2017-11-17 Learning Health Systems Call

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
	Michelle Miller	Cerner
	Benjamin Kummer	Columbia University
	Matt Rhan
	Michael Padula
x	Joseph Quinn
	Thomson Kuhn
	Rob Hausum
	Serafina Versaggi	VA

Minutes

• Chair: John Roberts
• Scribe: Emma Jones

• Approve Last Meeting Minutes - Stephen Moved; Lisa second
• Cancel next week call - No objections

CIC (Clinical Interoperability Council) PSS - Common data elements for registries

• Project scope statement - Russ (CIC co-chair) - states the PSS has been difficult to do because the data element should not be any different from Common Clinical Data Elements used in clinical care, population health, quality measures, etc
• Previous interaction with PC was about creating the CDA structure. This group need more information about what this PSS is about.
• Not the same as the CIMI work
• CIC need to make sure the data element is understood by everyone. Some data elements is not recoginized by everyone
• What do they mean by 'data elements' - Common Clinical Data Set for MU is not really data elements
• ISO 1-1179 - specifies what constitutes data elements. CIC need to adhere to what standards is necessary to specify data element.
• SDC profile and IHE profile specifies data elements
• Per Evelyn, two new projects under ONC that has just started- one focus on clinical registries - common data model
  • How is this relevant to the CIC PSS?
  • Data element and data model - is this a data dictionary or a data model (e.g. FHIR resource and repository to collect them)?
  • NLM has common data element registries - single source of truth. To provide one shop stop (use for research or clinical care, etc)
  • Precore(?) work is new, just started.
• Per Russ, CIC project has not been approved by CIC - was put forward by a few individuals and have not been discussed in CIC. We don't need to discuss this yet.
• Reiteration that Russ is co-chair of CIC. John moved that Russ be LHS representative with respect to CIC proposed project and to advise LHS at appropriate time about actions to take
  • No further discussion - 0 abstain /0 against /7 for.
• Noted the PSS already shows LHS as 'TBD' co-sponsor as well as PC. Public Health is co-sponsor (John is aware)

Story board: update

• Continue updates from last week
  • Stephen made updates as discussed last week
    • Added community service manager and contact information
    • Explanation that the use case was done this way because the organization relies heavily on the volunteers
    • suggestion to remove the word 'manager' to reflect the care team as the organizaton
    • Noted that CDA structure has a person and the person has an organization - able to represent the organization without needing to use the person

Story board: Use Case 7

• Lisa presented the use case
  • Individuals as well as "staff is on the care team
  • Suggestion to make each member their own line to be able to describe their role. By doing this will be able to name a named person
  • Addressed consent - following the other use cases pattern
  • Noted that access to patient's PHR not accessible to all care team members - just the patient daughter
  • Use case is from the patient and care giver perspection
    • Evelyn pointed out that ONC is hearing a lot about easing the burden on the caregiver and the need for caregivers to coordinate care

Story board: Next use case from Lisa

• Caring for a parent where multiple siblings are sharing the caregiver role across different states (related to the Snow bird situation)
  • Relates to HL7 Care Plan work - CCS - RACI notion and family pecking order. Gets very involved and include the need to have the provider know which caregiver calls the shot.
  • Lisa will work on this one for next call

Story board: Public health Use cases

• John presented the use cases
  • Use Case 1: public health provider is consulting and participating in the care of the patient - Public Health program is providing some health care for the patient
    • The PCP is coordinating. The public health provider is an indirect member of the care team
  • Use Case 2: Nurse Cratchet performing duty as public health professional that has an effect on patient care
    • public health professionals can perform primary care
    • In this situation, the patient knows the public health providers are part of their care team - there is no distinction from primary providers - they are their providers
  • Use Case 3: purely population health - Is this consider part of the care care team?
    • May be an indirect part of the care team - their interventions as it relates to the patient is documented and used by other members of the care team - i.e. nurses. This is common in home health or community health nursing.