Conference call minutes 21 May 2015

Health Concern Topic

Patient Care WG

May 21, 2015

Attendees:

• Michael Tan – Chair
• David Pyke
• Ken Chen
• Susan Campbell
• Lisa Nelson

Participation Information Phone Number: +1 770-657-9270 Participant Passcode: 943377

Web Meeting Info www.webex.com Meeting number 230 634 425

Recap of Paris Working Group Meeting

• Two quarters were dedicated for Health Concerns
• On Tuesday Q2 we continued the discussion on the harmonization with Care Plan, specifically the persons expressing a concern or persons not agreeing with the concern. Example is the anorexia patient. Decision was to add a related person attached to the health concern event.
• Persons not agreeing with the concern were to be captured as an observation event.
• Notes on this quarter can be found here.

http://wiki.hl7.org/index.php?title=May_2015_WGM_Paris,_France:_May_10_to_May_15#Patient_Care_Tuesday_Q4

• On Thursday we looked at the Contsys models and the HL7v3 RMIM of Care Structures 2009. These contain V3 RMIM models.
• The newest diagram will be sent along in this minutes.
• Lisa was searching for the Care Plan documents. The Care Plan documents were discussed briefly in Paris. The last known status is, that Enrique Mensezes has to update the document. Laura has tried to get in touch with Enrique, but so far he has not replied.
• Michael will add the most recent model of the Concern diagram and the last DAM document in this meeting notes.

Modeling Health Concern

We continued with the discussion on harmonization that was initiated in the Care Plan call of Wednesday 22 April. The request was to add the following elements:

• expressed by (for example family members)
• disagreed by ( for example the patient with anorexia nervosa).

We analyzed the possible use cases and came with 3 different variations:

1. Someone may or may not be concerned with something someone else has called a concern. That person can choose whether to put it on his or her problem list for the patient.
2. Different members of a care team may disagree about a judgment, and the care coordination process needs to take these disagreements into account in order to support a reconciliation process. But this is true of proposed procedures, goals, any judgment, and it's not specific to the health concern. However we address this requirement, it belongs in the Care Plan domain.
3. A patient disagrees that something is a concern. This may be a barrier to care, so it's important. But it seems similar to other care barrier concepts, such as compliance. It may require a special model, or it may want to store it as an observation ( health concern event), especially if patient changes their opinion over time and you would want to track these changes. Different institutions may choose to prioritize different sorts of concern event for display in the problem list, but it's not specific to the concern domain.

None of these seem to require a change to the domain model.

Next Meeting

We will continue the discussion of the Health Concern Model at the HL7 WGM in Paris

The document of the model can be found here: File:ConcernModel.doc

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