Pressure Ulcer Prevention 20110214

HL7 project team meeting, 14 February, 2011, 12:00 PM ET

Dial-in

Back to Pressure Ulcer Prevention

Attendees

Patty Greim	Y	Jay Lyle	Y
Ioana Singureanu		John Carter
Catherine Hoang		Moon-Hee Lee
Mimi Haberfeld		Donna DuLong	Y
Charlie Selhorst	Y	Sherri Simons
You-Ying Whipple	Y	Holly Miller	Y
Walter Suarez		Susan Matney	Y

Agenda

1. Agenda check
2. PSS has been accepted
3. Clinical experts in process
4. Move Presidents Day meeting to Wednesday
5. Agenda change: DDL has a lot of these questions answered, so we are going to address those she knows she has not already
6. Detailed review of class diagrams
   1. Categories and examples: how to encode a concept parent? e.g. diabetes
   2. Readability: color code observables vs chart (& chart terms)
   3. Number of actors for item or assessment?
   4. age: patient, not instrument
   5. Snap in abnormality model
   6. Snap in care plan: is anyone familiar with the Care Plan project?

Minutes

As Donna's documentation answers many of the questions listed, we did not review every question, but we did address several.

We don't yet have an HL7 line on the HL7 calendar.

Question: should the assessor be associated with the entire assessment, with the section, or with each question? I.e., how many people can collaborate on an assessment, and at what level? Tentative answer: a team may have many different people answering questions. Tabled for reevaluation after we've looked at all the classes.

Question: is Braden numeric? It's ordinal. Meta-model note: we'll import the HL7 data types and use those to avoid ambiguity.

Question: are the Braden age ranges appropriate in all cases, e.g., a 19-year-old with cerebral palsy? Open.

Question: How best to code conditions, if the value sets are not exhaustive? This may proceed on a case-by-case basis; 'fracture' may have a single parent for all relevant values (and no extraneous ones), whereas 'diabetes' may not.

Observation: make all condition specializations congruent. OK to have different specializations, as long as they are commensurate.

Question: how to model the source of information. See 'source' in HL7. May be system, relative, patient.

Decision: History is irrelevant: we want the current problem list. True for mental illness. True for COPD (chronic). True for CHF. Not true for pressure ulcers: treat them differently. Identify source in EHR, a la e-measures. It's Problem list.

Question: True for all?

Decision: Model Ulcer as another condition here (rather than at top, as in draft); include specific properties (stage, location, structure).

Question: how best to coordinate with ICNP?

Question: In Adherence, how do we know there is a plan? We need to work with the Care Plan team to ensure our models harmonize. For our purposes, adherence is a risk factor, so we don't need to know too much--though we may need a null value for "there is no plan," at least.

Action Items

ID	Item	Who	Due	Status	Notes
11	Determine whether modeling tool can support vocabulary metadata in a readable format	Jay	2/21	IP
10	Identify clinical experts we want to review the ballot	Team	2/14	IP
9	Send out schedule with model packages assigned to dates; request for team to address specific questions	Jay	2/10	closed
3	Confirm workgroup sponsorship from Patient Care or Clinical Interoperability Council or both	Patty and Holly	2/9	closed	Working on scheduling time with Stephen Chu (1/20) Meeting for 2/9, per Wm Goossen (1/24). Accepted in PC 2/9
4	Find out from Moon Hee how we can encourage or support more participation	Patty		closed	Time change seemed to work well
5	Contact Audrey Dickerson to clarify how IHE specifications relate, affect us	Holly		closed	Met; FSA to be considered in model
6	Contact SMEs to coordinate clinical input into the model	Holly		IP
8	Find a better time for this meeting	Jay, Holly		Closed	Moved to 3 pm ET
7	Ensure 2/9 PC meeting time is sent to KP participants	Jay		Closed	HL7 info sent 2/1
1	please send feedback on the project scope statement	All	1/17	Closed
2	meet to clarify the model boundaries	Jay and Donna	1/11	Closed	We recommend that the conceptual scope be “Pressure Ulcer Risk Assessment” and "Intervention," two key focuses of the KP-VA model.

Issues

ID	Issue	Recorded	Status	Notes
2	No official HL7 project sponsor	1/10	Closed	See action item 3, in process (1/12) PC probably; needs meeting to confirm (1/19); approved 2/9
1	Model boundaries unclear	1/10	Closed	See action item 2, to be confirmed (1/12) Clarified in meeting (1/19)