December 02, 2014 CBCC Conference Call

Community-Based Collaborative Care Working Group Meeting

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Attendees

x	Member Name		x	Member Name		x	Member Name
x	Johnathan ColemanCBCC Co-Chair		.	Wende Baker		.	Steve Eichner
x	Suzanne Gonzales-Webb CBCC Co-Chair		.	Mike Lardiere		.	Rita Torkzadeh
x	Jim Kretz CBCC Co-Chair		.	Lori Simon		.	Paul Knapp
.	Max Walker CBCC Co-Chair		.	Mohammed Jafari		.	Harry Rhodes
x	Kathleen Connor		.	Ioana Singureanu		.	Tony Weida
x	Diana Proud-Madruga		.	Steve Daviss		.	Bob Yencha
x	Serafina Versaggi		.	Marlowe Greenberg		.	Chris Clark, WV
x	Rick Grow		.	Matt Peeling		x	Brian Newton
x	Lisa Nelson		.	Amanda Nash		.	Kathy Odorow
	Ken Salyards		x	John Moehrke		.	Toria Thompson, Colorado
.	Neelima Chennamaraja		.	Ken Ortbals		x	Oliver Lawless
x	Reed Gelzer		.	Mike Davis Security Co-Chair .		.	David Tao
.	Robert Dieterle		.	[		.	[ .

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Agenda DRAFT

1. (05 min) Roll Call, Approve Meeting Minutes from November 23
2. (05 min) Action Item Review
   1. (05 min) HL7 Implementation Guide for CDA Release 2: Privacy Consent Directives, Release 1 - Ballot Reconciliation Update
   2. (05 min) Patient Friendly Natural Language - Update on PFL map to HCS and development of FHIR Consent Directive Suite See CBCC PFL Wiki page for:

• Consent Directive Profile spreadsheet
• FHIR Contract Resource spreadsheet

1. (05 min) Patient Friendly Natural Language - Domain and Scope for the PFL Language
2. (30 min) Data Provenance - Vote on whether to withdraw from Jan Ballot. Review and vote on proposed ballot dispositions Proposed DPROV CDA IG dispositions as of 12-01. Comment dispositions for voters asking for in person reconciliation will be prioritized if those voters attend the call.

Meeting minutes from November 25 were unanimously approved.

January 2015 HL7 WGM in San Antonio, TX

Suzanne has posted the agenda template, with some DRAFT agenda items, to the CBCC Wiki. CBCC WG members were asked to please send any information that they would like to be added to the WGM agenda.

Patient Friendly Natural Language

Update on PFL map to HCS

Suzanne has transferred the patient friendly consent directive template out of the spreadsheet and into a Word document. As a result, the template is now in a ballot format. The CBCC WG will have a chance to review this draft ballot template once completed in next week's meeting, and through email correspondence. Rick additionally rewrote the purpose of use (POU) categories in accord with the recommendations made by the CBCC WG last week.

Update on development of FHIR Consent Directive Suite

We walked through the steps of the Consent Directive Profile and the FHIR Contract Resource spreadsheets, and the information that was covered was approved.

Kathleen walked us through the steps. This conversation is detailed below.

Kathleen: "Most of this builds off what John put down as a straw man. We walked through a contract and it has a header level, which says you’ll be my friend (this is a grantor, grantee type of thing). You have a witness, you have a notary…or you could have a contract saying Suzanne and Kathleen are going to be friends and there are terms to our friendship. The first one will be: we’ll remember each other’s birthdays. That would be contract term 1. We can have contract term 2: we will buy presents for each other on our birthdays, but we will not spend more than $5. And, we could also say this contract is only effective in the U.S. So, we can talk about the domain. We can say there’s an authority. We filed this in a court of law, so it has a binding authority. We could scan and sign it, or we could simply have a URI if you wanted to sign it someplace on the Web. We could have it in very friendly terms, where we could have flowers and have happy faces all over it, and that would be our friendly version. It could be something in a repository, or it could be something that could be pulled out from a FHIR server. We could also have a copy that we signed. We could have several friendly versions where Suzanne did it with flowers and I did it with butterflies. We could have several that were not signed, like this was version 1 and this was version 2. Or here is a template for having a friendship contract. And we could even create some kind of policy language to talk about whether Suzanne and I had in fact sent emails to report our compliance. You could have that in bold language.

So, all those components are in this contract at this point, and we have various signers. You can have a notary, you can have a witness, etc. One thing that we did run into – that I’d specifically like to address to John – is that we’re having to put in date/time for every one of our attachments, which is unfortunate."

John: "With the contract resource itself, it has the date/time, and all of the attachments would be the same. There’s the issued date and then there’s the period in which the terms are open. Why would you have different date/time per attachment?"

Kathleen: "There is an ongoing difference of opinion about whether attachments should have the date/time in it, versus forcing folks to put it in as an extra element, so that’s an outstanding methodology issue."

John: "I was expecting the three attachments – the friendly, legal and the rule – to be intentionally the same meaning per version of a particular instance of a contract."

Kathleen: "Let’s have a consent directive and it’s in Spanish and in English and patient friendly. Maybe there’s 6th grade level and 12th grade level versions. The content is meant to be the same, but they could look very different. Another thing I just wanted to point out is that we have it so you can put it in as an attachment and/or a document reference.

One more thing: we differentiated between a policy profile, a contract profile, and a consent directive profile. If you had a policy like a privacy law, it’s not a binding contract, so maybe you can say, “Here you can find it in the Federal Registry; here’s the date on which it was published…” That’s different from saying, “Suzanne and I signed a contract and it’s stamped by a notary.” That binding contract is separate and it’s zero-to-one."

John: "So, you’re keeping the legal at zero-to-one?"

Kathleen: "No. Legal can mean something that is not signed. So, we meant zero-to-many. If you wanted to talk about policy, and you wanted to say that there is a policy and that it is not binding policy, you can do that in legal. It’s use case specific, but it makes a differentiation because bunching them together causes issues with respect to being able to do policies that are not contracts or where you might want to have two versions of that one version."

Ballot Reconciliation - HL7 Implementation Guide for CDA Release 2: Privacy Consent Directives, Release 1

• E-mail requesting withdrawal of negative votes from commenters has been sent via HL7 balloting per deadline/Lynne Laasko on 12/1/2014

Ballot Reconciliation - DATAPROV_R1_D1_2014SEP

The CBCC WG passed a motion to withdraw the Notification of Intent to Ballot (NIB) for the Data Provenance project. Kathleen had put in a NIB as a placeholder in case the project team came up with huge changes. In that case, the team would have felt more comfortable taking the project to a second ballot (and not to ballot in January 2015). The ballot will be published as a DSTU ballot.

Kathleen has resolved the technical comments on the ballot and is working with commenters on approaches that would make them feel comfortable. The CBCC WG worked through several of the dispositions in this week's meeting, and passed a motion to approve the dispositions.

Going forward, the CBCC WG will set aside time in its meetings to resolve additional dispositions. In person reconciliations:

• Bob Dieterle - on board for next week's meeting
• Benjamin Flessner, Epic

Action Items

• [Completed] Rick to rewrite the POU categories in accord with the recommendations made by the WG.

• [Completed] Suzanne to follow up with Ioana and Serafina on the status of the CDA IG for Privacy Consent Directives.

Meeting adjourned at 1203 PST