Virtual C-CDA Implementation-a-Thon 5

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Event Date: Thursday, June 22, 2017

Planning Committee

Name Affiliation
Calvin Beebe Mayo Clinic
Benjamin Flessner Redoxengine
Brett Marquard River Rock
Dave Hamill HL7
Matt Rahn ONC
David Degandi Cambia Health Solutions
Shawn Muer Veterans Administration
William Ormerod Cerner
Joe Lamy Social Security Administration
Michael Clifton Epic
Lisa Nelson Life Over Time Solutions
John Donnelly IntePro Solutions
Matt Blackmon The Sequoia Project
Didi Davis The Sequoia Project
Joe Quinn Optum
Evelyn Gallego

Summary of Findings & Next Steps

Transitions of Care

  • Use of multiple identifiers - Samples Taskforce
  • Participants wanted to be in both tracks, but could not
  • Need a way to visualize or quantify consistency in documents
  • General guidance on effectiveTime and statusCode relationships
  • General education needs on CDA and C-CDA

Care Plan

  • Need enhancements to Scorecard for Care Plan
  • IDs in Care Plan on how to use
  • Clarify the use of value in goal observation
  • Use of status for planned and completed interventions
  • Guidance on the use of sub-headings (sub-sections)
  • Guidance on linking across entries in different sections
  • Guidance on use of codes (value sets) for Care Plans
  • Need enhancements for Care Plan Scorecard rubrics


Agenda / Meeting Info / Notes



Scenarios

Track 1 - Referral Note Scenario

  • File:IAT-T1-REF.docx
    • Referral note
    • Medication & Immunization History
    • Problems (open and resolved) with author
    • Other misc. sections


Track 1 - Continuity of Care Scenario

  • File:IAT-T1-CCS.docx
    • Load in content from earlier Referral note
    • Close a previous problem from referral
    • Update smoking history
    • Include a new current medication
    • Include a new Immunization
    • Include record of surgical procedure & implant
    • Include additional content in misc. section

Track 1 - Discharge Summary Scenario

  • File:IAT-T1-DIS.docx
    • Update various medication references
    • Include CBC results
    • Include medical supply
    • Include additional content in misc. section


Track 2 - Care Plan -HANDS-ON-EXPLORATION
The Care Plan track provides participants with the opportunity to explore and share emerging capabilities with creating and consuming care plan information using C-CDA Care Plan Document exchange. Scenario 1 explores the general qualities of all Care Plan Documents. Scenario 2 explores the distinctive qualities present in Care Plan Documents that are "specialty" Care Plans.
Participants are encouraged to show and share C-CDA Care Plan Document samples that demonstrate current progress and implementer challenges. The goal of the Care Plan track is to get the conversation started and to learn collaboratively as the industry begins to share digital care plan information using guidance provided in the C-CDA Implementation Guide for Care Plan Documents.

Track 2 - Care Plan Scenario 1 General Care Plans


  • Participants acting as Care Plan Creators will supply documentation of the patient health story scenario they are supporting, and the associated C-CDA Care Plan Document generated for that scenario. CDA Schema and C-CDA Schematron testing will be performed on provided documents to review identified errors and warnings. The generated C-CDA Care Plan Document also will be reviewed to:
    • Examine Health Concerns
    • Examine Goals
    • Examine Interventions
    • Examine Health Status Evaluations and Outcomes
    • Examine other sections of content that may be present in the document
  • Participants acting as Care Plan Consumers will process the created C-CDA Care Plan Document and demonstrate the extent to which they can:
    • Attach the care plan document to the participants record in their system
    • Render the contents of the document for human review
    • Process available machine entries from the document (to the extent they are available)
  • All participants will address these questions:
    • In what ways does the Care Plan show patient health concerns?
    • In what ways does the Care Plan show patient goals?
    • In what ways does the Care Plan show the patient's goals for care?
    • In what ways does the Care Plan show the patient's treatment preferences for care?
    • In what way does the Care Plan show planned actions for specific goals or specific conditions?
    • In what way does the Care Plan show the progress or completion status associated with interventions or goals?
    • In what way does the Care Plan show or address a patient's self-management care plan?



Track 2 - Care Plan Scenario 2 Specialty Care Plans

  • Participants acting as Care Plan Creators will supply documentation of the patient health story scenario they are supporting, and the associated C-CDA Care Plan Document generated for that scenario. CDA Schema and C-CDA Schematron testing will be performed on provided documents to review identified errors and warnings. The generated C-CDA Care Plan Document also will be reviewed to:
    • Examine Health Concerns
    • Examine Goals
    • Examine Interventions
    • Examine Health Status Evaluations and Outcomes
    • Examine other sections of content that may be present in the document
  • Participants active as Care Plan Consumers will process the created care plan and demonstrate the extent to which they can:
    • Attach the care plan document to the participants record in their system
    • Render the contents of the document for human review
    • Process available machine entries from the document (to the extent they are available)
  • All participants will address these questions:
    • In what ways does the Care Plan show patient health concerns?
    • In what ways does the Care Plan show patient goals?
    • In what ways does the Care Plan show the patient's goals for care?
    • In what ways does the Care Plan show the patient's treatment preferences for care?
    • In what way does the Care Plan show planned actions for specific goals or specific conditions?
    • In what way does the Care Plan show the progress or completion status associated with interventions or goals?
    • In what way does the Care Plan show or address a patient's self-management care plan?

Track 2 - Care Plan -DISCUSSION-

  • What abilities does your system support to customize which of these elements are included within the care plan and how these elements are displayed?
  • What kinds of triggers (e.g. a risk score or event) do you support to indicate different care management actions?
  • How does you system handle care plan version control across care team members?
  • Do you capture the date of the last review or change in plan?
  • Do you generate a scheduled date for reviewing and updating the plan?
  • How are gaps in care identified or planned to be identified?

Pre-Published Patient Information

Pre-Published Practitioner Information

Deliverables/Documents

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