2017-05-19 Learning Health Systems Call

Facilitator	Russell Leftwich	Note taker(s)	Michelle Miller
Attendee	Name	Affiliation
X	Russell Leftwich	InterSystems
	John Roberts	Tennessee Department of Health
X	Stephen Chu	Individual
X	Evelyn Gallego	ONC
X	Kathy Walsh	LabCorp
	Asim Muhammad	Philips Research Europe
	Laura Heermann-Langford	Intermountain Healthcare
X	Emma Jones	Allscripts
	Jeff Brown	Cancerlinq
X	Lisa Nelson	Individual
	Dave Carlson	VA
	Chris Melo	Phillips Healthcare
X	Michelle Miller	Cerner
	Benjamin Kummer	Columbia University
	Matt Rhan
	Michael Padula
	Serafina Versaggi	VA
	New person	VA

Minutes

• Chair: Russell Leftwich
• Scribe: Michelle Miller

• Motion to approve previous call minutes, 2017-04-28_Learning_Health_Systems_Call: Stephen/Michelle

• San Diego WGM Schedule
  • Russ will not be there Mon/Wed
  • Wed Q2 -- PA discusses CareTeam (among other PA/PC joint resources)
  • Russ will work with John to schedule Thurs Q4 for CareTeam (and another quarter for LHS business meeting)

• Suppose we reverse engineer a virtual care team
  • For any individual, their care team is everyone who touches them
  • ...touches them physically, face to face, or virtually
  • touches may be episodic, usually are
  • care team participants or roles may be limited time engagements
  • care team participants may be inactive in the plan for periods of time
  • there is a difference between inactive and retired (not expected back)

• Mode of contact
  • face or face
  • telehealth
  • interpretation of diagnosis procedures (e.g. radiologists or pathologists)
  • remote care manager
  • remote patient education or instruction

• Discussion
  • Lisa suggested an remote participant role or relationship and some care teams have it, while others may not have it. It's a value in the value set, but don't use it if you don't think of that person as a member of the care team.
  • Russ said Learning Health System -- has both patient perspective as well as mechanism for follow-up for incorrect interpretation
  • Emma mentioned patient preferences -- desire to have it read at a certain place due to trust
  • Stephen mentioned cognitive computing -- where machine does the interpretation
  • Speciality vs Role -- reviewed 2017-03-24_Learning_Health_Systems_Call
    • CareTeam.participant.role (existing) 0..* -- but the relationship (e.g. mom) is RelatedPerson.relationship
    • CareTeam.participant.responsibility 0..*
    • CareTeam.participant.specialty 0..*
  • Russ said intensivists can and do cover intensive care units remotely
  • Lisa asked if the role is more like clinician for all non-related persons - versus - PCP, Night Nurse as responsibilities? Use role to determine who is getting paid vs who is a volunteer? The Rhode Island Transportation (paid) vs next door neighbor (volunteer)
  • Is literacy or skills of a related person represented as specialty? No.
  • Michelle logged a tracker (GF#13425) to OO to consider whether Observation can be used for health literacy or skills of the related person
  • Does it matter if participant is remote or not?