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2017-12-15 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
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
x Ann Wiz
Rob Hausum
x Kathleen Mountjoy VA


  • Chair: Russell Leftwich
  • Scribe: Emma Jones

Approval of December 8 meeting minutes: moved: Stephen; Emma Second

Use Case Discussion

  • LTPAC SNF Care Team Storyboard
    • Russ created story board, reviewed
      • Would there be a care coordinator?
      • In Australia a lot of the care providers are contracted providers
      • Who would coordinate the patient care?
        • May have a social worker who coordinates care but there may be many variations
          • Insurance care coordinator
          • Care coordinator on staff - point of contact
          • Physician would be the doctor of record
    • US have 7 different post acute level of care that are recognized by Medicare - except for adult day care services
  • National study of LTC. HIMSS is working with ONC to do another survey
    • Include (driven by payment)
      • In-home care
      • Adult day care
      • Assisted living facilities
      • Intermediate Care OR Skilled Nursing Care facilities
      • Residential Care facilities
      • Continuing Care Retirement Communities
      • Hospitals
      • Hospice (In-home and In-Facility) - we don't have a story board for this one.
  • Suggestion - When looking at new storyboards -need to determine what will the story board add to requirements we have not captured and also bear in mind the 80/20 rules - so we can move forward to the modeling
  • Evelyn will upload the LTPAC community care use cases
  • Mike working on behavioral health related to kids with special needs
  • Emma uploaded link to the DS4P uses cases
  • Russ has spoken with Dave Carlson about the VA effort to coordinate with community care
  • Lisa Questions about the value set progression
    • 27 concepts not available - who is doing the request for SNOWMED concepts?. Has to go thru Jim Case (he did it for the allergy project)?
      • Seem there is not an official process - LOINC seem to have a process but not SNOMED
      • One of the things LHS need is facilitators - modeling and vocabulary. LHS do not currently have that. Is the answer to have Jim Case, Rob Hausum, Rob McClurd add to LHS work group?
      • Need a process. In Australia if there are new concepts - process is thru the SNOMED CT extension. SNOMED CT international takes it into consideration and if international enough will add to the international list. Expectation is this to be replicated in other realms. Suggest the quickest route is to go to US realm first
    • 84 concepts available
      • Want to create value set in VSAC
      • Getting it in VSAC is a place to start as a started set.
    • Suggest Rob Hausum or McClure to be the interface with SNOMED CT and bring back the process we need to use
    • John suggest using the Univ of Tenn vocab facilitator to assist
    • Russ will contact Rob Hausum about this as soon as we get off today's call. If a conversation with Jim Case is needed Russ will follow-up with that.
    • Harmonization happens 3 X year. It's asynchronous to SNOMED but won't go into SNOMED international until it harmonizes. Fill out a harmonization requests - an HL7 thing. This triggers a change to SNOMED and LOINC
    • Lisa asked for Care Team update presentation to SDWG (fixed function code for the body - was in the header but now in the body) - what will it take to change the existing binding to this new value set?

Need the back up for the context of why to use this new valueset.

    • Let's coordinate this off line. Stephen will put together a slide deck to provide the context and lisa will add the technical part.
    • Didn't Laura do a presentation on the summarization of the care team stuff? This was for care plan to ONC - Are there any slides in there for care team that would be at a high level to re-use? Stephen will check
    • Lisa will send an email with description, etc
    • Annette presented to this group about her care team study. Will be good to re-use her information.
    • Next call January