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Care Plan Project 2012

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Return to: Patient Care

Got to:

- Current Care Plan Project - PCWG wiki page (from 2017)
- Care Plan Project - PCWG (2015 onward)

This is a Care Plan Project initiated in 2012.
This wiki page contains latest contents for the Care Project post September 2012 WGM at Baltimore.
It includes information on a collaboration project with SOA group to define Care Coordination Services (CCS)


Care Plan has been balloted in 2007 as DSTU. However, a number of ballot issues were not resolved satisfactorily and consequently the balloted contents did not reach DSTU status.

The project plan initiated in 2011 is to first develop a Domain Analysis Model (DAM) for the Care Plan, and then decide on follow on activities. The HDF 1.5 (HL7 development framework) approach will be followed. HL7 PC will work together with various groups including HL7 Work Groups (e.g. EHR, Structured documents), IHE, NEHTA, Canada Health Infoway, and others.

Project Co-Leaders

Laura Heermann Langford
Intermountain Healthcare, USA
Phone: 801.290.6888
Stephen Chu, MD
NEHTA Australia
Phone: +61.416.960.333

Meeting Information

  • Fortnightly: every second Wednesday at 17h00 NA Eastern Time /16h00 NA Central Time/ 15h00 NA Midwest Time/ 14h00 NA Pacific Time/ 22h00 UK / 23h00 Central Europe / 07h00 Australia (Eastern Standard Time)
    • Interim meetings can be scheduled if needed.

  • Call Logistics- voice
    • Phone Number: 770-657-9270
    • Participant Passcode: 943377#

  • Call Logistics- screen sharing/

Web conferencing URL:
To be announced

Meeting Agendas and Minutes
Post September 2012 Baltimore WGM Meetings:

Agendas and Minutes

Archives of Meeting Agenda and Minutes prior to September 2012 Baltimore WGM:

Agendas and Minutes Archive

Important Discussion Topics

During the development of the Care Plan models and related work, a number of topics continue to attract numerous inputs and debates.

They include:

  • Types of Plan: The concepts "Care Plan", "Plan of Care" and "Treatment/management Plan" attracted extensive debates over a long period of time. Summary of the discussions and final resolution/decision is available on this wiki page:
Types of Plan - Differentiation and Definitions (This topic replaces previous topic: Care Plan Definition)

  • Health Concern: The Health Concern topic has been extensively debated on a number of HL7 Workgroup mailing lists.
PCWG has a Health Concern project with the objectives of clearing defining this topic and related concepts, and how these concepts are used in patient care. Information on the Health Concern project can be access through this wiki:
Health Concern
How the Health Concern and Concern Tracking topics are related to the "Health Concern", "Health Goal", "Care Activity", etc concepts identified in the Care Plan Domain Analysis Model will also be addressed by the Health Concern project

  • Care Team: The composition of Care Team has also be discussed quite extensively and evolves over time. It is anticipated that this will continue to attract discussions and will continue to evolve.
Currently, the following is a list of roles/professional roles that is considered as care team members:
- Medical Practitioners (including all specialties and sub-specialties)
- Nurses
- Allied Health Practitioners (including Physiotherapist, Occupational Therapist, Speech Therapist, Psychologist, Pharmacist, etc)
- Social workers
- Care Managers, Disease Managers, Care Coordinators
- Patient
- Nominated patient family members
- Care givers/carers

Care Plan Model and C-CDA Templates

C-CDA R2 includes a set of sections and entry templates to support care plan exchanges.

This section is dedicated to explore how the Care Plan model components are implemented as C-CDA templates.

Also in scope for exploration/discussion is the terminology/code sets required to support Care Plan implementations

Working Documents and Project Deliverables

Note: the following list of documents/deliverables will change as the project progresses.

Latest Update

Care Plan DAM - May 2014 Ballot and ballot reconciliation: in progress

2013 Documents

Draft Care Plan DAM Specification for Informative Ballot 1 - September 2013:

Comparison of International Care Plan Structure as at 2011:

Coordinated Care Services Specification:

Older documents

Links to Other Related and Relevant Projects

Care Coordination

  • The IHE Patient Care Coordination Technical Committee has published an IHE Technical Framework supplement:
- IHE - Reconciliation of Clinical Content and Care Providers profile
- This document is open for public comment in the period from June 6 through July 5, 2014
- More details about comments submission can be obtained from this IHE link:
- IHE comment spreadsheet:
o IHE - Reconciliation profile comment spreadsheet
o Comments can be emailed to:

Care Coordination Services Project details:

ONC/LCC Project website:

Structured Document WG: C-CDA Care Plan Template Project:

This wiki page provides drafts, updates to, and discussion forum on C-CDA Care Plan Templates work.

Structured Document WG: CDA Implementation Guilde Project on Clinical Oncology Treatment Plan and Summary:

Project Scope

As per Project Scope Statement documents.

To include link to Care Plan 2012 Project Scope Statement document when approved by TSC
Also to include Care Coordination Services Project Scope Statement document when approved by TSC

Project Objectives and Outcomes

To be revised. 1. Domain Analysis Model with the following deliverables (together with SD WG):

    • Definitions of Care Plan and others.
    • Work on storyboards and use cases (multiple). Emergency, Clinical hospital (discharge), Nursing home, chronic disease, primary care. Multidisciplinary. Example use cases can be: 1 chronic condition, obstetric case with transfer. After that CDA can use the work that is be done. CDS is an addition to the messages which already exist. They must be updated.
    • Dynamic model for the Care Plan Topic
    • Structural model. -> DAM (HDF within HL7)

Project Work Plan and Timeline

As per Care Plan Project Scope Statement.

Care Plan Project Archives

Care Plan Initiative project 2011

Care Plan Topic project (Project contents prior to 2011)

Project Team and Ressources

Primary Sponsor/Work Group is Patient Care WG

Work Group Team Members
Role Name Email Notes
Project Co-Lead Laura Heermann Langford
Project Co-Lead Stephen Chu Co-Chair PCWG
Publishing facilitator ??
Vocabulary facilitator ??
Modeling facilitator Enrique Meneses
Domain expert representative Stephen Chu
Domain expert representative Russ Leftwich
Domain expert representative Kevin Coonan
Domain expert representative Susan Campbell
Data Analyst facilitator ??
Business requirement analyst ??
Requirements process facilitator
Business requirement analyst
Requirements process facilitator ??
Implementor ??


Users of Care Plan

Contributors of the Care Plan Topic

To be revised.

Collaborating with Agreement status Comments
IMIA-NI Existing
IHE Existing
CEN Existing Swedish Care Plan project

Download CEN materials from Sweden here:

See also the reference material wiki page (link above)

Project Resources

Most will be done in normal committee work time, and online via meetings.

Project Budget

To be defined.

Action items

Table to be inserted.

=Ballot strategy - general||

To be defined.