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2017-11-10 Learning Health Systems Call

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

x Russell Leftwich InterSystems
x John Roberts Tennessee Department of Health
x Stephen Chu Individual
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
Michelle Miller Cerner
Benjamin Kummer Columbia University
Matt Rhan
x Michael Padula
x Joseph Quinn
Thomson Kuhn
Rob Hausum
x AnnWiz
Serafina Versaggi VA


  • Chair: Russell Leftwich
  • Scribe: Emma Jones
  • Motion to approve previous two call minutes: John Roberts/Stephen Chu

Mission and Charter

  • Finalization and approval needed
  • TSC is going through the mission and charters checking scope areas that are not covered by a work gorup or scope areas that are covered by more than one work groups. HL7 is going through an ANSI audit
  • Are we still focusing on "triple aim"? Has been changed to quadruple aim, taking into consideration the experience of health care providers
  • Discussion about the use of the quadruple-aim
    • Glad to see efficiency has been removed - can do the wrong things in an efficient way
    • Per capital cost relates to effectiveness - can't look at it in silo
  • Hope is not to vote on the Mission and Charter today but to edit it and vote in the near future
  • Russ will make edits and send out for review -
  • Existing relationship section and the scope need to be reviewed
  • Include a reference to the quadruple-aim document in the Mission and Charter

Care Team Use cases

  • Update provided by Stephen
  • Action items from last week -
    • Review the use case document
    • Emma added the IHE/Chronic Condition storyboard
    • John added public health use case
    • Stephen added use case 5
    • Lisa added use case X
    • Mike added use case 6

Review of Use Case 6

  • Children with special needs
    • Attempt made to add a contact point for service line or group
      • This is intended to be an ongoing service.
      • We've talked about distuishing between roles - members of the team that provide the services. Need to distinguish between contributing to the plan Vs just providing

a service.

      • In the event of an acute episode - a way to be able to reach out for the metabolic service or whoever is covering for them
      • CCR, CCD in the early days had an alert section
      • FHIR has the Flag resource - used to be alert. FHIR has category - 0..1 to be able to say what type of 'Alert" it is. Cardinality is 0..1 but could be more than one
      • Suggestion made to add mom as care team member
      • Metabolic specialist - trying to convey that this is a group. The specialist would be a member of this group. When the kids go home, parents are given letters with instructions on what to do in case they need the service for a future episode.
      • Metabolic service could be represented by a care team or organization
    • This use case captures well when a service can be represented by an organization.

Review of Use Case 5

  • Extension the first use case
  • Identified organizations that could be member of the care team. Community services involved in the care team.
  • Aligns well with mike's use case for a clinical care team. This use case identifies non-clinical teams
  • Suggestions:
    • Allow the home helper as an individual - a named person. Stephen will add. Didn't name the person because of the volunteer nature - Will add the service coordinator as a named person.
    • Might want to include contact information for these services as well. Stephen will add to the use case
  • Need a Snow bird use case (someone who lives in one part of the country part of the year and in another part of the country the other part of the year) - Lisa will add.


  • Lisa will review the new obligation instruction and prohibition instruction templates at the patient care co-chair call on Monday at 5pm. Stephen will email out an announcement
  • Call adjourned