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2017-10-06 Learning Health Systems Call

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Facilitator Russell Leftwich Note taker(s) Emma Jones
Attendee Name Affiliation

X Russell Leftwich InterSystems
John Roberts Tennessee Department of Health
X Stephen Chu Individual
X Evelyn Gallego ONC
Kathy Walsh LabCorp
X Annette DeVito Dabbs
Laura Heermann-Langford Intermountain Healthcare
X Emma Jones Allscripts
Jeff Brown Cancerlinq
X Lisa Nelson Individual
Dave Carlson VA
Chris Melo Phillips Healthcare
Michelle Miller Cerner
Benjamin Kummer Columbia University
Matt Rhan
Michael Padula
X Joseph Quinn
X Thomson Kuhn
Rob Hausum
X Evelyn Gallego ONC
Serafina Versaggi VA


  • Chair: Russell Leftwich
  • Scribe: Emma Jones

LHS Comment to ISA

  • Request consideration for a new subsection representing Dynamic Care Team Management.

Care Managers - Roles, Responsibility and Credentials

  • Discussion
    • multiple certifying bodies with the same sertification
    • Do any accredating organization certify the training? No - the graduates are expected to certifiy via exams or experience (years in the role, etc)
    • Titles can be the same with varying degrees
    • See table 3 of the presentation for exams and eligibility criterias
    • Even with these variation there is little evidence that these roles are attributed to outcomes
      • AAANurses - have attribute positive out comes if the role is an RN
      • Some Social worker organizations have outcome data
    • Some organizations use increase in behavioral health issues to designate a social worker trained in behavioral health as ther care manager
    • All accrediting bodies are US based
    • Certifying body by health system - next step is to contact health systems to assess their job requirements
    • University of Pittsburg Medical System - roles are all over the map - e.g. acute seperate from the ambulatory, etc
    • Difficult to determine what next steps with this data will be
    • LHS interest in how to define some of these roles - as part of the governance of a care team. Trying to determine capability to be the lead in the planning role, etc
      • It would be interesting to see a summary of the various credentials and credentialling organizations. Then a summary of real world job titles and what credentials the job titles called for.
    • Findings so far - Wide variation, poorly defined, lack standizations
    • Problems
      • Unable to identify the differences
      • Unable to attribute differences in coordinations with outcomesUnable to guide practices about best model for their practices
    • Purpose:
      • compare and contrast characteristics (titles, education, disciplines, experience, roles, responsibilities, competencies, certifying bodies)
      • Provide a framework to examine differences and their impact.
    • Were care managers from any payer organizations? Haven't looked at settings yet.
    • AACM credentialing for RN only - but no overaching guidelines.
    • No payer network endorsed a certain certification.
    • Is there relationship between harmonizing certification?
    • CCM - not associated with a particular organization but certified thousands.
    • Re-imbursement driven? typically at the state level.
    • AAN and Social work groups as well as other disciplines with certain level of expertise - have written white papers as to why they are the best fit.
    • How does this relate to the LHS Care Team project?
      • Related to the governance of the care team - who can create the plan, the arbitrar, first line contact with the patient and the process of coordination
    • Study next step - to do contextual inquiries - whether using electronic care plans or not. How care managers interact with others on the care team.
    • Summary: validates the concern that there is no standardization across there roles
    • Starting the write-up for a manuscript.
    • Our value set of care team members and functions - matches with the roles and credentials.
      • This is useful for flushing their functions on the team and the role they play on the team. Second attribute is qualification.
      • Job title does not align with these concepts.
    • Many people filling these roles feel that social workers are more aligned to do a lot of the care coordination tasks.