caEHR Domain SME Meeting

1. caEHR Domain SME Meeting April 7, 2010

2. Welcome! • Session Objectives • Analytical Artifact Log Q/A • Outcomes Management Discussion • Outcomes Storyboards • Use Case Development • Referrals • Clinical Data • Demographic Data • Financial Data • ACTION ITEM Follow – ups • Outcomes Management document

3. Agenda • Analytical Artifact Log Q/A • Outcomes Management Discussion • Outcomes Storyboards • Use Case Development • Referrals • Clinical Data <today> • Demographic Data • Financial Data • BREAK MIDWAY THRU CALL *** if required

4. Outcomes • Therapy vs. Treatment • Therapy is the global treatment of the patient • Implies an act of intervention against the cancer • NCI thesaurus • Outcomes Management Document • Too much content needs to be expanded to fully understand • Describe very protocol centrically • Not the case • Proposed first Outcome • Performance Status • Currently captured in medical record but often as part of a text input • Needs to be a discrete data element • Karnofsky’s and/or ECOG • Patient Reported?

5. Outcomes • Proposed first Outcome • Performance Status • Currently captured in medical record but often as part of a text input • Needs to be a discrete data element • Karnofsky’s and/or ECOG • Patient Reported? • On protocol • Off study • Disease Response • Solid Tumor • RECIST • Liquid • Varies by disease • Blasts, Proteins, Marrow

6. Outcomes • Patient arrives at office, physician begins assessment asks how they have been feeling entering data into the progress note • Is there subjective and/or objective narrative that provides context to that assigned performance status – yes but it is a more subtle documentation currently. If we are moving to an electronic format how can we capture these context setting events and make more available • The reason for linking them together would only be for someone other than a physician could understand why the performance status was assigned. Needs to be reflected in the UC • Is there a step to select a standard assessment? No • SOAP notes are part of the progress note • The reporting portion would be for patients on protocol the discrete data element of performance status can be extracted from the patient record and populated on CRF • Performance status is a key criterion for deciding eligibility for patients being considered for a protocol

7. Outcomes • Template used to note performance status: enter in a 0- 5 (aligns with ECOG) • Standard assessments need to support this • Trending would be nice to have • Pull up previous status on Flow Sheet? • Graphical representation would be useful • Would there be value to see this patient’s status against patients of the same gender, age, disease – No • Consumers of this information is the physician, the clinical trial (for pt on protocol)

8. Referrals • Clinical Data • Diagnosis – current, previous ? • Active medical problems • Progress note – last clinical note • Problem list – current yes • Allergies – • Immunizations - no • Medication List - yes • Diagnostic Tests - • Lab Reports - relevant • Images - • Pathology – • Next Step • HS and CB to craft a list and vet with the group

9. Referrals • Three levels of referral • Lowest level • Lab, radiology, pathology • Middle level to another consultant • Pertinent labs, images, progress notes? • Complex

10. Meetings and Follow-up • Upcoming Meetings and Follow-up • Weekly Teleconference April 14, 28 12 – 2:00 ET ***NEW Meeting Requests sent via email contains updated phone in details and Web Ex links • F2F Meeting #4 April 22 – 23 Las Vegas, NV • Agenda and Meeting Logistics to follow • AD HOC Meetings - TBD

11. caEHR Use Case Development

12. Thank you!