Conference call minutes 2 April 2015

Health Concern Topic

Patient Care WG

April 2, 2015

Attendees:

• Michael Tan – Chair
• Jay Lyle
• Dave Pyke
• Ken Chen
• Laura Heermann Langford

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

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

Previous Meeting

Minutes from March 26 th, 2015 Move: Jay/Ken No – 0, Abstain – 0 Approve – 3

Review of new diagram

We continued with the new model and the questions that Jay had prepared for the call.

1. Is an order associated with a problem part of a concern or part of a plan?
   1. The conclusion is that an order could be attached directly to a health concern or either find it's relationship through the diagnosis that initiated that order. Both are possible. There were concerns that this would might lead to the risk of duplication of orders, but that is more of a governance issue. An example was that an care provider managing a Care Plan could initiate an order as well as the custodian of a concern. We agreed that this was not a Health Concern issue and that we would signal this case to the Care Plan group.
2. Is there a rule or assumption that related events (e.g., results, administrations) be associated with the source event's concern?
   1. The case is similar as question 1. Events are already attached through the diagnosis.

Possibly; could be left to policy.

1. 1. Links are already there; do you buy anything by creating the explicit concern tag?
   2. There is a need for editorial control over potentially large volume of data
   3. Leave this as an option for manual or automatic attachment.
2. Is there a 'context' that automatically associates an event with a particular “in context” concern? Are there boundaries we need to identify--i.e., does the clinician need to be aware of context and consciously indicate when it changes?
   1. Good to reduce need to explicitly associate things.
   2. But closing contexts may not happen.
   3. Need more clinician input on UX.
   4. Or leave context management to implementers. Out of scope for DAM.
3. When merging, is the name the more recent, or does the merger get to choose?
   1. Both kept. Option to adopt or not
   2. But: you may also want a “locally familiar” name that does not diverge semantically but is easier to read.
   3. Added “localName” to model to support this.
4. Is ‘follow-up’ a concern? It looks like it might be a classifier for an encounter associated with the discharge dx concern.
   1. It may be an event under a concern.
5. Would a provider add a separate concern to the list to support past medical history, or is there a different mechanism for history? Might there be a different status--e.g., active, resolved but historically relevant, and inactive?
   1. Or are there rules for what shows up in History -- timeframe, seriousness. These “history inclusion” rules are specific to the institution.
   2. Active & inactive.

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

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