Patient Authored Documents Informative Document

Project Details

Overview

In the “era of patient empowerment”, we want to define a specification for patient-authored clinical documents. Medical practices are looking for ways to allow patients to electronically complete certain tasks online such as filling out registration forms, health history forms, consenting to certain practice policies, and other types of clinical documents yet to be defined. As electronic document interchange increases, we see a growing need to communicate documents created by patients (including those needed by providers and/or those document types defined by patients). Often, this is done through a secure web interface controlled by the patient such as a patient portal or a personal health record. As more and more practices incorporate EMR technology into their practice workflow, they want to be able to import patient provided structured information into their EMR’s. This is being driven by the need to meet Meaning Use 2 requirements for patient engagement as well as other needs to reduce manual processes managing patient-provided data.

The HL7 CDA Consolidation Documents types only address provider-initiated documents and do not incorporate guidance for patient-generated documents. It is necessary to create a new implementation guide describing how to incorporate patient-generated input. In many cases, existing templates within the current Consolidation Template Library can be re-used with minimal modification.

The scope of this project is to create an implementation guide, which will guide the users on using the elements of the C-CDA consolidation header for patient authored documents. New CDA document types for patient authored documents is NOT in scope for this project. The document described by this guide could be characterized as a parallel to Consolidated CDA, that would ultimately cover specific patient-authored document types. We anticipate that Consolidated CDA templates will be heavily reused. If required, we may extend the project scope or introduce another project for defining an implementation guide for a set of patient authored document types.

HL7 Project Scope

• HL7 Project Scope Statement (approved June 07, 2012 by SDWG, pending review/approval by Steering Division and TSC):

http://wiki.hl7.org/images/4/4c/HL7_Project_Scope_Statement_v2012_Patient_authored_notes.docx

Subgroup Members

• Virinder Batra, Intuit Health
• Lisa Nelson, Life Over Time Solutions LLC
• Elaine Ayres, Academy of Nutrition and Dietetics, National Institutes of Health
• Catherine Welsh, St. Jude Children's Research Hospital
• Bob Dolin, Lantana Consulting
• Emma Jones, Allscripts
• Shawn Meyers, Healthwise
• Brian Scheller, Healthwise
• Chris Schultz, Child Health & Development Interactive System (Chadis)
• Gordon Raup, Datuit
• David Tao, Siemens Healthcare
• Jessi Formoe, Intuit Health
• Leslie Kelly Hall, Healthwise
• Kevin Harbauer,Healthwise
• Allen Traylor, Child Health & Development Interactive System (Chadis)

Meeting Logistics

Meeting Schedule

*SPECIAL NOTICE* For 08/24/2012 the goto meeting link will be: https://www3.gotomeeting.com/join/671430974

• Every Friday noon EST to 1PM EST
• Phone Number: +1 770-657-9270
• Participant Passcode: 310940
• Webex : https://intuitcorp.webex.com/intuitcorp/j.php?J=593844616

Meeting Agendas

• Agenda for 08092012: File:PGHDAgenda08092012.docx
• Agenda for 08172012: File:PGHDMeetingAgenda08172012.docx
• Agenda for 08242012: File:PGHDAgenda08242012.docx

Meeting Minutes

• Minutes for 07272012: File:PGHDMinutes0727.docx
• Minutes for 08032012: File:PGHDMeetingMinutes08032012.docx
• Minutes for 08102012: File:PGHDMeetingMinutes08102012.docx
• Minutes for 08172012: File:PGHDMeetingMinutes08172012.docx
• Minutes for 08242012: File:PGHD Meeting Minutes for 20120824.docx

Deliverable Timelines

• Notice of ballot in September 2012
• Word document (Implementation Guide) by Dec 1, 2012
• Ballot in WG Meeting in Phoenix January, 2013

Use Cases

• Use Case Template : File:PGHDUseCaseTemplate.docx
• Use Case List Version 20120809 : File:PGHDUseCases08092012.zip
• Use Case List Version 20120814 : File:PGHDUse Cases 20120814.zip (Adjusted Use Cases to use HL7 Scenario Names. Updated Use Case 1 to include the creation of a CDA document from the PHR.)
• Use Case List Version 20120824 : File:PGHD Use Cases 20120824.zip (Adjusted Use Case 1 and Use Case 2 to reflect prior concensus and record on-going open disucussion points.)

Discussion on Header Attributes

• Date reflects notes following the review date
• 20120803 Review of Header Elements : File:PGHDReviewHeader0805.docx
• 20120810 Review of Header Elements per Use Case : File:PGHD Header Element Analysis 20120810.xlsx
• 20120817 Review of Header Elements per Use Case : File:PGHD Header Element Analysis 20120817.xlsx

Implementation Guide

• Draft Implementation Guide: File:PGHDDocumentHeaderIG.doc

Other Documents

• White Papers
  • Policy White Paper : File:PGHDWhitePaper.docx
• Use case actor names: Publishing facilitators guide, Appendix 3: [1]
  • Appendix – table 5 has patient information;
  • Appendix - table 6 has healthcare staff, etc
• Sample Forms
  • Sample Hospital PreVisit/Registration Form : File:AdultAdmissionRegistrationForm.pdf

Open Issues

• When will the Patient Authored CDA documents be created; What are the trigger points;
  • These will be application workflow dependent
  • The CDA document will define the content, NOT the workflow or the application business logic