagram & Base Flow 62/26 Review: Activity Diagram & Base Flow Introduce: Functional Requirements & Sequence Diagram Review: Functional Requirements & Sequence Diagram 73/5 Review: Functional Requirements & Sequence Diagram Introduce: Data Requirements Review: Data Requirements 83/12 Review: Finalize Data Requirements Introduce: Risks & Issues Review: Risks & Issues 93/19 Review: Risks and Issues Begin End-to-End Review End-to-End Review by community 103/26End-to-End Comments Review & dispositionEnd-to-End Review ends 114/2Finalize End-to-End Review Comments & Begin ConsensusBegin casting consensus vote 124/9Consensus Vote*Conclude consensus voting Proposed Use Case & Functional Requirements Development Timeline 35

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37. eLTSS Use Case Use Case Scope Overview Introduction to the scope of the Use Case (not the scope of the overall initiative) Explain how a scope of a Use Case relates to other Use Cases Includes the following subsections: – Background (will be drafted from Project Charter text) – In Scope – Out of Scope – Communities of Interest (will be drafted from Project Charter text) 37

38. eLTSS Use Case In Scope DRAFT **To identify, evaluate and harmonize standards needed for the creation, exchange and re-use of: key domains and associated data elements of CB-LTSS person-centered planning assessment and services interoperable, accessible person-centered service plans for use by providers and beneficiaries, accountable entities and payers **eLTSS Plan will be designed in such a way that it can be exchanged electronically across multiple CB-LTSS settings, institutional settings and with beneficiaries and payers **eLTSS Plan is led by the beneficiary and includes individuals chosen by the beneficiary to participate in his or her care **Standards identified will support consistent data collection and interoperable exchange with various information systems to include clinical information systems, State Medicaid and HIE systems, PHR systems and other information systems 38 ** Leveraged from Project Charter

39. eLTSS Use Case In Scope DRAFT cont’d **Information will be shared and accessed in compliance with policy, regulation, and Patient Consent Directives **Standards will support revisions to the eLTSS plan as the beneficiary receives services **eLTSS Plan content or data elements will be specific to the types of services rendered and information collected for CB-LTSS **Beneficiary populations will be able to access the eLTSS plan through their PHR system, including the option of a state-identified PHR OTHERS???? 39 ** Leveraged from Project Charter

40. eLTSS Use Case Out of Scope DRAFT **eLTSS plan will be specific to LTSS information collected for community- based services. The eLTSS plan may contain relevant clinical data needed to support the continuum of beneficiary care, support and services. **Harmonization of state assessment templates **Resolve potential gaps in client assessment content collected across states Integration of eLTSS Plan into an EHR or other clinical IT system Transmission protocols describing the most efficient means of transport of eLTSS Plan information from sender to receiver The packaging of eLTSS data elements into a specified form or template for submission from one EHR system to another Health Information system 40 ** Leveraged from Project Charter

41. Call for Participation To make this initiative a success, we need the help of volunteers who are eager to make rapid progress on this important project We need experts to develop standards, first-movers to pilot new tools, innovators to push the envelope, and patients and providers willing to give feedback Minimum commitment: regular participation in community meetings (1-2 hours / week) and active contribution to one or more workgroups (1-3 hours / month). It is okay to participate in one phase and not another. There will be opportunities for your organization to: Pilot new ways to give providers and beneficiaries’ access to information Hear about and provide input to the latest policy and standard issues affecting information exchange and individual access Directly contribute to a potential game-changer for health care 41

42. Next Steps JOIN THE INITIATIVE: The electronic Long-Term Services and Supports Initiative is OPEN for anyone to join. http://wiki.siframework.org/eLTSS+Join+the+Initiative http://wiki.siframework.org/eLTSS+Join+the+Initiative HOMEWORK: –VOTE on the Project Charter http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Charter http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Charter –Review and Comment on the Draft In Scope and Out of Scope Sections of the Use Case http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case 42

43. eLTSS Initiative: Project Team Leads ONC Leads – Elizabeth Palena-Hall (elizabeth.palenahall@hhs.gov)elizabeth.palenahall@hhs.gov – Patricia Greim (Patricia.Greim@hhs.gov)Patricia.Greim@hhs.gov CMS Lead – Kerry Lida (Kerry.Lida@cms.hhs.gov)Kerry.Lida@cms.hhs.gov Federal Lead – Jennie Harvell (jennie.harvell@hhs.gov)jennie.harvell@hhs.gov Initiative Coordinator – Evelyn Gallego-Haag (evelyn.gallego@siframework.org)evelyn.gallego@siframework.org Project Management & Pilots Lead – Lynette Elliott (lynette.elliott@esacinc.com)lynette.elliott@esacinc.com Use Case & Functional Requirements Development – Becky Angeles (becky.angeles@esacinc.com)becky.angeles@esacinc.com Standards Development Support – Angelique Cortez (angelique.j.cortez@accenture.com)angelique.j.cortez@accenture.com Harmonization – Atanu Sen (atanu.sen@accenture.com)atanu.sen@accenture.com 43

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45. LTSS Information Sharing: As-Is Workflow Transport Emergency Services Personal Care Meals Caregiver Support Housing Home Maintenance & Repair Behavioral Health Employment Education Legal Services Criminal Justice Acute Care Primary Care Specialty Care Long-Term Care Post-Acute Care Emergency Care Intensive Care Person-Centered Patient-Centered

46. eLTSS Record Exchange: To-Be Workflow Updates and displays eLTSS Record; stores/transmits data Updates and displays eLTSS Record; stores/submits data Updates and displays eLTSS Record; stores/transmits data Extract, Transform, & Load eLTSS Record Data Move from Patient-Centered to Person-Centered Planning and Information Exchange

47. eLTSS Record Exchange: To-Be Workflow Updates and displays eLTSS Record; stores/transmits data Updates and displays eLTSS Record; stores/submits data Updates and displays eLTSS Record; stores/transmits data Extract, Transform, & Load eLTSS Record Data Move from Patient-Centered to Person-Centered Planning and Information Exchange 3. Receives updated eLTSS Record with new Service 2. Acknowledges Service Need; updates eLTSS Record 1. Identifies Service Need