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Difference between revisions of "EpisodeOfCare FHIR Resource Proposal"

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This page documents a [[:category:Pending FHIR Resource Proposal|Pending]] [[:category:FHIR Resource Proposal|FHIR Resource Proposal]]
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This page documents a [[:category:Approved FHIR Resource Proposal|Approved]] [[:category:FHIR Resource Proposal|FHIR Resource Proposal]]
 
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[[Category:FHIR Resource Proposal]]
 
[[Category:FHIR Resource Proposal]]
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[[Category:Pending FHIR Resource Proposal]]
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[[Category:Approved FHIR Resource Proposal]]
  
  
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==Contributing or Reviewing Work Groups==
 
==Contributing or Reviewing Work Groups==
−
* "None"
+
* Patient Care
 +
* Financial Management
  
 
==FHIR Resource Development Project Insight ID==
 
==FHIR Resource Development Project Insight ID==
Line 27: Line 28:
  
 
==Scope of coverage==
 
==Scope of coverage==
−
<!-- Appointment resources are used to provide information about a planned meeting that may be in the future or past. The resource only describes a single meeting, a series of repeating visits would require multiple appointment resources be created for each instance. Examples include a scheduled surgery, a follow-up for a clinical visit, a scheduled conference call between clinicians to discuss a case, the reservation of a piece of diagnostic equipment for a particular use, etc. The visit scheduled by an appointment may be in person or remote (by phone, video conference, etc.) All that matters is that the time and usage of one or more individuals, locations and/or pieces of equipment is being fully or partially reserved for a designated period of time.  
+
The EpisodeOfCare Resource contains information about an association of a Patient with a Healthcare Provider for a period of time under which related healthcare activities may occur.
  
−
This definition takes the concepts of appointments in a clinical setting and also extends them to be relevant in the community healthcare space, and also ease exposure to other appointment / calendar standards widely used outside of healthcare.
+
This may include information such as:
 +
* Organization
 +
* Practitioners (and roles)
 +
* Problem/Condition/Diagnosis
 +
* Care Team
 +
* Care Manager/Care co-ordinator
 +
* Funding Sources (Government Agencies/Health Insurers/Individual payers/Guarantors)
 +
* Contact information
 +
* Period
 +
* Status information
 +
* Referral source
 +
* Consent?
 +
* other episodes of care
  
−
This resource is not expected to handle recurring appointments (at this stage) due to the complexities of recurrences, time-zone transitions, and status changes of variations to the recurrence. If a user of an appointment desires to handle recurrences, they will need to "expand" the recurrences as separate resource instances and use some form of identifier to "join" them together as the one logical collection.
+
In many cases, this represents a period of time where the Healthcare Provider has some level of responsibility for the care of the patient regarding a specific condition or problem, even if not currently participating in an encounter.
  
−
This resource does not also cover a more extensive definition/description of the actual service that is to take place during this appointment. This is likely to be the content of another new resource "Healthcare Service".
+
Note: The primary difference between the EpisodeOfCare and the Encounter is that the Encounter records the details of an activity directly relating to the patient, while the EpisodeOfCare is the container that can link a series of Enounters together for a specific problem/issue.  
−
This new "Healthcare Service" would cover a multi-level category and type structure to assist in the discovery of what services are provided in an organization/location.
+
 
−
-->
+
These resources are typically known in existing systems as:
 +
* EpisodeOfCare: Case, Program, Problem
 +
* Encounter: Visit, Contact
  
 
==RIM scope==
 
==RIM scope==
 
<!-- Act (ActMood = ActMoodAppointment or ActMoodAppointmentRequest) -->
 
<!-- Act (ActMood = ActMoodAppointment or ActMoodAppointmentRequest) -->
 +
TBD.
  
 
==Resource appropriateness==
 
==Resource appropriateness==
−
<!-- Many systems already exchange appointment information using iCal appointments, and some use the HL7v2 schedule messages, or proprietary format messages.
+
Systems collect a coherent group of activities (such as encounters) related to a patient's health condition or problem often referred to as a Care Episode.
 +
 
 +
Information about an episode is often shared across systems, and in some cases organizational and disciplinary boundaries.
 +
 
 +
An Episode Of Care contains details about the purpose of the care and can exist without any activities.  
  
−
The existing iCal standard does provide a good basis that is widely accepted by many (mostly non-healthcare related) software packages. However we would like to extend these basic features to better meet the complex needs in the healthcare space where transparency and traceability is critical.
+
The minimal information that would be required in an episode of care would be a patient, healthcare provider and a reason for the ongoing association.
−
-->
 
  
 +
Other reasons for creating an EpisodeOfCare could be for tracking the details required for government reporting or billing.
  
 
==Expected implementations==
 
==Expected implementations==
−
<!-- This resource is expected to be implemented by scheduling systems used by community clinics, general practice and specialists to receive and publish their appointments directly to/from users external to the organization providing the information.
+
This resource is likely to be implemented by applications:
−
-->
+
* Chronic Disease Management Systems
 +
* Community Care Systems
 +
** Tracking progress of a specific condition
 +
** Tracking government funding
 +
* Problem based General Practice systems
 +
* Disability Support Systems
 +
* Aged Care Systems (Community and Residential)
  
 
==Content sources==
 
==Content sources==
−
We will be evaluating the HL7 v2 and v3 messages and models which are closely related.
+
We will refer to the HL7 v2, v3 and OpenEHR  messages and models.
  
