Care Plan (CP) Team Meeting Notes (As updated during meeting)

1. See agenda for May 4th on page 3 Documents mentioned in these minutes are on the wiki Care Plan (CP) Team Meeting Notes(As updated during meeting) André Boudreau (a.boudreau@boroan.ca) Laura Heermann Langford (Laura.Heermann@imail.org) 2011-04-27 (No. 11) Care Plan wiki:http://wiki.hl7.org/index.php?title=Care_Plan_Initiative_project_2011 HL7 Patient Care Work Group

2. Agenda for April 27 • Summary of care plan situations (Susan) • Feedback and discussion on first storyboard: Chronic Care (Danny to circulate in advance) • Highlights from IHE Patient Centered Coordination Plan (PCCP) (Ian M.) • MU material (Susan) • Next meeting agenda

3. Agenda for May 4th • Preparation for WGM in Orlando • Care plan situations update (Susan) • MU material (Susan) • Care Plan elements from KP, Intermountain, VA, etc. (Laura) • New storyboard for acute care (Danny) • Business requirements: summary of key aspects since February (André) • Coaching on Eclipse: what to install for our needs, quick start (Kevin) • Next meeting agenda • Later • Overarching term to use (Ian M.) • Care Plan Glossary

4. Participants- Meetg of 2011-04-27 p1

5. Participants- Meetg of 2011-04-27 p2

6. Care Plan Situations

7. Care Plan Situations • See document prepared by Susan Campbell: Care Management Concept Matrix-v2-20110427a.xls • Identifies different types of care management and for each, presents characteristics from a provider and payer perspective as well as from a patient perspective • Matrix has some elements that are US specific. • Some columns could be added so that other country specific terms/types could be added • Next steps • Add explanations and brief descriptions for the various types and characteristics (second worksheet added) • Add if possible another worksheet with vendors and roles

8. Care Management Resources • See document prepared by Susan Campbell: Care Management Professional Organizations Matrix-20110427b.xls • Formerly named CM Society & Certification2.xls • Identifies societies that provide certification in care or case management in health care and /or social services

9. Discussion • To what extent are we connected to the S&I Transition of Care initiative in the US? • Contacts have been established • We have looked at their methodology and integrated some elements into our structure of deliverables • Our goal is to produce the Domain Analysis Model (DAM) for Care Plan. We are at the business need level and at the conceptual level of what must happen with information exchange. The how (e.g. the use of CDA or IHE or both) will come later

10. Storyboards

11. Care Plan Storyboards- Chronic Care Plan • See document prepared by Danny Probst: Care Plan Storyboards-HL7 Patient Care WG- v0.2 20110427a post CP meetg.docx • Is format/structure of document ok? Yes • Introduction: explains what storyboards are and how they should be structured • List of storyboards: will these cover the range of situations for which we want care planning to apply • Chronic Care: a first version is proposed. Add Asthma? • Acute Care: should be the next one and should cover a broken hip situation from ER to rehab (see amended doc above) • Home Care: for elderly • Perinatology • Pediatric: include Allergy/Intolerance? • Stay healthy? • Chronic Care Plan: some adjustment made • Feedback is wanted to ensure a robust storyboard

12. IHE Patient Centered Coordination Plan (PCCP) • By Ian McNicoll

13. IHE Patient Centered Coordination Plan (PCCP): Highlights and Discussion • Highlights: see document prepared by Ian McNicoll : HL7 Care PlanComparison.zip • This zipped file is available on the wiki. It uses the xmind mind mapping SW available free. • Compares the structure and types of contents for the care plan of IHE, Sweden, and NEHTA • IHE and Sweden have many similarities • NEHTA model is more detailed. It is a draft proposal prepared by Stephen (see meeting of 2011-03-09) • The full IHE PCCP specification is available on the IHE web site, at: http://www.ihe.net/Technical_Framework/index.cfm#pcc • It is key that we focus on structure and not reinvent contents that already exists in HL7 for contents supportive to the care plans • Care plans typically are based on predefined guidelines for specific problems or care objectives/ goals • What is the scope of care planning that we want to address? Medical, behavioural, social, financial, etc?

14. Conclusion

15. Action Items as of 2011-04-27 NB: Completed action items have been removed.

16. Appendix

17. Storyboard: what is it? Narrative of business (clinical; administrative) processes on domain/area of interest Non technical (conceptual in nature) Describes: Activities, interactions, workflows Participants High level data contents feeding into or resulting from processes Provides inputs for: Activity diagrams Interaction diagrams State transition diagrams High level class diagrams Stephen Chu 12 April 2011

18. Storyboards • 5 to 10 max • See list on wiki • Identify actors and understand their roles • Understanding the care planning processes will help understand the needs for info exchange • E.g. query for resource availability vs the care plan needs for patient X • 3 types of requirements • Functions to be carried out, workflow, processes • Static semantics: info model, glossary, vocabulary • Functions to be carried out by the system: EHR FM, PHR FM, etc • Interactions between systems: interoperability • Include meaningful use items that are universal in perspective

19. Modeling Tool- Eclipse

20. Includes post-meeting notes Modeling Tool to Use • Responses from Lloyd Mackenzie and Jean Duteau • Both use Enterprise Architect (EA) • Response from Andy Stechishin, HL7 Tooling and V3 Publishing co-chair • First, there is an active Tooling project (called MAX) to export information from EA using MIF, the HL7 official interchange format. • Second, at the WGM in Sydney, Sparx gave each attendee a license for EA. • Third, during my tenure as a co-chair of Publishing, most DAMs that have been submitted for ballot have been developed (or at least published) using EA. • It seems to me that a convergence is occurring and EA seems to at least be the tool of choice for many. • Eclipse is a platform for doing many different things using specific plug-ins • Recommended by HL7 • Open Source but not as intuitive as Enterprise Architect (which costs some 100$ for a desktop version) • However, choosing which tool and plug-in (for UML) to install is difficult for non technical folks (vs the easy-to-use EA) • We would need some coaching to allow a quick start • Adel agreed to help us there • André will find a resource • The tool will be used to do: • Use cases • Activity and workflow diagrams • Interaction diagrams • Class models

21. Requirements