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2017-05-17 Conference Call minutes

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  • Laura Heermann Langford
  • Stephen Chu
  • Emma Jones
  • Dave Carlson
  • Evelyn Gallego
  • Iona Thraen
  • Irina Conelly
  • Jay Lyle
  • Michelle Miller
  • Michael Padula


  • Agenda
    • ONC update in convening the Care Plan vendors – feedback on the standard
    • Updates from Dave Carlson

  • Minutes
    • 1. ONC update in convening the Care Plan vendors – feedback on the standard – Evelyn
    • a. There is robust functionality in the vendor base.
    • b. June 22 HL7 CCDA implementationathon. All are being invited.
    • c. Datuit – using both CCDA and FHIR. The challenge is they need to live in both worlds. But moving forward they are going down the FHIR route.
    • d. Feedback – key takeaway for ONC is the CCDA is useful for the generation and initial care plan but as you move down the road and updating the FHIR route is better.
    • e. In real life – there ends up being only one role… and often it is the care manager in the coordination role – the one assigned to make the updates, changes etc. Four vendors have reported this. It is very hard to get the physicians to care about the care plan. It is changing under value based models – but they are slow to embrace the care plan.
    • i. Will talk more about it at the care team meeting
    • f. Biggest challenge to the vendors are the standards are not harmonized. There is a big ask for harmonization between Care plan CCDA template and FHIR.
    • g.
  • 2. Updates from Dave Carlson
    • a. Datuit – Dave has organized to connectathons – January San An and the mini coonectathon in April at the payor thing. Dave has been helping Gordy updating his server to STU3 along with help from Jeff Danford (allscripts).
    • b. Connectathons have been helpful.
    • c. An internal VA presentation given today. The potential and value of the APIs (not just sharing and exchanging documents – but making the data available by applications or by patients.) Dave continues to evolve his mobile app for the patient (not VA – but personal R&D project). Patient use application. Accessing care plan and other resources through APIs – the CCDA has not been useful at all in that aspect. Dave has tested his app against gordy’s server at the April event. Gordy is populating his database with CCDA records.
    • d. Looking at September meeting – starting to plan themes for that connectathon. So we can start doing analysis as well as with implementers some scenarios to test. The academy of Nutrition and Dietetics – Margaret… evaluation of nutrition order. There is discussion about how nutrition fits within care plan. Expect that to be a tract. Malnutrition storyboard…Leslie, Margaret – ADA - Nutrition on FHIR – have submitted it to HIMSS for a possible Interoperability showcase use case. Storyboard is being developed -
    • e. Another theme is accessing the data through APIs – integration with CDSS. Progress towards outcomes or goals? Outcomes based management. Looking at examples from Bryn Rhodes. Clinical Reasoning tract at the April Connectathon. Care plan with measureable goals, and then with CDS Hooks evaluate if the findings/outcomes have met the goals. (patient generated or provider provided data). Perhaps provide the patient with feedback.
    • f. Would like to know more from Iona and the shared care plan -
    • g. Using the CCDA for the assessment process and then using

FHIR for the on-gong iterative Care Planning – interesting concept.

    • h. Evelyn suggests and would like to see the components tested at the CCDA connectathon in the FHIR connectathon track.

  • 3. HL7 activities,_Spain:_May_6_to_May_12#Patient_Care_Thursday_Q1a
  • 4.
  • 5. Review of upcoming Care Plan activities
  • 6. FHIR – Activity Statement – There was a discussion on the procedure side asking if we need to split it up into….. Contrast is the Procedure statement – is where the patient states where a procedure was done (with and without details)
    • a. Similar discussion regarding nutrition statement
    • b. Then also another discussion around activity statement….
    • c. Procedure will be done in the Thursday calls – lets work through that one first on Thursdays and then see where that goes.
    • d. Care plan will be a user of the activity statement…. So may need to bring it to the care plan call.
  • 7. Care Plan Activity Status – could do on Wednesday or Thursdays. Do touch it on Wednesday if we can.
  • 8. CCDA – Clinical Status FUP – SD deprecated a couple of statuses… Stephen worked on it and presented (again) to SD. This time they said we needed to do 3 things – 1) harmonize vocabulary, 2) enter in CCDA STU comments as a future update (cannot be done as an errata as that is meant for technical changes to the IG)- errata has to be submitted by June1, 3) if not done as errata then needs be submitted as an update to the CCDA ballot – Perhaps Sept - but likely would be the January ballot – Emma has entered in the STU ballot comment – will initially address at the ClinonFHIR call Tues next week. Emma will try to pull the team together tomorrow to discuss the vocabulary harmonization discussion with Rob Hausem.

9. Information for Special Needs -

Put the notes here: