Transcript Slide 1

With meeting notes
To join the meeting:
Phone Number: +1 770-657-9270
Participant Passcode: 943377#
WebEx link (thanks to Canada Health Infoway):
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Care Plan (CP) Meeting
90 minutes
André Boudreau (a.boudreau@boroan.ca)
Laura Heermann Langford (Laura.Heermann@imail.org)
Stephen Chu (stephen.chu@nehta.gov.au)
2012-03-14 André to lead
*Care Plan wiki: http://wiki.hl7.org/index.php?title=Care_Plan_Initiative_project_2011
HL7 Patient Care Work Group
Agenda- March 14th (Lead: André)
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Review
Review
Review
Review
changes to Pediatric immunization SB (Susan)
Coordination of care concepts (Susan)
Care Plan BPMN first results (Luigi)
Care Plan Class Model first results (Luigi)
 William’s Guidelines for DAM Information Modeling
• Next meeting agenda
• If time permits: Postponed
• Review and augment draft of requirements (André)
 Coordination of care
 Care management matrix
 Do a few past meetings
• Update work plan
Page 2
Participants- Meetg of 2012-03-14 p1
Name
email
Country
Yes
Notes
André Boudreau
a.boudreau@boroan.ca
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
Laura.Heermann@imail.org
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
stephen.chu@nehta.gov.au
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
Carolyn.silzle@choa.org
US
Susan Campbell
bostoncampbell@mindspring.com
US
Margaret Dittloff
mkd@cbord.com
US
Luigi Sison
lsison@yahoo.com
US
Peter MacIsaac
peter.macisaac@hp.com
AU
HP Enterprise Services. MD; Clinical Informatics Consultant; IHE Australia; Medical Practitioner General Practice
William Goossen
wgoossen@results4care.nl
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
agoossen@results4care.nl
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
ian.townend@nhs.net
UK
NHS Connecting for Health. Health Informatics; Senior Interoperability Developer, Data Standards and
Products; HL7 Patient Care Co-Chair
Rosemary Kennedy
Rosemary.kennedy@jefferson.edu
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
jaylyle@gmail.com
US
JP Systems. Informatics Consultant; Business Consultant & Sr. Project Manager
Ian McNicoll
Ian.McNicoll@oceaninformatics.com
UK
Ocean Informatics . Health informatics specialist; Formal general medical practitioner; OpenEHR;
Slovakia Pediatrics EMR; Sweden distributed care approach
Maggie Gilligan
mmgilligan@gmail.com
US
Dietician; Owner, Senior Member , Nutra Tech Technology, LLC
Kevin Coonan
Kevin.coonan@gmail.com
US
MD. Emergency medicine. HL7 Emergency care WG.
Gordon Raup
graup@datuit.com
US
CTO, Datuit LLC (software industry).
Elaine Ayres
EAyres@cc.nih.gov
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
hzv3@cdc.gov
US
CDC Immunization
American Dietetic Association
Yes
PhD microbiologist. Principal at Care Management Professionals. HL7 Dynamic Care Plan Co-developer
The CBORD Group, Inc.. RD (Registered Dietitian); Product Manager, Nutrition Service Suite; HL7 DAM
project for diet/nutrition orders; American Dietetic Association
Yes
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.
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Participants- Meetg of 2012-03-14 p2
Name
email
Country
David Rowed
drowed@bigpond.net.au
AU
Charlie Bishop
charlie.bishop@isofthealth.com
UK
Steve Hufnagel
US
Notes
Yes
MD. Family GP.; Was chair, 2005, Electronic Communications
Working Group of the AU General Practice Computing Group
Yes
Peter Hendler
Peter.Hendler@kp.org
US
Ray Simkus
ray@wmt.ca
CA
Practicing Family GP, Vancouver, BC. User of EMR. Intense interest and
involvement in EHR and EMR standards , functionality and terminology
Serafina Versaggi
serafina.versaggi@gmail.com
US
Clinical Systems Consultant
Brett Esler
brett.esler@pencs.com.au
AU
Pen Computer Sys
Catherine Hoang
catherine.hoang2@va.gov
US
VA
Hugh Leslie
hugh.leslie@oceaninformatics.com
AU
a General Practitioner ; Chief Medical Officer, Ocean Informatics
Seam Heard
sam.heard@oceaninformatics.com
Thomson Kuhn
TKUHN@acponline.org
US
Sr. Systems Architect at American College of Physicians
Russell Leftwich
Russell.Leftwich@tn.gov
US
Md, Allergist, internal medicine; Chief Medical Informatics Officer, Office
of eHealth Initiatives, State of Tennessee
Michael Tan
tan@nitctiz.nl
NL
Publishing Facilitator , Care Provision, PC WG; Senior Project manager,
Nictiz, NL
Corinne Gower
Corrine@paradise.net.nz
NZ
Senior Business Analyst at NZHIS; Senior Advisor at Ministry of Health
New Zealand
Susan Matney
samatney@mmm.com
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
adickerson@himss.org
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
gjewell@cerner.com
US
Senior strategist at Cerner Corp,
US
Co-Chair, HL7 Service Oriented Architecture Work Group; Chief Architect, Federal Healthcare
Portfolio, HP Enterprise Services
US
Member of HL7 since 1992. Co-Chair, HL7 Template WG; Shafarman Consulting Inc.
