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Care Plan Initiative project 2011

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Return to: Patient Care

Go to: Care Plan Project - PCWG
Go to: Care Plan Project 2012
Go to: Care Plan Topic project (Project contents prior to 2011)

This is the Care Plan project initiated in 2011. Latest updates on this project has been moved to the Care Plan Project 2012.

Return to: Care Plan Project 2012


Care Plan has been balloted some years ago as DSTU. However, it was felt at that time that more work needed to be done in defining care plan, the components of the care plan, identifying use cases and use. The plan for 2011 is to first develop a Domain Analysis Model (DAM) for the Care Plan, and then decide on follow on activities. The HDF 1.5 (HL7 development framework) approach will be followed. HL7 PC will work together with various groups including HL7 Work Groups (e.g. EHR, Structured documents), IHE, NEHTA, Canada Health Infoway, and others.

Project Co-Leaders

Laura Heermann Langford
Intermountain Healthcare, USA
Phone: 801.290.6888
Stephen Chu
NEHTA Australia
Phone: +61.416.960.333

Meeting Information

The Care Plan project team meets via conference call on a regular basis. The group will report to the HL7 Patient Care Workgroup through one of the Co-Chair or at the HL7 meetings.

  • Standing Meeting Date/Time: every second Wednesday (starting on Feb. 1st for winter 2012 period) at 17h00 NA Eastern Time /16h00 NA Central Time/ 15h00 NA Midwest Time/ 14h00 NA Pacific Time/ 22h00 UK / 23h00 Central Europe / 08h00 Australia
    • Interim meetings can be scheduled if needed.
  • Duration: 90 to 120 minutes (1,5 to 2 hours)
  • Call Logistics- voice
    • Phone Number: 770-657-9270
    • Participant Passcode: 943377#
  • Call Logistics- screen sharing/

To be determined

Meeting Agendas and Minutes

Agendas and Minutes

Project Deliverables and Working Documents

Note: the following list of deliverables will be adjusted as the project progresses.

These are the working versions of the Care Plan requirements, as the DAM work progresses.

The following list of storyboards covers the relevant range of situations sufficient to identify the needs for Care Plan interoperability.

-Acute Care
-Chronic Care
-Home Care
-Pediatric Allergy
-Pediatric Immunization
-Stay healthy

Note: Primary care encounters appear in many of the above SB. We may decide to add a specific Primary Care SB as we move along.

LATEST VERSIONS of Storyboards (in alphabetical order)

OLDER VERSIONS of Storyboards (in alpha order, most recent on top)

The business process models (BPM) are built with Enterprise Architect (Sparx Systems) but the files cannot be uploaded to this wiki. The xml version have been uploaded here in a zip file and can be read with any browser.

OLDER VERSIONS OF MODELS These diagrams are provided in original Enterprise Architect format (eap) but zipped due to file size, and in pdf.

CLASS DIAGRAM To be added here

GLOSSARY OF TERMS To be added here

Project Scope

To be revised.


The Care Plan Topic is one of the roll outs of the Care Provision Domain Message Information Model (D-MIM). The Care Plan is a specification of the Care Statement with a focus on defined Acts in a guideline, and their transformation towards an individualized plan of care in which the selected Acts are added.

The purpose of the care plan as defined upon acceptance of the DSTU materials in 2007 Care Provision: Care Plan 2007 DSTU Feedback is:

  • To define the management action plans for the various conditions (for example problems, diagnosis, health concerns)identified for the target of care
  • To organize a plan for care and check for completion by all individual professions and/or (responsible parties (including the patient, caregiver or family) for decision making, communication, and continuity and coordination)
  • To communicate explicitly by documenting and planning actions and goals
  • To permit the monitoring, and flagging, evaluating and feedback of the status of goals, actions, and outcomes such as completed, or unperformed activities and unmet goals and/or unmet outcomes for later follow up.
  • Managing the risk related to effectuating the care plan,

Generally a care plan greatly aids the team (responsible parties – it could be the patient caregiver/family) in understanding and coordinating the actions that need to be performed for the person. The Care Plan structure is used to define the management action plans for the various conditions identified for the target of care. It is the structure in which the care planning for all individual professions or for groups of professionals can be organized, planned and checked for completion. Communicating explicitly documented and planned actions and goals greatly aids the team in understanding and coordinating the actions that need to be performed for the person. Care plans also permit the monitoring and flagging of unperformed activities and unmet goals for later follow up.

Project Objectives and Outcomes

To be revised. 1. Domain Analysis Model with the following deliverables (together with SD WG):

    • Definitions of Care Plan and others.
    • Work on storyboards and use cases (multiple). Emergency, Clinical hospital (discharge), Nursing home, chronic disease, primary care. Multidisciplinary. Example use cases can be: 1 chronic condition, obstetric case with transfer. After that CDA can use the work that is be done. CDS is an addition to the messages which already exist. They must be updated.
    • Dynamic model for the Care Plan Topic
    • Structural model. -> DAM (HDF within HL7)

Project Work Plan and Timeline

To be inserted.

Project Team and Ressources

Primary Sponsor/Work Group is Patient Care WG

Work Group Team Members
Role Name Email Notes
Project Co-Lead Laura Heermann Langford
Other interested parties Stephen Chu Co-Chair PCWG
Publishing facilitator ??
Vocabulary facilitator ??
Modeling facilitator Luigi Sison
Domain expert representative 1 ??
Domain expert representative 2 ??
Data Analyst facilitator ??
Business requirement analyst ??
Requirements process facilitator
Business requirement analyst
Requirements process facilitator ??
Implementor ??


Users of Care Plan

Contributors of the Care Plan Topic

To be revised.

Collaborating with Agreement status Comments
IMIA-NI Existing
IHE Existing
CEN Existing Swedish Care Plan project

Download CEN materials from Sweden here:

See also the reference material wiki page (link above)

Project Resources

Most will be done in normal committee work time, and online via meetings.

Project Budget

To be defined.

Action items

Table to be inserted.

=Ballot strategy - general||

To be defined.