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Conference call minutes 7 November 2013

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Health Concern Topic

Patient Care WG, November 7, 2013


  • Michael Tan – Chair
  • Elaine Ayres – Scribe
  • Lynette Elliott
  • Stephen Chu
  • Lisa Nelson

Review of use cases received (posted on the wiki):

  1. From various points of view – from Lisa Nelson
    1. Various points of view
    2. Conflicting
  2. How individuals interact with system
  3. Tracking a concern over time
  4. Transitions of care.

The health concern according to Stephen can be divided in two basic concepts:

  • concern as a placeholder for observations
  • concern as a tracking mechanism

The health concern observations can contain issues, risks, problems, diagnosis, plans. The common element in health concerns is that it displays the patient journey over time.

Tracking example – progressive symptoms of asthma with multiple episodes of treatment. Final diagnosis of asthma. Review of observations related to asthma into a tracker (asthma health concern tracker). With CDA’s much confusion about how to organize these various concerns. Therefore, the ability to organize and track is key to this project.

Lisa notes that CDA R2 – have different definitions for “health concern” and “problem concern”. The latter is designed to manage medical concerns which groups together problems, and diagnoses. Now – there is a higher level template called “health concern” to express the patient’s concerns along with provider concerns. The definition of Health concern as it existed in the DSTU version of 2012 now seems more like the problem concern and thus leads to confusion between Patient Care and Structured Docs. This has to be sorted out. Lisa will provide definitions for CDA templates.

We still need additional use cases.

Next meeting will be on November 21 at 4 PM ET.

Action items:

  • Lisa: CDA templates for health concern/ problem concern
  • Stephen: use case stories containing asthma episodes
  • Michael: write introduction on the use case document