PhCP FHIR IG Proposal

Pharmacist Care Plan Document

Owning work group name

SDWG

Committee Approval Date:

Please enter the date that the committee approved this IGproposal

SDWG approved on 2/21/2019 (first post HIMSS conference call).

Contributing or Reviewing Work Groups

Pharmacy

FHIR Development Project Insight ID

1232

Scope of coverage

The goal of this project is to develop an electronic care plan with enhanced medication management content based on the templates in the HL7 Implementation Guide for C-CDA Release 2.1: Consolidated CDA for Clinical Notes and FHIR profiles based on the US Core specification. This care plan called “Pharmacist Care Plan” will serve as a standardized, interoperable document for exchange of consensus-driven prioritized medication-related activities, plans and goals for an individual needing care Pharmacists work in multiple environments (community, hospital, long term care, clinics, etc.) and increasingly participate in patient-centered care teams providing essential clinically oriented patient care services such as medication therapy management, clinical reconciliation (medication, allergies and problems), patient immunization management, disease state monitoring, and therapy adherence programs. The pharmacist works with the patient or care giver to identify manageable medication-related goals of therapy, defines needed interventions and strategies for achieving those goals and monitors outcomes in an iterative process. Consultation with other providers involved in the patient’s care are performed as needed. Though the Pharmacist Care Plan is static and represents an instance in time, care for the patient is dynamic and will contains information on the patient, pharmacist and care team’s concerns and goals related to medication optimization. The care plan may also contain information related to individual health and social risks that may impact care, planned interventions, expected outcomes, and referrals to other providers or for additional services e.g., nutrition consultation or diagnostic laboratory studies. The intent of this project is in alignment with the goals set forth in the roadmap - Connecting Health and Care for the Nation A Shared Nationwide Interoperability Roadmap the Office of the National Coordinator for Health Information Technology noted the following: “Providers should have the tools they need to support care transformation, i.e. using technology that supports the critical role of information sharing. This shift will open up new possibilities for providers in how they engage with patients and interact with other care, support and service team members. For example person-centered planning, which includes individual goals and preferences, is increasingly recognized as an integral tool for supporting person-centered health, individual-provider partnerships, and coordinating care, particularly for individuals with chronic conditions and multiple co-morbidities. In a learning health system, person-centered plans will be seamlessly shared amongst a group of individuals in a way that allows all care, support and service team members to contribute to and maintain the person-centered plan. These interoperable plans will be used to support informed, shared decision-making between providers, patients and the full care support team. Further, the learning health system will require nationwide interoperability to support transparent, integrated cost and quality data, accurate outcome measures, and a continuous cycle of improvement. Information gathered and decisions made during the normal course of care will be transformed, in real-time, into computable data and knowledge that is shared across the learning health system.”

The Pharmacist Care Plan is key to the incorporation of medication-related goals and outcomes into a patient’s care profile and planning.

This project scope includes the development of a CDA and FHIR based Pharmacist Care Plan. The FHIR Composition Profiles will be based on the CDA Pharmacist Care Plan sections.

IG Purpose

The goal of this project is to develop an electronic care plan with enhanced medication management content based on the templates in the HL7 Implementation Guide for C-CDA Release 2.1: Consolidated CDA for Clinical Notes and FHIR profiles based on the US Core specification. This care plan called “Pharmacist Care Plan” will serve as a standardized, interoperable document for exchange of consensus-driven prioritized medication-related activities, plans and goals for an individual needing care Pharmacists work in multiple environments (community, hospital, long term care, clinics, etc.) and increasingly participate in patient-centered care teams providing essential clinically oriented patient care services such as medication therapy management, clinical reconciliation (medication, allergies and problems), patient immunization management, disease state monitoring, and therapy adherence programs.

