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2017-08-18 Learning Health Systems Call

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Facilitator John Roberts Note taker(s) Emma Jones
Attendee Name Affiliation

X Russell Leftwich InterSystems
X John Roberts Tennessee Department of Health
X Stephen Chu Individual
X Evelyn Gallego ONC
Kathy Walsh LabCorp
Asim Muhammad Philips Research Europe
Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
Jeff Brown Cancerlinq
X Lisa Nelson Individual
Dave Carlson VA
Chris Melo Phillips Healthcare
x Michelle Miller Cerner
Benjamin Kummer Columbia University
Matt Rhan
Michael Padula
x Joseph Quinn
x John Ritter



  • Chair: John Roberts
  • Scribe: Emma Jones
  • Motion to approve previous call minutes: <Russ>/<Emma>


  • Care Team Use Case Development
    • Structure to use
    • Follow the Care Plan Dam model as an example to the Care Team use cases
    • more practical to use the use cases to maximize the relationships between the care team members and the patient and the care team members and each other
    • Used to seeing very skinny use cases
    • more use cases rather than longer uses cases to capture the relationships
    • Need succinct and short use cases - looking for the care team members, roles and relationships and functions to guide story board development. to a certain degree their activity as it relates to consent. Will use this to test the care team model.
    • Need some special attributes (like the issue of consent) that are seperate from relationships, and how we auto mate this.
    • Russ reached out to DS4P folks about the work they've done with consent - they can join us - need to use this to incorporate
    • DS4P
    • Need to add how did this care team member come to the care team - referral, hosp admission, patient referred the care team member, etc
    • Need this so new care team members would know where the rest of the care team members came from
    • Would be needed for care team management and care coordination
    • Snowbird scenarios - Patient may have 2 primary care physicians
    • Use Case: Care Team Initiation and adding or removing care team members
      • Care team under the stewardship of an organization
      • Care team formed under the initiation by patient itself
    • Should we categorized in the story board?
    • Will there be points of views based on scenarios or specialty situations? - pharmacy care team, nursing care team, etc like the care plan DAM story boards.
    • VA care team model - care team fulfilling role on other care teams - Russ asked Dave Carlson to provide use case
    • Public Health use case for public health
    • Use case when there is no care coordination
      • Need to identify the categories in advance to cover particular concepts
    • Started categories
      • collaborative of care storyboard
      • Transition of care storyboard
        • children with special needs will fall into one of these two
      • public health storyboard
      • Research storyboard
      • consent storyboard
      • patient as the care manager (patient does their own care coordination) - may need to fold this into the other storyboards
  • Examples
    • Consent Use Cases
        • See this for the use cases development examples that Stephen has doneGoogle Doc
  • Comments and suggestions
    • Discussion about the use case format - explore usingthis
    • Need to use something that is collaborative
    • Could ask collaborators to do the low level details before adding to the care team dam so that it doesn't become a burden for the care team DAM
    • suggest having a library of use cases to publish with the DAM and make available as a stand alone thing and have other work reference them. Story is developed because reflective of reality.
  • Next steps
    • Russ will reach out to Jonathan and Kathleen to join us for the consent as it relates to DS4P
    • Another overarching issue is care team communication
    • Russ will ask Dave Carlson - care team plays role on another care team
    • Russ will ask Elaine for research care team use case
    • Stephen and Emma will work on cleaning up the document
    • Others to take a look and edit as needed.