Conference call minutes 26 January 2016

Health Concern Topic

Patient Care WG

January 26 2016

Attendees:

• Michael Tan – Chair
• David Pyke
• Dan Russell
• Ray Simkus
• Hank Mayers
• David Tao
• Russell McDonell

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

Web Meeting Info www.webex.com Meeting number 238 558 505

Topics

Feedback from WGM Orlando

The DAM publication was postponed. The PCWG had joint meetings with SDWG about TOC. ( Part of MU3). The proposal from David Tao was discussed. The PCWG considers a Problem Concern as a subset of Health Concerns. A problem concern is a health concern, but health concerns could be more than a problem concern. A problem concern on the TOC document would contain the problems that the author of the TOC document considers as the essential problems he would want the receiver to take account of. Additional health concerns are other health concerns which do not have to be specifically the author’s concern or the author’s domain of care, but are worthwhile to communicate to the receiver. These could be concerns from the patient, relatives of the patient or other care providers concern. In the meeting with PA WG the PC group discussed the topic of episode of care. The meaning of episode of care has similarities with health concerns and PA uses the episode of care to relate encounters to that episode. The episode is then used to collect the events under that episode for reimbursement purposes. The viewpoint of PA is that health concerns are a level higher than the episode of care. In PC’s view we should use health concern mechanism to represent episodes of care. This discussion is expected to continue. We also had an exchange of views with the FMG on the modelling of resources in FHIR. Lloyd McKenzie’s perception of the health concern topic is that you can capture the functionality of health concerns with conditions and the list resources. PCWG is not convinced.

Dan Russell questions what the meaning is of a condition in FHIR perception and points out that conditions in FHIR do not cover the concept of risk concerns. The health concern DAM also describes the different roles of persons in relationship with a concern such as author, custodian, asserter, monitor. This is not available in the current condition resource. This discussion will continue.

DAM document

We discussed on the open issues of the DAM document. Should the problem list and allergy list not contain attributes? (See figure 5). The problem lists and allergy lists are examples of output which could be generated with the use of the health concern mechanism. Ray Simkus points out that the output will inherit attributes from the health concern class, but that would depend on the person generating the output list. The problem list and the allergy list are implementation of mechanism of health concerns and as such beyond the scope of the health concern DAM. Perhaps these boxes should also be grayed out ( like Care Plan). Action Jay Lyle.

Where do procedures fit in the concept of health concerns? A procedure is considered as a health concern event and is thus included in the current model.

How do we communicate priorities between health concerns? This would be considered as an implementation issue and would be manifested in the problem list. This is not in scope of the DAM and should be a separate project. This should explained in the DAM. Action David Pyke. One of the issues discussed in Orlando was the confusion between the process of creation of health concerns and the use of health concerns as a method to create output. It should be clear that in the registration of health concerns a system could propose to attach certain events to a health concern, but in the end it is a person that decides which health concern events should be related to that health concern or even discarded because they are no longer relevant. A second care provider can make use of a health concern originated by the health concern author to produce a problem list as output, but it should be clear that this second care provider could filter the health concern events for problems that are relevant for the second care provider. ( for example the general health concern is diabetes and because he is an ophtamologist he would only be interested in issues regarding the eye sight). We should extend the storyboard to explain this process more clearly. Hank Mayers has analyzed the storyboard in the DAM and created a table that explains the interactions between health concerns and different care providers. Michael will distribute the table and PCWG will study the suggestion. Action Michael Tan.

Action items

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

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