Longitudinal Coordination of Care Pilots WG

1. Longitudinal Coordination of Care Pilots WG Monday, March 31, 2014

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 • Hold = Elevator Music = frustrated speakers and participants This meeting is being recorded • 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. • 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

3. ReminderJoin the LCC WG & Complete Pilot Survey • http://wiki.siframework.org/Longitudinal+CC+WG+Committed+Member+Guidance • http://wiki.siframework.org/LCC+Pilots+WG ** If your contact information has recently changed, please send your updated information to Becky Angeles at becky.angeles@esacinc.com

4. Agenda

5. Pilot Work Group Purpose and Goals • Purpose • Provide tools and guidance for managing and evaluating LCC pilot Projects • Create a forum to share lessons learned and best practices • Provide subject matter expertise • Leverage existing and new partnerships • Goals • Bring awareness on available national standards for HIE and care coordination • Real world evaluation of parts of most recent HL7 C-CDA Revisions Implementation Guide (IG) • Validation of ToC and Care Plan/HHPoC datasets

6. Meeting Reminders S&I Framework Hosted Meetings: http://wiki.siframework.org/Longitudinal+Coordination+of+Care LCC Pilot WG meetings are Mondays from 11:00– 12:00 pm Eastern • Focus on validation and testing of LCC Standards for Transitions of Care & Care Plan exchange LCC All Hands WG meetings are Mondays & Thursdays from 5:00– 6:00 pm ET are on hold for now HL7 Structured Documents WG Meetings Thursdays from 10:00 – 12:00pm Eastern • WebEx: https://iatric.webex.com/iatric/j.php?ED=211779172&UID=0&RT=MiMxMQ%3D%3D • Dial In: 770-657-9270; Access Code: 310940 • Focus on block voting of HL7 C-CDA R2 Ballot comments • ALL 1013 comments have been reconciled. Ballot reconciliation package to be voted on 4/3.

7. HL7 Patient Care WG Meeting Reminders Coordination of Care Services Specification Project • Provide SOA capabilities/models to support coordination of patient care across the continuum • Current working documents found here: http://wiki.hl7.org/index.php?title=Coordination_of_Care_Services_Specification_Project • Meetings every Tuesday 5:00 – 6:00pm ET • Meeting Information: • Web Meeting URL: https://meetings.webex.com/collabs/meetings/join?uuid=M55ZKYUA35CE2U3J4SV41XMZR3-3MNZ • Meeting Number: 193 323 052 • Phone: 770-657-9270, Participant Code: 071582

8. HL7 Patient Care WG Meeting Reminders, cont’d... Care Plan Project • Developing user stories that define and differentiate Care Plan, Plan of Care, Treatment Plan • Current working documents found here: http://wiki.hl7.org/index.php?title=Care_Plan_Project_2012 • Meetings every other Wednesday from 4:00 – 5:30pm ET • Next meeting scheduled for April 2nd • Meeting Information: • Web Meeting URL: nehta.rbweb.com.au • Phone: 770-657-9270, Participant Code: 943377

9. HL7 Patient Care WG Meeting Reminders, cont’d... Health Concern Topic • Developing user stories highlighting the following: What is a Health Concern Observation; How Health Concern Tracker is Used; How Health Concern is different from Problem Concern • Current working documents found here: http://wiki.hl7.org/index.php?title=Health_Concern • Meetings every other Thursday from 4:00 – 5:00pm ET • Next meeting scheduled for April 3rd • Meeting Information: • Web URL: https://meetings.webex.com/collabs/#/meetings/joinbynumber • Meeting Number: 236424669 • Phone: 770-657-9270, Participant Code: 943377

10. FACA Updates HIT Policy Committee Certification and Adoption Workgroup: March 4th and 6th Meeting Highlights 2015 Edition EHR Certification Criteria Presentation: Discussion on overlap between 2014 Edition and 2015 Edition certification criteria Reviewed final LTPAC and BH EHR Certification Recommendations • No consensus on inclusion of “MU3” from the Transitions of Care item because the LTPAC and BH Providers are not part of the EHR incentive program • Advance Care Planning: Support the ability to record whether an advance directive exists for the patient • Data Portability: Support the ability to electronically create a set of export summaries on all patients, formatted in accordance with the CCDA. • Public Health Transmission to Immunization Registries (LTPAC Only): Support the ability to electronically generate immunization information for electronic transmission using ONC specified standards.

11. FACA Updates, continued… HITPC Certification and Adoption Workgroup, cont’d. Some Workgroup members commented that “past history” is not part of the MU certification criteria but noted that this information can be important, particularly in LTPAC/BH. • Additional clarification is needed here: is this criteria being recommended for inclusion in certification and by all providers? Recommend ONC track national trends in LTPAC and BH health IT adoption. Such efforts should include tracking use by functionality and criteria. Recommend national survey data on LTPAC/BH HER adoption and use utilize definitions that are consistent with those in the MU program.

