Longitudinal Coordination of Care LCP SWG

1. Longitudinal Coordination of Care LCP SWG Thursday, June 27, 2013

2. Agenda

3. ONC S&I Update • The Care Plan/Home Health Plan of Care Contract with Lantana has been signed!! • This contract will bring the functional requirements of Use Case 2.0 into the C-CDA Revisions planned for the HL7 fall ballot • Next Thursday’s call is cancelled due to the holiday • Propose meeting on Monday July 1st at 3pm or 4pm ET • ONC Report to Congress on Health IT Adoption and HIE 2012: http://www.healthit.gov/sites/default/files/rtc_adoption_of_healthit_and_relatedefforts.pdf • Provides updates on adoption of HIT from 01JAN12 to 20APR13 • Describes CMS and ONC efforts to facilitate nationwide adoption and exchange of electronic health information • Identifies barriers to adoption and exchange • Calls out work of State HIE Challenge Grantees and S&I LCC WG • Call for Pilot Participation! • LCC Pilot Wiki Page • Pilot Survey

4. Announcements & Reminders • Review and Submit Comments to the IHE Patient Care Plan Supplement • The document is available for download at http://www.ihe.net/Technical_Framework/public_comment.cfm • Comments can be submitted by July 3rd at http://www.ihe.net/pcc/pcccomments.cfm • Meeting Reminders (next week) • LTPAC SWG meeting – Monday at 11am ET • LCP SWG meeting – Monday at 4pm or 5pm ET • LCC HL7 Tiger Team SWG meeting – Wednesday at 11am ET • LCP SWG meeting – Thursday at 5pm ET - Cancelled • Visit the LCC Use Case 2.0 Wiki Page for all current artifacts to review: (http://wiki.siframework.org/LCC+WG+Use+Case+2.0) • Use the comment form to provide feedback on UC sections (http://wiki.siframework.org/LCC+Use+Case+2.0+Comments)

5. Care Plan - CDA Document Type Development Project Overview Sarah Gaunt Gaye Dolin RN, MSN June 27, 2013

6. Objective • Develop CDA Care Plan Framework for information exchange of instances of a Patient Care Plan in the C-CDA IG • Add a Care Plan document type • New section templates to convey Care Plan structure • Modify existing or create new entry templates to represent relationships between Care Plan Activities • Create new templates where key Care Plan concepts are not already represented by existing templates.

7. Background

8. Background • S&I Framework’s Longitudinal Coordination of Care Work • http://wiki.siframework.org/LCC+Longitudinal+Care+Plan+%28LCP%29+SWG • HL7 Patient Care Work Group – Care Plan Project • Project wiki: http://wiki.hl7.org/index.php?title=Care_Plan_Project_2012 • Care Plan DAM (soon to be updated): http://wiki.hl7.org/images/2/24/CpDetailedModelImg.png • IHE Patient Care Plan Content Profile (PtCP) • http://www.ihe.net/Technical_Framework/upload/IHE_PCC_Suppl_PtCP_Rev1-0_PC_2013-06-03.pdf

9. Stakeholders and Participants • ASPE/HHS – Assistant Secretary for Planning and Evaluation • ONC S&I Framework • HL7 International Structured Documents Work Group • HL7 International Patient Care Work Group • HL7 International Child Health Work Group • IHEPatient Care Coordination Work Group

10. Project Deliverables • Project Scope Statement (already submitted) • HL7 Ballot Package • Published HL7 in Consolidated CDA IG V2 • Limited to 20+ New templates (up to 35 if needed and time allows) • Schematron and Sample Files

11. Timelines • The timelines are EXTREMELY short for this ballot with final material to be reviewed by stakeholders and submitted to HL7 HQ prior to August 16th • Cross dependency with 2 other projects also to be submitted in the C-CDA ballot: • eLCC (Transfer, referral and Consult Notes) • SMART – Updates to MU2 C-CDA templates • More specific time lines to be discussed next call

12. Next Steps: • Utilize this Thursday’s meeting for CDA design sessions • Determine Next Week's Open Stakeholder Meeting • On July 11th determine if 2 meetings per week are needed • Review HL7 Submitted Project Scope Statement next call • Discuss design heuristics in more detail next call • Translate HL7 Patient Care DAM into CDA Framework sample file and start template development • After the S&I Care Plan Use Case is voted on – begin incorporating requirements

13. High Level Overview of Care Plan "Framework" • Map LCC data elements to HL7 Care Plan model and C-CDA (reference IHE PtCP) LCC Evaluation of Health Status C-CDA Problem Concern Act with subject C-CDA Problem Observation C-CDA Possible New "Goal" Template LCC Goals

14. High Level Overview of Care Plan "Framework" • Map relationships between Care Plan model classes in CDA LCC Evaluation of Health Status C-CDA Problem Concern Act with subject C-CDA Problem Observation C-CDA New "Relationship" Template C-CDA Possible New "Goal" Template LCC Goals

15. High Level Overview of Care Plan "Framework" • "Relationship" templates are the key to unlocking the power of C-CDA for use with Care Plan • Many (most?) required templates already exist in C-CDA • Any template can be used in any section or be related to any other template in C-CDA • "Relationship" templates with descriptions will form a "Framework" on which to hang Care Plan • More details to come on later calls

16. Questions?

17. Consensus on the Use Case • On July 8th, Committed members will be asked to cast a vote on the “LCC Care Plan Exchange Use Case” • 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- with 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

18. Submitting Your Vote 1 http://wiki.siframework.org/LLC+Care+Plan+Exchange+Use+Case+Consensus • Review the Care Plan Exchange Use Case: • Final document will be available 6/28/2013 • Complete the Voting Form: • NOTE: You must be a Committed Member to Vote • Yes • Yes with comments. • Formal Objection • Abstain (decline to vote) • Submit your Vote • A Message is displayed verifying your vote was recorded 2 3 4

19. Viewing Your Vote 5. You can view and track your Vote (located directly below the Voting Form) • Note: you may need to refresh your browser a few times to see your vote 5 Note: All Consensus Votes are due July 15th by 8:00 pm EST

20. Consensus Timeline

21. LCC Use Case 2 Development Schedule

22. Use Case Outline • 1.0 Preface and Introduction** • 2.0 Initiative Overview • 2.1 Initiative Challenge Statement** • 3.0 Use Case Scope • 3.1 Background** • 3.1.1 Care Plan Definitions and References • 3.2 In Scope • 3.3 Out of Scope • 3.4 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 Stories • 10.2 Activity Diagram • 10.2.1 Base Flow • 10.2.2 Alternate Flow • 10.3 Functional Requirements • 10.3.1 Information Interchange Requirements • 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 • Glossary ** Leverage content from Charter Draft sections complete Content available for review