May 23, 2017 CBCC Conference Call

Community-Based Collaborative Care Working Group Meeting

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Meeting Information

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Attendees

	Member Name		x	Member Name		x	Member Name		x	Member Name
x	Johnathan ColemanCBCC Co-Chair		x	Suzanne Gonzales-Webb CBCC Co-Chair		.	Jim Kretz CBCC Co-Chair		x	David Pyke CBCC Co-Chair
x	Kathleen Connor Security Co-Chair		.	Mike Davis		.	John Moehrke Security Co-Chair		x	Diana Proud-Madruga SOA Co-Chair
.	Mohammed Jafari		.	Glen Marshall		.	Ken Salyards		.	Ken Sinn
.	David Staggs		x	Steve Eichner		.	Ioana Singureanu		x	Beth Pumo
x	Chris Shawn		.	Neelima Chennamaraja		.	Joe Lamy		.	Joseph Quinn
.	David Tao, Mobile Health		.	Nathan Botts, Mobile Health		.	Milo Janowski, Abbvie Pharmaceutical company]		.
.	[		.	[		.	[		.

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Agenda

1. (05 min) Roll Call, Approve Agenda
2. Approve Meeting Minutes
3. (05 min) PASS Audit
4. (05 min) Security and Privacy Impact Assessment Cookbook (SPIA) - Mike Davis
5. (05 min) Post HIMSS Meeting, after Action Report and To-DO list - MDavis, KSalyards
6. (05 min) FHIR Consent Issue Resolution FRIDAY call update discussion reminder
   • FHIR Consent discussion
   • Friday FHIR CP Consent Meetings are 2:00ET - calls to resume this Friday
   • FHIR Consent CPs are located: link to ALL Change requests
7. May WGM DRAFT Agenda, Minutes
8. New Project NIBs? September 2017 Ballot Cycle

Please contact a CBCC Co-chair if you wish to add agenda items! Thank you!

MEETING MINUTES

PASS Audit Unsure who is taking over the document update

• Diana is still an SOA co-chair
• request made to SOA to find out who will be doing th eupates (Diana)

SPIA Mike is okay with someone else taking the document over Volunteers from groom - no answer from current attendees

• JOhn Moehrke was nominated for taking over on behalf of CBCC; David will notify

small update from Spain Information from outside the US Berndt did some wonderful presentation; (ontology) 19 documents trust framework;

• David will send Bernd a heads-up e-mail and will post documents in gForge : <<link:>>

post HIMSS meeting link added to HL7 wiki <<add link>>

• front page of security; several links to Bernd presentation

mHIN and VA work

CBCC FHIR Friday no meeting FHIR Managemnt group is supposed to be meeting tomorrow by adding additional scope

• dual role of security, AND patient care
• deemed by FHIR group/FRI - may be confusing for developers and may not be optimal
• FMG will be looking at whether this should be done as separate or single resrouces;
• J - raised concerned that conversation had not been back to CBCC WG ; only copied but no opportunity for discussion; now there has been a proposal made without the word from the main CBCC WG and snc we are
• purelyprivacy or different variations, different consent in direcgtives does not automatically mean developed/managed/processed by another workgroup

hitspt tiger team and the work done there; working on consent; those members are still here in CBCC/participating in CBCC; would hate the work to pawned off to antoehr WG

• K - would echo there are manay wGs who are building profiles/bundles that bring in references resources by other WGs; there arethings in PC medical procedures/approaches ues, where adv directives kick in; we can profile one of those resources and
• Mike; I thought our concept from the beginner the consent directive was a description of patient choies in healthcare; whether privacy or medical there are still choices / which is correct
• this has since evolved to include different patient choices; sounds like convo came to the conclsion that perhaps the consent resolurce will be overloaded; and then moved to FMG without further input from CBCC (from behind closed doors)
• should this be privacy resource only; or both
  • not that we should have only one consent resource

• • brought forth before spain; no one commented at that time; David determendt that this meant this was not an issue
  • possible confusion on

MOTION: (Johnathan/JIm* we should have input to the FMG discussion or have FMG invited to our meeting; have a technical discussion... not just on the Friday call.

