October 28, 2014 CBCC Conference Call

Community-Based Collaborative Care Working Group Meeting

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Attendees

x	Member Name		x	Member Name		x	Member Name		x	Member Name
x	Johnathan ColemanCBCC Interim Co-Chair		x	Suzanne Gonzales-Webb CBCC Co-Chair		x	Jim KretzCBCC Interim Co-Chair		.	Max WalkerCBCC Co-Chair
.	Wende Baker		.	Bill Braithwaite, MD		x	Kathleen Connor		.	Kathy Odorow
.	Steve Eichner		x	Rick Grow		.	Paul Knapp		.	Mohammed Jafari
.	Lisa Nelson		.	Mike Lardiere		x	Diana Proud-Madruga		.	Harry Rhodes
.	Lori Simon		.	Ioana Singureanu		.	Tony Weida		.	Tim McKay, Kaiser
.	Maryann Juurlink		.	Steve Daviss		.	Kate Wetherby		.	Neelima Chennamaraja
.	Dina Passman		x	Serafina Versaggi		.	Marlowe Greenberg		.	Chris Clark, WV
.	Ken Ortbals		.	Matt Peeling		.	Tracy Leeper		.	Brian Newton
x	Lisa Nelson		.	Amanda Nash		.	Ken Salyards		.	_Bob Yencha
.	.		.	.Oliver Lawless		.	.		.	.
.	Rita Torkzadeh		.	John Moehrke		x	Toria Thompson, Colorado		.	[Leo Achembon,] DSHS

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Agenda DRAFT

1. (05 min) Roll Call, Approve Meeting Minutes from October 21
2. (05 min) Update CBCC Vocabulary Facilitator
3. (10 min) Patient Friendly Natural Language - Update on PFL map to HCS and development of FHIR Consent Directive Suite See CBCC PFL Wiki page
4. (05 min) Patient Friendly Natural Language - Domain and Scope for the PFL Language
5. (05 min) Vote: Move forward with PFL NIB? (NIB due November 2)
6. (10 min) Data Provenance - Update HL7 DPROV Ballot Dispositions
7. (10 min) Provenance Device RoleCode Concept Domains Harmonization Proposal Vote Initial Provenance Device RoleCode Concept Domains Harmonization Proposal and [ Harmonization Proposal Presentation]
8. (05 min) Privacy Consent Directives - Ballot Reconciliation

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Meeting Minutes

Approve Meeting Minutes from October 21 (Suzanne/John); Unanimous approval

Patient Friendly Natural Language [http://gforge.hl7.org/gf/download/docmanfileversion/8420/12501/Domain%20and%20scope%20of%20the%20Patient%20Friendly%20CD%20language%20ontology.docx Domain and Scope for the PFL Language

Discussion:

Suzanne and Diana discussed the spreadsheet they have created that places content for the consent directive into three separate context buckets: Disclose All, Disclose Some, and Disclose None. They used example consent directives to help populate the buckets with patient friendly language. The spreadsheet starts mapping out a way to convert from patient friendly language to legal language, and then to security and privacy language, which ultimately constrains sharing of information between different parties.

One of the things that they have identified is that we need to have the language of the consent directive to be around the 6th grade reading level. One of the easiest ways of improving readability is to have the wording be in active voice rather than passive voice. All of these considerations would have the net effect of reducing the reading level required of the patient to understand the information to which they are signing and agreeing.

Their work is based on the privacy use cases listed in HL7, which are based on a couple of documents from the Security and Privacy DAM and the Composite Privacy Consent Directive.

Question asked by Lisa Nelson on use cases: Have you thought about giving people the ability to articulate when they want to consent when the information is shared? For what purpose and with whom should the consent be shared? With the "whom," is there a way to have language that a person can say, "I’m consenting to share my information with party X, Y, Z, but I do not consent to party X, Y, Z sharing my information with anyone else (third parties)?" Is there a way to constrain the language to say I’m sharing it with whom and that the consent to share doesn’t go beyond them; it just stays with them?

Response from Diana: We can give them the option to say “opt-out" of redisclosure or where they have to get additional permissions to redisclose. There would need to be additional language letting them know that if they deny the ability to redisclose, it could adversely impact their healthcare...they would have to have a Consent2Share for every single one of their healthcare providers. This would require someone with a legal background to determine to what extent the patient can restrict this. There are some cases where information can be disclosed or redisclosed with or without their permission.

Additional question asked by Lisa Nelson: I have a question about the project title. It’s named the "Patient-friendly language for Security and Privacy for Consent Directives." The word “consent” is way too far into the title.

ACTION

NIB approved for the HL7 Patient Friendly Language project (HL7 side voted on, not the FHIR piece); Suzanne to complete NIB.

Action item: Proposing new language for the name of the project. Lisa takes the action. Proposes naming it the "Patient Friendly Consent Directive."

Action item: The CBCC WG plans to address and possibly vote on suggested project title changes next week. The current title in the online NIB contains FHIR in the title. Suzanne will contact Lynn Laasko to correct.

Data Provenance - Update

The harmonization proposal to create Provenance Device RoleCode Concept Domains needs to be approved by the CBCC WG for final submission, due in to HL7 by November 9. CBCC plans to vote on the final proposal next week in order to meet the submission deadline.

Regarding the ballot reconciliation, Kathleen Connor plans to post a PowerPoint showing Bob Yencha and Lisa Nelson's comments. CBCC plans to review and reconcile these comments in the WG meeting.

Privacy Consent Directives - Ballot Reconciliation

Ballot reconciliation will remain on the CBCC WG agenda for next week's meeting.

Meeting adjourned at 1207 PDT