2017-03-03 Learning Health Systems Call

Meeting Information

Facilitator	Russell Leftwich	Note taker(s)	Emma Jones
Attendee	Name	Affiliation
X	Russell Leftwich	InterSystems
X	John Roberts	Tennessee Department of Health
X	Stephen Chu	Individual
	Evelyn Gallego	ONC
X	Kathy Walsh	LabCorp
X	Asim Muhammad	Philips Research Europe
X	Laura Heermann-Langford	Intermountain Healthcare
X	Emma Jones	Allscripts
	Jeff Brown	Cancerlinq
X	Lisa Nelson	Individual
	Dave Carlson	VA
	Chris Melo	Phillips Healthcare
	Michele Miller	Cerner

Minutes

• Call out
  • Need to incorporate past calls initiative with this group
  • TSC have not officially approved the PSS. Anticipate it's just a matter of getting around to it
  • Action: Russ will f/u with next week TSC call

Review of previous minutes/Conclusions Reached:

• Care Team (CT) roles being fulfilled by an organized group
  • Specialty service
  • Specialty practice - nutritional clinic
  • Some organization refers to such a group as a care team (groups that fullfill a rolw on the care team)
  • Home care servide or vendors that provide a service where not based on individuals

• Care team role fulfilled by an indiv - coverage group
  • Will be need for consent and access to be able to cover for another indiv
  • Adhoc care team members and how to represent them
    • Specialists that have one time encounter

• Urgent care clinician
• Out of town emergency department. How do these become documented as part of a care team or do they?

• Is alternative medicine providers in scope
• Lab corp provides patient educational materials to patient based on lab test results - is time care team activity?
  • Question of whether asynchronous engagement with some entity or individuals should be considered a care team member.

Stephen: comment on number 4 (care team roles fulfilled by organized group) and number 5 (Care team role usually fulfilled by a coverage group id the usual member is unvailable) - ONC CT project have done some work on this. This work can inform these points. Would be useful to continue those discussion here. Russ: agree this is what we dhoule do and get the information posted on the wiki

Stephen: #6 (Adhoc care team members) - would adhoc emergency response teams be considered as care team members? Emma: need to take into consideration that folks use the ED for routine HC services Russ: retail clinics use is growing and more folks are using them for primary care. Out town folks can use the ED as a care team Evelyn: How does research care team fall into the fold? Russ: would group it with the organized groups that fulfill a role on the care team. Evelyn: how can the research team - may be directly engaged or may be the recipient of the data. Will that put them out of scope? Russ: anybody that touches the individual electronically and asynchronally. But these are all questions we need to answer. Will not consider secondary use of the patient data - that researcher -as part of the care team. Not having access to the researcher data and researched not having access to the patient clinical data is contrary to a learning health system. Evelyn: will see that that is a feedback look when looking at interventions and evaluating outcomes of care. Along with their roles and responsibility. Stephen: in the ideal world, the PCP will have a care plan that will be shared worth the research team. And if the research establish a research plan will share that with the research team. CP DAM addresses this so should be covered on the CT DAM.

Lisa: cover how to integrate the value set work with the CT DAM. The previous activity approaches the problem from the bottom up where this is approaching it from the top down. Stephen: Couple of approaches 1) we continue the work initiated by the ONC group and bring it close to completion. The work is being done based on the data points of the FHIR resource where it's good to use as a starting point. Then come at the DAM and look at aligning the two. 2) pause the value set work and know that it will change based on the DAM work. Then continue it after we have a better idea of what a logical model will look like. 3) run it in parallel with the DAM. Even if we have two separate calls the two groups align. Evelyn: suggest we finish the value set work as a project knowing that it will need to be revised. Russ: option 1 does not align with the PSS Evelyn: we need to get to a value set as a building block. It may be a matter of updating the PSS Russ: updating the PSS is a possibility and will be necessary to align with the HL7 rules. What is a reasonable estimate of the time to finish the value set work Stephen: need another 4-6 weeks of work max. at least to get the started set. Lisa: would be excited to keep the momentum going and get finished Laura: agrees and the logistic around HL7 and process will just need to be worked thru Stephen: we struggle with bandwith and don't have the lux Motions to modify the PSS to allow for 4-6 weelk Moved: Laura - Second: Lisa - Further discussion: will work off line on modification to the PSS Abstain: 0 - Against: 0 - Affirmative: 10

Stephen: Has PC been added back as co-sponser (Russ: yes) Russ: will plan on taking the valueset work up next week. Can use this conference call.

© 2012 Health Level Seven® International. All rights reserved.