 
==Example Scenarios==
 
==Example Scenarios==
−
<!-- A Physio-Therapy clinic that has its available times published via Availability and Slot resources wants to be able to accept appointment requests from users outside the organization.  
+
A General Practitioner wants to review how well his patient is managing his diabetes over time  from information within his clinic and also the regional community care organization's system(s).
  
−
Appointment resources would exist for appointments that have occurred in the past, are scheduled to occur in the future, and also requested appointments which may occur once accepted/approved.
+
The Episode Of Care enables him to easily separate the diabetes activities from the mental health problem's activities.
−
-->
 
  
 +
A Community Care organization wants to track all activities that occur with a patient relating to their disability to simplify the reporting to the government to receive funding to care for the patient.
  
 
==Resource Relationships==
 
==Resource Relationships==
−
<!-- The Appointment Resource will reference any slots that it is booking to, along with the participants that are involved in the appointment, such as the patient and provider (but not restricted to just these).
+
This resource is expected to reference Patient, Location, Organization and Practitioner.  
−
It will also reference the Location resource where the appointment is to take place.
+
 
 +
Resources that are expected to reference the EpisodeOfCare are: Appointment, Encounter, Coverage and CarePlan.
  
−
The Appointment will be referenced by both the Encounter, and also the AppointmentResponse, where replies to requests are made.
+
Other draft resources such as Claim and Invoice may also reference the EpisodeOfCare resource.
−
-->
 
  
 
==Timelines==
 
==Timelines==
−
PA plans to include this resource for inclusion in the next Ballot (expecting September 2014).
+
We are hoping that this resource will be ready for inclusion in the next Ballot (expecting September 2014).  
  
 
==gForge Users==
 
==gForge Users==
 
brian_pos
 
brian_pos

Latest revision as of 21:32, 5 December 2014

OpenHotTopic.GIF

This page documents a Approved FHIR Resource Proposal



EpisodeOfCare

Owning committee name

Patient Administration

Contributing or Reviewing Work Groups

  • Patient Care
  • Financial Management

FHIR Resource Development Project Insight ID

pending

Scope of coverage

The EpisodeOfCare Resource contains information about an association of a Patient with a Healthcare Provider for a period of time under which related healthcare activities may occur.

This may include information such as:

  • Organization
  • Practitioners (and roles)
  • Problem/Condition/Diagnosis
  • Care Team
  • Care Manager/Care co-ordinator
  • Funding Sources (Government Agencies/Health Insurers/Individual payers/Guarantors)
  • Contact information
  • Period
  • Status information
  • Referral source
  • Consent?
  • other episodes of care

In many cases, this represents a period of time where the Healthcare Provider has some level of responsibility for the care of the patient regarding a specific condition or problem, even if not currently participating in an encounter.

Note: The primary difference between the EpisodeOfCare and the Encounter is that the Encounter records the details of an activity directly relating to the patient, while the EpisodeOfCare is the container that can link a series of Enounters together for a specific problem/issue.

These resources are typically known in existing systems as:

  • EpisodeOfCare: Case, Program, Problem
  • Encounter: Visit, Contact

RIM scope

TBD.

Resource appropriateness

Systems collect a coherent group of activities (such as encounters) related to a patient's health condition or problem often referred to as a Care Episode.

Information about an episode is often shared across systems, and in some cases organizational and disciplinary boundaries.

An Episode Of Care contains details about the purpose of the care and can exist without any activities.

The minimal information that would be required in an episode of care would be a patient, healthcare provider and a reason for the ongoing association.

Other reasons for creating an EpisodeOfCare could be for tracking the details required for government reporting or billing.

Expected implementations

This resource is likely to be implemented by applications:

  • Chronic Disease Management Systems
  • Community Care Systems
    • Tracking progress of a specific condition
    • Tracking government funding
  • Problem based General Practice systems
  • Disability Support Systems
  • Aged Care Systems (Community and Residential)

Content sources

We will refer to the HL7 v2, v3 and OpenEHR messages and models.

Example Scenarios

A General Practitioner wants to review how well his patient is managing his diabetes over time from information within his clinic and also the regional community care organization's system(s).

The Episode Of Care enables him to easily separate the diabetes activities from the mental health problem's activities.

A Community Care organization wants to track all activities that occur with a patient relating to their disability to simplify the reporting to the government to receive funding to care for the patient.

Resource Relationships

This resource is expected to reference Patient, Location, Organization and Practitioner.

Resources that are expected to reference the EpisodeOfCare are: Appointment, Encounter, Coverage and CarePlan.

Other draft resources such as Claim and Invoice may also reference the EpisodeOfCare resource.

Timelines

We are hoping that this resource will be ready for inclusion in the next Ballot (expecting September 2014).

gForge Users

brian_pos

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