Content location

GitHub content location:

https://github.com/HL7/PhCP-R4

Trifolia on FHIR project location (must be logged and have the HAPI R4 server selected in your settings):

https://trifolia-fhir.lantanagroup.com/implementation-guide/phcp-r4

Current build:

http://build.fhir.org/ig/HL7/PhCP-r4/index.html

Previous version located at:

https://github.com/HL7/PhCP

Proposed IG realm and code

us/phcp

Maintenance Plan

The national community pharmacy association is supporting the development, balloting, and publishing of this IG.

Short Description

This is an electronic care plan with enhanced medication management content based on the templates in the HL7 Implementation Guide for C-CDA Release 2.1: Consolidated CDA for Clinical Notes, represented using FHIR profiles.

Long Description

The goal of this project is to develop an electronic care plan with enhanced medication management content based on the templates in the HL7 Implementation Guide for C-CDA Release 2.1: Consolidated CDA for Clinical Notesand FHIR profiles based on the US Core specification. This care plan called “Pharmacist Care Plan” will serve as a standardized, interoperable document for exchange of consensus-driven prioritized medication-related activities, plans and goals for an individual needing care Pharmacists work in multiple environments (community, hospital, long term care, clinics, etc.) and increasingly participate in patient-centered care teams providing essential clinically oriented patient care services such as medication therapy management, clinical reconciliation (medication, allergies and problems), patient immunization management, disease state monitoring, and therapy adherence programs. The pharmacist works with the patient or care giver to identify manageable medication-related goals of therapy, defines needed interventions and strategies for achieving those goals and monitors outcomes in an iterative process. Consultation with other providers involved in the patient’s care are performed as needed. Though the Pharmacist Care Plan is static and represents an instance in time, care for the patient is dynamic and will contains information on the patient, pharmacist and care team’s concerns and goals related to medication optimization. The care plan may also contain information related to individual health and social risks that may impact care, planned interventions, expected outcomes, and referrals to other providers or for additional services e.g., nutrition consultation or diagnostic laboratory studies. The intent of this project is in alignment with the goals set forth in the roadmap - Connecting Health and Care for the Nation A Shared Nationwide Interoperability Roadmap the Office of the National Coordinator for Health Information Technology noted the following: “Providers should have the tools they need to support care transformation, i.e. using technology that supports the critical role of information sharing. This shift will open up new possibilities for providers in how they engage with patients and interact with other care, support and service team members. For example person-centered planning, which includes individual goals and preferences, is increasingly recognized as an integral tool for supporting person-centered health, individual-provider partnerships, and coordinating care, particularly for individuals with chronic conditions and multiple co-morbidities. In a learning health system, person-centered plans will be seamlessly shared amongst a group of individuals in a way that allows all care, support and service team members to contribute to and maintain the person-centered plan. These interoperable plans will be used to support informed, shared decision-making between providers, patients and the full care support team. Further, the learning health system will require nationwide interoperability to support transparent, integrated cost and quality data, accurate outcome measures, and a continuous cycle of improvement. Information gathered and decisions made during the normal course of care will be transformed, in real-time, into computable data and knowledge that is shared across the learning health system.”

The Pharmacist Care Plan is key to the incorporation of medication-related goals and outcomes into a patient’s care profile and planning.

This project scope includes the development of a CDA and FHIR based Pharmacist Care Plan. The FHIR Composition Profiles will be based on the CDA Pharmacist Care Plan sections.

Involved parties

Pharmacy HIT collaborative The National Community Pharmacists Association (NCPA) Community Care of North Carolina (CCNC) ONC

Expected implementations

The comment-only ballot version of this IG is already in production with many independent pharmacies in the state of North Carolina and with Community Care of North Carolina (CCNC). It is expected that they will continue to implement this IG and upgrade to the STU once published. l

Content sources

See the dependencies section.

Example Scenarios

Independent Pharmacies reporting information to primary care organizations and medicaid administrators about fulfillment and other pharmacy information.

IG Relationships

• US Core
• C-CDA on FHIR

Timelines

The content for this ballot will meet the HL7 deadlines for the May 2019 ballot.

When IG Proposal Is Complete

When you have completed your proposal, please send an email to FMGcontact@HL7.org