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2017-12-08 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
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 Optum
Thomson Kuhn
Rob Hausum
Serafina Versaggi VA


  • Chair: Russell Leftwich
  • Scribe: Emma Jones

Approval of November 24th meeting minutes: moved: Stephen; Emma Second

Use Cases

  • Behavioral health
    • Suggest having behavioral health integrated within the other use cases. Prevent having behavioral health in a silo by itself
  • Child health
    • Mike Padula working with nutrition - suggest a use case from this collaboration
  • Community base care
    • Suggest calling that out as human services or long term services and support
    • Goes beyond clinical setting
    • Evelyn - have several use cases. Will look at LHS use cases and provide sample use cases
  • Lisa presented use case 8 - 2 daughters living in different states share care of elderly parent
    • Discussion
      • Two care teams - one where each daughter live
      • Treatment plan vs Care Plan - Suggestion to use just Care Plan
      • listed type of information shared and description
    • Noted that majority of folks does not have a PCP as in the storyboards. May have PCP on the insurance card or someone they may have seen only once
    • Specialists are not always duplicated in both locations
    • Might have providers folks see regularly and ones they see on stand-by (this need to be an attribute for the DAM)
    • Need to take patient preference into consideration as an attribute for the DAM
    • Payer perspective - a payer might be more interested in having their patients in a certain market for value based care
    • Patients can cross country boundaries - some due to payer dynamics and less out-of-pocket costs.
  • Suggestion to make a use case with payer variants rather than forcing it into this one use case
  • Have enough use cases to start the modeling. The following are suggested started set for the modeling:
    • Individual in a SNF and have special consideration around the patient's care teams
      • Employees in the facility becomes the patient care team - most SNF has a medical director who becomes the patient's PCP and bill for services. If another provider sees the patient is at risk for not

getting paid. This is disruptive to care teams (whoever the patient's care team was before will no longer be the patient's care team)

      • Changing care team members as part fo this use case
      • Russ volunteered to create
    • Veteran receiving part of their care from the VA and part from community providers - this might get interests from the VA
    • Suggest a use case where a person is locked in (e.g. prison - places restrictions on who can be care team members and on patient preferences as well)
  • Next steps
    • Russ volunteer to create the SNF use case
    • Russ will ask Dave Carlson to do the VA and community care use case
    • Need to start to shift gears and identify how to get the modeling done
    • Need UML or some sort of modeling artifact. Suggestions:
    • Michel with Furore might be willing to work with us on modeling tool - Russ is meeting with Ewout next week, will discuss this possibility
    • Julia Skapik works for Cognitive health and they do modeling - she has access to modelers.
    • Will follow up with Michelle Miller - if she has modeling contacts.
    • We have a call next week but will be the last call for December