Conference call minutes 15 December 2015

Health Concern Topic

Patient Care WG

December 15 2015

Attendees:

• Michael Tan – Chair
• David Pyke
• David Tao
• Jay Lyle
• Emma Jones
• Dan Russler
• Darell Woelk
• Laura Heermann Langford

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

Web Meeting Info www.webex.com Meeting number 249 522 346

Minutes previous meeting

• There were no comments about the minutes of the previous meeting.
• Motion to approve: David, second: Jay. Vote: 7 in favor, 0 abstain, 0 against.

Topics

• Jay has written a suggestion to explain the difference between a problem concern and a health concern.
• This suggestion was sent earlier on the 15th to the patient care list.
• In general readers felt, that a problem concern and consequently also the problem list were the tools with which care providers would work, while health concern and a concern list would be the topic under which patient concerns would reside.
• The first part of this statement might be true, but health concern are not the exclusive ownership of patients for patient's concern. Any person including care providers could make use of health concerns. Problem concerns could be a subset of a health concern, that would have a longer span and could connect evolving problems together.
• This is true about the conceptual model of a health concern, but David Tao has an issue with the implementation in MU3, where straightforward specifications are required for IT vendors. They need consistent guidance to know in which sections to put the care providers concern and the patient's concern.
• Michael points out that it is important to recognize that there are 2 steps in working with concerns.
• The first step is the registration of concern events. A concern author/ custodian identifies a concern. (I.e. "I want to collect information under the grouping of Diabetes") and selects which elements ( called health concen events in the DAM) are relevant for this health concern.
• The second step is to produce output, such as a CCDA for transition of care. This could be a half automated step in which filtering could take place. The first step is the key of how step 2 will work.
• Filtering could take place depending on protocols or agreements between specialism's. An ophtamologist requires a different information than a dietitian. Filtering could depend on the type of receiver.
• For this purpose it could be necessary to identify the type of information on the concern or concern event.
• The author/ custodian of the health concern is also an indication of the source of the concern. It could be the patient, or it could be the cardiologist and with this method you can identify which elements are relevant for the type of receiver.
• The alternative to a push mechanism, where you send a TOC document, would be a pull mechanism where the receiver would ask for information which he considers relevant for treatment of that specific patient. This scenario is not yet common, although we do see more queries.
• Jay and David Tao will attend the Thursday conference call of SDWG.
• In chapter 5 of the DAM we describe the various actors and roles in the DAM. This is not yet consistent. Sometimes we use the term concern expresser which is not explained anywhere
• Perhaps we should also simplify and group certain actors together. A custodian could also be the author.
• It is essential to recognize that there is a distinction between a concern custodian who has responsibilities to select problems and events that are relevant for a concern and a list owner, that produces a tailored list making use of the concern from the custodian. The term tailored must be interpreted as tailored to an individual, team or profession depending on the rules of the system. The list owner does not even need to be a person. It would be a configuration setting that would produce a fixed set type of concern events for a primary care provider.

Action items

• Jay will function as a liaison between PCWG and SDWG for harmonization of Health Concerns between these groups.

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