• this should be a topic fromt he cbcc WG would ask FMG to withdraw that item as a topic for discussion at this time until CBCC group has discussion and made a decision/concucurence and then return to FMG with our recommendation. DaveP will take information to FMG with

objections: zero ; abstentions: none in favor: 16 (Diana to provide actual count)

David will contact Lloyd that CBCC would like to hold off on FMG discussion for now

CBCC FHIR Friday will be meeting this Friday

WGM meeting minutes: will be posted once loaded into propeor format (Dave P)

Bh Cross pa finalized the model updates ready to publish request to widraw negative comments; need co-chair assistance Sept 2016 / ballot cycle BH Cross Paradigm

Two opportunton via ONC Dta provenance challenge deadline has not passed applications have been received announcement is approx. june second week technical demo to follow from winners

ONC patience choice tech moving foraward with phas 4 piloting on consent fo research pilots have been received to further the developme the appropriate standaards there nice to see uptake here and in security as well

some areas of concern in privacy (Mike Davis) concern about of relations of privacy system of US with EU divergent courses; we are getting less EU more security

• since we are an internation group; the new EU directive; unsure if ONC is paying attentionto this if impacting any current projects
  • know that there was stds collation (USTU?) ; ONC leading was forcution of standars that were in brouad use in EU and not in US; not sure if there were involved n the policy issues... good question

• present trump signed an amendment to law; gives VA the authority to send patient protectied information (include BH) for purpose of referrals. this is interesting; unsure of implecation... this is a policy matter but will affect manypeopol on the call
  • thanks for bringing that up; we will have to hav efurther discussion/expertise. it sounded there was still requirement to include

II no proghibtion on redisclolesure

• • video and fact sheets on changes; one changes providers can no longer can bill for veternal choice program whichwill in turn coordiatie with other plans. they will vgo after other payment plays

pOU: payment; providers will have to redisclose back to the VA and VA will in turn contact payers

off line conversation interesting perspective in law

food for thought; 42CFR part II; the hcanges made it clearer that disclosures to a non-.. facility; that part II becomes legal protector of the information; if the VA is not covered by part II but is releasing that information... there is an execptioin for theVA with VA, the question is does the exemption still hold? Va doesn't have to

• clarification needed

Jim sent note to management; has not heard word back

• M concernt might be; witht he VA; with the size of the agency... weire sending out 42CFR info without constraints. which is illogication (not a legal point of view); these two lawas are connected by the exceptions and should be considered a pair... they impact each other.

the local provider if received data from 42cfr they are constraint from redistribution; but if they receive information from antoehr source...they are not held to that same level

a nonpart 2 provider ; if they got a copy of the same thing but treat each record differently

Mike: community graps the notion that there are different POUs for different purposes

• i.e. POU treatment, ER access are very distinct
• recently fournd that some providers with respect to pat consent; if you opt out of sharing your info, we won't share your information even int he event of an ememrgey (ki.e. we will let you die...); the notion that we would let peopolel die to protect hteir information is odd ; not sure how to deal with this... maybe a paper coming out of CBCC regarding best practices--this is not a good idea in the US
• we do have other POU and should encourage the use of them
• break glass for treatment vs break glass for emergency treatment
• ememgecy room vs emergency vs treatment

available white paper for POU, Mike / links on security wiki page we should approach sequoia; the business of ER access; encourage to implement to have other options... ask sequoia to adopt the hl7 code system

• sequoia uses treat' (vs hl7 as 'treatment')

Mike: XSPA SAML - was balloted and given public review. the original saml (HITSP das) v2 when balloted will refere entirely to the HL7 code sets, because oasis is not an appropoate place to define the codes NSTIC is interested in adopting the XSPA SAMl v2

Motion to adjourn (JIm/johnanthan) 1152 AZT --Suzannegw (talk) 14:53, 23 May 2017 (EDT)