2017-10-06 Learning Health Systems Call

Facilitator	Russell Leftwich	Note taker(s)	Emma Jones
Attendee	Name	Affiliation
X	Russell Leftwich	InterSystems
	John Roberts	Tennessee Department of Health
X	Stephen Chu	Individual
X	Evelyn Gallego	ONC
	Kathy Walsh	LabCorp
X	Annette DeVito Dabbs
	Laura Heermann-Langford	Intermountain Healthcare
X	Emma Jones	Allscripts
	Jeff Brown	Cancerlinq
X	Lisa Nelson	Individual
	Dave Carlson	VA
	Chris Melo	Phillips Healthcare
	Michelle Miller	Cerner
	Benjamin Kummer	Columbia University
	Matt Rhan
	Michael Padula
X	Joseph Quinn
X	Thomson Kuhn
	Rob Hausum
X	Evelyn Gallego	ONC
	Serafina Versaggi	VA

Minutes

• Chair: Russell Leftwich
• Scribe: Emma Jones

LHS Comment to ISA

• Request consideration for a new subsection representing Dynamic Care Team Management.

• • Emma posted write up for folks to review prior to submitting to HL7 LHS ISA Comment is here. Please edit as needed
    • Review comment over the next week
    • LHS will vote next Friday

Care Managers - Roles, Responsibility and Credentials

• Care Manager Roles and Responsibility (Presented by Annette DeVito Dabbs)

• Discussion

• • multiple certifying bodies with the same sertification
  • Do any accredating organization certify the training? No - the graduates are expected to certifiy via exams or experience (years in the role, etc)
  • Titles can be the same with varying degrees
  • See table 3 of the presentation for exams and eligibility criterias
  • Even with these variation there is little evidence that these roles are attributed to outcomes
    • AAANurses - have attribute positive out comes if the role is an RN
    • Some Social worker organizations have outcome data
  • Some organizations use increase in behavioral health issues to designate a social worker trained in behavioral health as ther care manager
  • All accrediting bodies are US based
  • Certifying body by health system - next step is to contact health systems to assess their job requirements
  • University of Pittsburg Medical System - roles are all over the map - e.g. acute seperate from the ambulatory, etc
  • Difficult to determine what next steps with this data will be
  • LHS interest in how to define some of these roles - as part of the governance of a care team. Trying to determine capability to be the lead in the planning role, etc
    • It would be interesting to see a summary of the various credentials and credentialling organizations. Then a summary of real world job titles and what credentials the job titles called for.
  • Findings so far - Wide variation, poorly defined, lack standizations
  • Problems
    • Unable to identify the differences
    • Unable to attribute differences in coordinations with outcomesUnable to guide practices about best model for their practices
  • Purpose:
    • compare and contrast characteristics (titles, education, disciplines, experience, roles, responsibilities, competencies, certifying bodies)
    • Provide a framework to examine differences and their impact.
  • Were care managers from any payer organizations? Haven't looked at settings yet.
  • AACM credentialing for RN only - but no overaching guidelines.
  • No payer network endorsed a certain certification.
  • Is there relationship between harmonizing certification?
  • CCM - not associated with a particular organization but certified thousands.
  • Re-imbursement driven? typically at the state level.
  • AAN and Social work groups as well as other disciplines with certain level of expertise - have written white papers as to why they are the best fit.
  • How does this relate to the LHS Care Team project?
    • Related to the governance of the care team - who can create the plan, the arbitrar, first line contact with the patient and the process of coordination
  • Study next step - to do contextual inquiries - whether using electronic care plans or not. How care managers interact with others on the care team.
  • Summary: validates the concern that there is no standardization across there roles
  • Starting the write-up for a manuscript.
  • Our value set of care team members and functions - matches with the roles and credentials.
    • This is useful for flushing their functions on the team and the role they play on the team. Second attribute is qualification.
    • Job title does not align with these concepts.
  • Many people filling these roles feel that social workers are more aligned to do a lot of the care coordination tasks.