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Difference between revisions of "ELTSS:FHIR IG Proposal"

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<!-- What commitment does the WG have to maintaining this IG as the FHIR core specification continues to evolve - particularly if the initial project sponsors are no longer providing resources -->
 
<!-- What commitment does the WG have to maintaining this IG as the FHIR core specification continues to evolve - particularly if the initial project sponsors are no longer providing resources -->
  The current funding for the project expires in September 2019. The maintenance plan is to follow the path as the US Core FHIR IG where the initial content is developed and adopted by various pilot organizations  
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  The project is funded through ONC and CMS. The maintenance plan is to follow the path as the US Core FHIR IG where the initial content is developed and adopted by various pilot organizations  
 
  and networks and then transition the Implementation guide to the owning work group (CBCP) for the long term.
 
  and networks and then transition the Implementation guide to the owning work group (CBCP) for the long term.
  

Revision as of 18:14, 20 November 2018



Electronic Long-Term Services and Supports (eLTSS) Data Exchange FHIR IG

Owning work group name

CBCP

Committee Approval Date:

CBCP Approval Date: TBD
FMG Approval Date: TBD


Contributing or Reviewing Work Groups

The following workgroups own FHIR Resources that will be referenced in the IG:
* Patient Care
* Orders & Observations
* Financial Management Group


FHIR Development Project Insight ID

1431

Scope of coverage

* Subject: Human 
* Disciplines: Long-Term Service and Supports (non-clinical) are comprised of a diverse set of assistances designed to help with general care, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) 
like eating, toileting, dressing, cooking, driving, managing money, etc. These services are provided across various settings from facility-based or institutional care to community-based settings. 
* Delivery environment: Services and supports provided in the person’s home or in a community setting are referred to as Community-Based Long-Term Services and Supports (CB-LTSS) or Home and 
Community-Based Services (HCBS).
* Locale: US Realm

Electronic Long-Term Services & Supports (eLTSS) Service Plan Project aims to enable electronic data-level interoperability and exchange of data reflected on the person-centered service plans. 
The ultimate goal is to leverage HIT standards and electronic information sharing to improve the delivery and coordination of community-based care provided under programs such as Medicaid Waivers.
This project is the continuation of work performed under the eLTSS Initiative, a joint effort by ONC and CMS, that published an eLTSS Core Dataset and balloted the “HL7 Cross-Paradigm White Paper: Electronic Long-Term Services & Supports 
(eLTSS), Release 1” in the Sep 2018 ballot cycle. 
Current HL7 Content standards already include content to enable the creation and exchange of medically-focused care plans. This effort aims to ensure that service information can be captured and exchanged 
alongside the medical interventions for a comprehensive picture of a person’s care.
Integrating clinical and service information into comprehensive plans can help to improve the coordination of health and social services that support an individual’s mental and physical health.


IG Purpose

The adoption and use of Health IT and quality measurement for community-based long-term services and supports is limited. 
Limitations include:
* lack of uniformity in the terminology and definitions of data elements, including those important to the beneficiary, needed for assessments and service plans used across and between community-based information systems, 
clinical care systems and personal health record systems; 
* insufficient business and/or financial incentives for service providers to acquire and use Health IT to support coordination of services; 
* minimal national standards for quality measurement in LTSS outcomes; 
* lack of consensus on the inter-relationships between a beneficiary’s plans across care, services and supports; and 
* lack of evidence and understanding of how Health IT may benefit the beneficiary and encourage their adoption and use of Health IT.
* lack of established best practices for complying with legal security and privacy requirements when electronically exchanging data between covered clinical entities and non-clinical entities providing community-based services.
The eLTSS FHIR Implementation Guide will provide an official compilation of all the FHIR-related artifacts and documentation needed to enable exchange of eLTSS Dataset via FHIR (e.g. eLTSS Dataset FHIR mappings,
 computable FHIR artifacts such as profiles and capability statements, examples).
The eLTSS FHIR Implementation Guide will be matured to a Standard for Trial Use (STU) and will serve to support continued testing activities and evaluation by implementers.


Content location

Need a github 
https://gforge.hl7.org/gf/project/cbcc/docman/eLTSS%20-%20%20ONC%20Electronic%20Long-Term%20Services%20and%20Supports/
Additional Project Background Available Here:
* https://oncprojectracking.healthit.gov/wiki/display/TechLabSC/eLTSS+Home

Proposed IG realm and code

US/eLTSS

Maintenance Plan

The project is funded through ONC and CMS. The maintenance plan is to follow the path as the US Core FHIR IG where the initial content is developed and adopted by various pilot organizations 
and networks and then transition the Implementation guide to the owning work group (CBCP) for the long term.

Short Description

This IG will ensure that community-based service information can be captured and exchanged alongside the medical interventions for a comprehensive picture of a person’s care. Integrating clinical and service information 
into comprehensive plans can help to improve the coordination of health and social services that support an individual’s mental and physical health.


Long Description

The Georgia team (Georgia Department of Community Health (DCH) and Georgia Tech Research Institute (GTRI)) and ONC Support team (SRS, Carradora) teams will leverage the balloted “HL7 Cross-Paradigm White Paper: 
Electronic Long-Term Services & Supports (eLTSS), Release 1” to develop and publish an HL7 FHIR Implementation Guide (IG). The initial eLTSS FHIR IG is currently planned to be included in the May 2019 HL7 Ballot Cycle. 
Based on the scenarios articulated in the eLTSS use cases, the FHIR framework is a great fit for enabling eLTSS exchanges due to its focus on streamlined API-based interoperability, flexible and modular approach and comprehensive 
focus aimed at supporting clinical, administrative and social services workflow needs.


Involved parties

Community Based Care and Privacy (CBCP) is the primary sponsoring workgroup. A collaborative team made up of ONC and CMS contractors (SRS, Carradora, Georgia Department of Community Health 
(supported by Georgia Tech)) will create the IG.


Expected implementations

* CMS, ONC
* SAMHSA


Content sources

This project is the continuation of work performed under the eLTSS Initiative, a joint effort by ONC and CMS, that published an eLTSS Core Dataset and balloted the “HL7 Cross-Paradigm White Paper: Electronic Long-Term Services & Supports (eLTSS), 
Release 1” in the Sep 2018 ballot cycle. 
The IG will leverage US Core profiles for clinical data as applicable. 
The IG will use the following resources to enable eLTSS Plan Creation and Exchange:
* CarePlan
* CareTeam
* Claim
* Condition
* Contract
* Coverage
* DocumentReference
* EpisodeOfCare
* Goal
* Location
* Observation
* Organization
* Patient
* Practitioner
* Questionnaire
* QuestionnaireResponse
* Related Person
* RiskAssesment
* ServiceRequest


Example Scenarios

Create implementer guidance on how to use FHIR Resources and Profiles to create and exchange eLTSS Service Plans between care team members.

IG Relationships

Reuse the US Core IG for clinical data as applicable.

Timelines

* 2/17/2019: Submit a functionally complete IG to CBCP along with the Notice of Intent to Ballot (NIB) to CBCP.
* 3/3/2019: Submit a complete FHIR IG to HL7 for QA.


When IG Proposal Is Complete

When you have completed your proposal, please send an email to FMGcontact@HL7.org

FMG Notes