Collaborative Care Messages

1. Collaborative Care Messages For people who care Max Walker Co-Chair CBHS SIG DHS (Vic) Australia

2. Who Care? • General Practitioners • Hospitals • Primary Care Providers • Allied Health Providers • State Health Authorities • Federal Health Authorities

3. Who Collaborates? • General Practitioners • Hospitals • Primary Care Providers • Allied Health Providers • State Health Authorities • Federal Health Authorities • Others?

4. CCM - Collaborative Care Message • When sharing isn’t transferring care • Population Information?

5. We’ve got some patient data

6. We’ve got a complete clinical history

7. We’ve got some patient visits

8. We’ve got a complete drug chart

9. We’ve got problems

10. And Goals

11. And Pathways

12. And of course, we’ve got REL

13. We’ve got the lot

14. CCR – Collaborative Care Referral • CCM with extra bits • Bits of REF_I12 • Reason for referral and providers • A Clinical Order • And multiple patients

15. The bits from REF_I12

16. The Clinical Order

17. And multiple patients

18. But if you care, you really care • And you want to know what’s happening • You want to know if the referral has been accepted or rejected • You want to know how the patients are going • You want to know when treatment is complete

19. CCU – Collaborative Care Unsolicited Update • Notification from the receiver, to the sender, that something has happened. • Includes a Clinical History of treatment related to the referral • CCR without Clinical Order

20. CCQ – Collaborative Care QueryCQU – Collaborative Query Update • Demand an update on your referral • And if thing’s aren’t going well, then there’s CCR Modify and CCR Cancel

21. Uses for CCR • Collaborative Care Referral differs from Collaborative Care Message because it implies workflow. • CCR lets you order stuff in an informed way

22. The CCM Suite • Trigger Event I21 – Collaborative Care Message – Information from one Health Care Provider to another e.g. Discharge Summary, Registry Notification • I16, I17 & I18 – Collaborative Care Referral – Implies a Transfer of Care – I16 is the Referral for a single or group of patients(?). Expect a Collaborative Care Update (CCU) back – I17 Modify CCR (expect CCU back) – I18 – Cancel CCR

23. The CCR Suite cont. • I20 – CCU – Asynchronous Collaborative Care Update (ACK) • I19 – Collaborative Care Query/Update – A trigger that sends sufficient information to find a previously sent Referral & hence generate a CCU • I22 - Collaborative Care Fetch – Sends query to provider, repository, registry etc, on patient and returns Collaborative Care Information which is equivalent to a Collaborative Care Message