Ken Rubin
Mark Shafarman
Mark@Shafarman.net
Page 4
REVIEW OF STORYBOARDS
• Reference file from the wiki:
Chronic-Conditions_Care-Plan-Storyboard_V0-5_Revised_2012-01-06.docx
Page 5
Changes to Pediatric Immunization SB
(Susan)
• See
 Pediatric_Immunization_Care_Plan_Storyboard_v0_4_2012
0306.doc (available on wiki)
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•
•
•
•
The SB was simplified
We have to look at immunization beyond pediatrics
Influenza immunization
Part of preventive care
See the various notes and general comments in the
updated version (on the wiki)
 Pediatric_Immunization_Care_Plan_Storyboard_v0_5_2012
0314a.doc
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Coordination of Care (Susan)
• See document by Susan:
 Coordination of Care using a Care Plan- refinements-SEC-20120229.docx
 Available on the wiki (Ref Material section)
• Focus should be on supporting the process of care planning, not on
the static plan
• There are many different roles in care management
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Nurse case manager
Social case manager
Disease case manager
Care coordinator
Care navigator
• Care coordination may be viewed as just logistical in some contexts
but it is more than just logistical. It is about the proper execution of
the workflow, combining people and machine actions
• In our Requirements statement, we need to document this range of
complexity
• Our Glossary needs to clarify the meaning that we want to give to
these various terms. Semantics vary by culture and language
Page 7
CARE PLAN DAM MODELING
• Luigi
Page 8
BPMN Model (Luigi)
• Enterprise Architect SW (EA) is used
• Review of a first draft of the BPMN for the
encounters A and B of the Chronic care SB
• We use roles, not individuals or systems in the
model
• The other 2 encounters will be added in the next
round
Page 9
Class Model (Luigi)
• Discussion
• We need good definitions (Glossary of terms)
• The class model is being built in parallel to the
BPMN model in Enterprise Architect SW (EA)
Page 10
FORWARD PLAN
Page 11
Status of 7 SBs – 2012-03-14
Owner
SB Name
Status
Date for
Complete Draft
PCCP Final
review
Kevin Coonan
Acute Condition
Draft 1 completed
Second draft
pending
???
Pending
André
Boudreau
Home Care
Under external
review
Done
Feb 15th
Stephen Chu
Chronic Conditions
Reviewed.
Third draft
completed
Done
Feb 29th
Susan
Campbell
-Pediatric Allergy
-Immunization
Reviewed.
Second draft of
both
Immunization
done
March 14
Allergy done
Feb 29th
Laura
Heermann
Langford
Perinatology
Reviewed.
Second draft
Final: pending
Done
Feb 29th
Carolyn Silzle
Stay healthy/ health
promotion
Draft 1 completed
Final draft
distributed
Done
Feb 29th
Page 12
Ongoing and Future Work, and Outstanding
Items- as of 2012-03-14
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Acute Care SB to be completed - (Kevin)
Care Plan DAM Requirements (André and Care Plan Group)
BPMN models including information exchange (Luigi and CP Group)
Information model and glossary (Luigi and CP Group)
Business rules and triggers (TBD)
Action plan for balloting (CP Group and Co-Chairs)

Target:
Page 13
William’s Guidelines for DAM Information
Modeling (2012-03-07)
• See example from CIC/PC on Diabetes
 Use expression of data elements instead of a glossary with a list of
words
 Diabetes: data element name, definition, permissible values,
permissible values definitions, reference, and optional items
• For the DAM, develop a class diagram with just names.
 For example, if we encounter a scale: give the scale a class name
and stop. Next create a DCM for the scale that can hold all
knowledge, data elements, coding, data types, meta information
and so on
 DCM: variable, value set, description, example, data type,
vocabulary, code for variable, code for value, comments
• CP Group discussion (2012-03-14)
 We will still build a Glossary to clarify the meaning of our terms/
concepts
 We will give example of value sets to illustrate meanings
Page 14
Last updated: 2011-02-09
HDF- Domain Analysis Overview
act 3: Domain Analysis Ov erv iew
Business
Requirements
Source: HDF_1.5.doc, page 37
Project
Approved
Analyze Use
Cases
Analyze Business
Context
(from 3.4.2 Use Case Analysis)
«outcome»
(from 3.4.1 Business Context Analysis)
«outcome»
Use Case Analysis
Story board
(from 3.7 Artifacts)
(from 3.7 Artifacts)
Analyze Process Flow
(from 3.4.3 Process Analysis)
Process Flow
(from 3.7 Artifacts)
Glossary
Analyze Information Exchanged
(from 3.7 Artifacts)
(from 3.4.4 Information Analysis)
Information Model (Analysis)
(from 3.7 Artifacts)
Analyze Business Rules
«optional»
Business Rules Description
(from 3.4.5 Business Rules Analysis)
(from 3.7 Artifacts)
Business Trigger Analysis
(from 3.7 Artifacts)
Publish DAM
DAM Approv al
Page 15
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. 1st
• Webex supplied by Canada Health Infoway
Page 16
Next meeting Agenda- March 28th (Lead: André)
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•
•
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EHRS FIM on Immunization profile (Steve)
Review Care Plan BPMN (Luigi)
Review Care Plan Class Model (Luigi)
Next meeting agenda
• If time permits
• Review and augment draft of requirements (André)
 Coordination of care
 Care management matrix
 Analyze a few past meetings
• Update work plan
Page 17
APPENDIX
Page 18
Updated
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
Page 19
CARE PLAN REQUIREMENTS
Page 20
Updated
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
 http://wiki.hl7.org/index.php?title=EHR
 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
Page 21
Forward Plan Discussion Notes 2012-01-19
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
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