LHS May 2018 Cologne Agenda

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  • Learning Health System wiki page
  • WGM Information

• Co-chairs
  • Russ Leftwich, MD (attending)
  • John Roberts (attending)

• Agenda
  • Wednesday Q3 - Business meeting
  • Thursday Q1 - meeting jointly with Patient Care WG - Care Plan/Care Team topic.
    • Care Team Domain Analysis Model discussion
      • complete Model requirements
      • Overview of ONC Healthcare Directory Project - any impact to Care team modeling?

Icons:

• Business meeting
• Ballot Reconciliation meeting
• Technical discussion

Thursday Q4

Agenda Overview

• Introductions and sign in
  • See attendance is here
• Approval of Mission and Charter
  • Learning Health Systems Mission and Charter
  • Mission and Charter Updates - Jay moved to adopt the changes; Laura second; 1 abstain; 0 against; 6 for.

Further discussion - what are the boundaries between patient care and LHS? No other workgroup have a system wide view. All work groups are at the domain level. Take care team as an example. Care teams are typically at the patient care level - does not take into account public health and research. Same apply to care management. When something is rejected because of CDS - what is the feedback loop? or if the clinician rejects a recommendation? what is the feedback loop? the care team is a gap from a learning health systems. the idea came from IOM - has 14 articles about LHS but is has not been implemented.

• Approval of DMP
  • Learning Health Systems Decision Making Practices
  • Adoption of the new HL7 Decision Making practices template. No changes needed. Quorum is co-chair + two other WG members - Michelle moved for reaffirmation to accept as is; Jay second;

1 abstain; 0 against; 6 for.

• Meeting times for Baltimore - Will continue this quarter in Baltimore
• Call times - Continue 4pm EST on Wednesday
• Other business
  • Invitation to PA - need a more specific agenda.
    • representation of community providers in health systems is very difficult.
    • representation of total expenditure for medicaid for the whole US has non-clinical expenditure higher than clinical expenditure.
• Modeling for care team DAM
  • Some work done with Claude with goal of creating CIMI models for a comment only ballot
  • CIMI model is re-considering their basic approach.
  • CIMI has learned about FHIR workflow models and CIMI has patterns. ToDo - CIMI folks are planning on joining the FHIR workflow calls to see where CIMI has extra

things and how the work in both speces come together. Need to have the mapping patterns to compare the different. there is also discussions about the need to change CIMI modeling tool

• • what is the problem that CIMI solves for us? Its implementation independent, specification of the semantics required from the clinical perspective. Include emphasis

on the terminology. the structure and the content from the clinical perspective.

• • CIMI has discussed exploring the use of structureDefinition to address CIMI modeling needs. Still investigation. Should not have any implications for Care team.
  • Discussion about the care team modeling work. See notes here
    • Currently in the requirements gatherign stage. Next is the modeling. Do a comparison to FHIR - see if need to do propose modifications to FHIR.
    • OpenAir CIMI representation
    • Logical FHIR representation.
    • Discussion about how care teams are represented in EHRs today and how does it relates to CIMI?
    • Suggestion to take a practical approach to this.
    • Claude need examples from the field - will be helpful.
    • Suggest the US is not the best place to start model based on. canada and europeans have done this.
    • Suggestion that the go forward plan is to pick a simplier one.
    • Suggestion made to take the existing careteam FHIR resource and start from there. Bringing a FHIR model into CIMI is trivial.