12. FACA Updates, continued… HITPC Certification and Adoption Workgroup, cont’d. LTPAC Setting Specific Recommendations • Survey and Certification • New: Support the ability to provide surveyors with immediate electronic access to the complete EHR, consistent with federal requirements • New: Support the capability of surveyors to obtain a copy of portions of the record, with patient identification, as needed to perform the surveyor’s role. • Future Work • Support surveyor navigation of the EHR. More work is needed in this area • Support the QIS process, More work is needed in this area • Support the creation of report templates needed by surveyors Next steps TBD by ONC and Committee Chairs

13. FACA Updates, continued… HIT Policy Committee Quality Measures Workgroup: March 7th Meeting Highlights Focused on issues around Long Term Post-Acute Care and the transition of patient from one facility to another non-affiliated facility. • Lack of standards for these transitions and how LTPAC standards should also be standards in all EMR/HealthIT systems • Discrepancy amongst the robustness of systems (hospitals have more robust systems as a whole than do nursing homes). • There is concern on how to transfer patients back to the hospital from an LTPAC efficiently. ONC was mentioned in the work with LCC and CCDA and how those standards might apply, but currently they are for LTPAC and not necessarily going to be something an EMR would consume (but would be consumed by a LTPAC). This discussion will be continued in the next meeting.

14. FACA Updates, continued… HIT Policy Committee : March 11th Meeting Highlights Vote was conducted and 19 final recommendations passed MU workgroup members were asked to revise MUWG draft recommendations to identify objectives that could be removed. Based upon guidance from HITPC, the following criteria were used to re-evaluate draft recommendations: • Reduce the overall number of objectives • Ensure relevant to a focus area • Weight of physician burden of use • Value to performance improvement and enabling new models of care • Flexibility • Needs of specialists • Avoid requirements where standards are not mature • Promote usability

15. FACA Updates, continued… HIT Policy Committee Meaningful Use Workgroup final recommendation list: Improving Quality of Care and Safety • Clinical decision support • Order tracking • Demographics/patient information • Care planning – advance directive • Electronic notes • Hospital labs • Unique device identifiers Engaging Patients and Families in their Care • View, download, transmit • Patient generated health data • Secure messaging • Visit Summary/clinical summary • Patient education Improving Care Coordination • Summary of Care at Transitions • Notifications • Medication Reconciliation • Improving Population and Public Health • Immunization history • Registries • Electronic lab reporting • Syndromic surveillance

16. FACA Updates, continued… HIT Standards Committee : March 26th Meeting Highlights 2015 Edition EHR Certification Criteria Presentation: Discussion on overlap between 2014 Edition and 2015 Edition certification criteria Gap Certification: certification of a previously certified Complete EHR or EHR module(s) to: • All applicable new and/or revised certification criteria adopted by the Secretary at subpart C of this part based on the test results of a NVLAP-accredited test laboratory; and • All other applicable certification criteria adopted by the Secretary at subpart C of this part based on the test results used to previously certify the Complete EHR or EHR Module(s). Public concern on C-CDA R2.0 backwards compatibility: what is the impact of 2014 certified EHRs consuming data from 2015 certified EHR?

17. FACA Meeting Reminders HIT Policy Committee Next meeting scheduled for April 8thfrom 9:30am – 3:00pm ET http://www.healthit.gov/facas/calendar/2014/04/08/hit-policy-committee-virtual HIT Policy Committee Certification and Adoption WG Next meeting scheduled for April 2ndfrom 10:00am – 12:00pm ET http://www.healthit.gov/facas/calendar/2014/04/02/policy-certificationadoption-workgroup HIT Policy Committee Meaningful Use WG Next meeting scheduled for April 16th from 10:00am – 12:00pm ET http://www.healthit.gov/facas/calendar/2014/04/16/policy-meaningful-use-workgroup HIT Standards Committee Next meeting scheduled for April 24th from 9:00am – 3:00pm ET http://www.healthit.gov/facas/calendar/2014/04/24/hit-standards-committee

18. LCC Pilot WG Timeline: Aug 2013 – Sept 2014 LCC Pilot Proposal Review LCC Pilot Monitoring & Evaluation LCC Pilot WG LCC Pilot Wrap-Up HL7 Ballot & Reconciliation HL7 Ballot HL7 C-CDA IG Revisions LCC Pilot WG Launch HL7 Ballot Publication HL7 Fall Ballot Close IMPACT Go-Live LCC Pilots Close LCC Pilot Test Spec. Complete Milestones GSI Health Go-Live NY Care Coordination Go-Live

19. Healthwise Pilots Proposal Presentation • David Foster • dfoster@healthwise.org

20. Next Steps • Next Meeting: Monday, April 14th • Homework Assignments: • Complete Pilot Survey • Sign up as an LCC Committed Member • Submit Pilot Documentation Proposals • Available on the LCC Pilot SWG Wiki: http://wiki.siframework.org/LCC+Pilots+WG • Email to Lynette Elliott (Lynette.elliott@esacinc.com)

21. LCC Initiative: Contact Information • LCC Leads • Dr. Larry Garber (Lawrence.Garber@reliantmedicalgroup.org) • Dr. Terry O’Malley (tomalley@partners.org) • Dr. Bill Russell (drbruss@gmail.com) • Sue Mitchell (suemitchell@hotmail.com) • LCC/HL7 Coordination Lead • Dr. Russ Leftwich (Russell.Leftwich@tn.gov) • Federal Partner Lead • Jennie Harvell (jennie.harvell@hhs.gov) • Initiative Coordinator • Evelyn Gallego (evelyn.gallego@siframework.org) • Project Management • Pilots Lead: Lynette Elliott (lynette.elliott@esacinc.com) • Use Case Lead: Becky Angeles (becky.angeles@esacinc.com) LCC Wiki Site: http://wiki.siframework.org/Longitudinal+Coordination+of+Care