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=Planning=
 
=Planning=
  
[[Media:Clinicians on FHIR Jan 2017 Master Plan_2016-10-25.docx | Master Plan for Baltimore Clinicians on FHIR - January 2017 - draft - date: 2016-10-25]]
+
[[Media:Clinicians on FHIR Jan 2017 Master Plan_2016-10-25.docx | Master Plan for San Antonio Clinicians on FHIR - January 2017 - draft - date: 2016-10-25]]
 
+
<br>
 
<br>
 
<br>
  
 
==Tracks to be addressed==
 
==Tracks to be addressed==
  
* Allergy/Intolerance and Adverse Reaction
+
* Care Plan
* Family Member History - Clinical Genomics
 
* Clinical documentation:
 
: - Past Medical History
 
 
* Emergency care, covering:
 
* Emergency care, covering:
: - Condition
 
: - Procedure
 
: - Referral Request
 
 
* Medication
 
* Medication
 
* Diagnostic Request, Report and Observation
 
* Diagnostic Request, Report and Observation
* Care Plan, covering:
+
* Family Member History - Clinical Genomics
: - Instruction
 
: - Care Team
 
 
 
<br>
 
 
 
Goal = create at least one (or more if possible) meaningful example(s) (actual JSON resource instance) for each FHIR resource otherwise the limitation of the FHIR resource is identified.
 
 
 
<br>
 
 
 
==Planning Notes for Each Track==
 
 
 
Seven tracks have been identified for the January 2017 Clinician-on-FHIR event.
 
 
 
===Family Member History===
 
 
 
* For discussion on: 1 November 2017 conference call<br>
 
 
 
''Track lead/co-leads'':<br>
 
: - Grant Wood
 
: - Gil Alterovitz
 
 
 
 
<br>
 
<br>
''Scope'':<br>
+
- Details of planning notes for each track can be accessed through the following wiki page:
: - To include clinical genomics
+
: - [[January 2017 Clinician-on-FHIR Planning Notes]]
  
 
<br>
 
<br>
''Goals/Objectives''<br>
+
* Goal = create at least one (or more if possible) meaningful example(s) (actual JSON resource instance) for each FHIR resource otherwise the limitation of the FHIR resource is identified.
 
 
  
 
<br>
 
<br>
''Lessons from previous Clinician-on-FHIR''<br>
 
 
  
<br>
+
==Supporting Tool and Information==
''Use cases / Scenarios''<br>
 
  
 +
* '''Tool'''
 +
:- Participants registered for the Clinician-on-FHIR event are strongly recommended to familiarise themselves with the clinFHIR tool
 +
:: - A new user interface has been created to support creation of clinical story built from a set of FHIR resources based on the clinical scenario described in the Tracks section below
 +
:: - Logon to the clinFHIR site:
 +
::: - [clinFHIR.com/]
 +
::: - Connect to the FHIR servers by selecting the appropriate Data Server (e.g. Public HAPI DSTU3), Conformance Server and Terminology Server
 +
::: - click on the "Tool" icon on the top right hand corner of the clinFHIR page and select "simple builder" option
 +
:::: (Note - "simple builder" will soon be changed to "scenario builder")
  
 +
* '''Supporting Information'''
 +
:: - Dr David Hay has provided some very useful information on this new "simple builder" ("scenario builder") tool.
 +
::: - [[Media:Clinfhir cheatSheet Jan 2017.docx | clinFHIR "simple builder" Getting started guide (created by Emma Jones)]]
 +
:: - Information on this tool can be accessed from his blog:
 +
::: - [https://fhirblog.com/2017/01/09/building-a-set-of-resources-in-fhir/#more-159489 Building a set of Resources in FHIR]
 
<br>
 
<br>
''Processes''<br>
 
 
  
 +
=Clinician-on-FHIR Tracks=
  
<br>
+
==Care Plan==
===Allergy/Intolerance and Adverse Reaction===
 
  
* For discussion on: 8 November 2017 conference call<br>
+
* Track lead: Emma Jones/Laura
 +
* '''Clinical Secenario'''
 +
:: - Patient with Type 2 Diabetes managed by multi-disciplinary care team with PCP as care coordinator
 +
:: - Multi-disciplinary care plan created by PCP after discussions with patient to coordinate care management
 +
*  FHIR resources used in this track:
 +
: - CarePlan which references the following resources:
 +
:: CareTeam, Goal, Condition, Observation, DiagnosticRequest, ReferralRequest, MedicationRequest
 +
:: +/- Vaccination
 +
:: Issue to be resolved - what to use for Patient Instruction?
  
''Track lead/co-leads'':<br>
+
* [[Media:FHIRCare Plan_Resource_Test_DataV2-1.xlsx |Diabetic Care Plan Test Data]]
: - Russ
 
: - Elaine
 
: - Rob
 
  
 
<br>
 
<br>
''Goals/Objectives''<br>
 
  
 +
==Emergency care==
  
<br>
+
* Track lead: Jim McClay/Laura
''Lessons from previous Clinician-on-FHIR''<br>
+
* '''Clinical Scenario'''
 +
: - Patient presents at ED suspected of exhibiting communicable disease signs and symptoms
 +
:: - ED intake/triage workflow is initiated
 +
:: - Physician/Nursing evaluation workflow is initiated
 +
::: - Travel history screening, Observation and diagnostic tests, triggering CDC communicable diseases management protocol
 +
* FHIR Resources used:
 +
: Questionnaire, QeustinnaireResponse, Observation, DiagnosticRequest, DiagnosticReport, ClinicalImpression, Condition
 +
:: +/- MedicationRequest, ReferralRequest
  
 +
* ED Workflow information: Refer to HL7 Domain Analysis Model: Emergency Care Release 1 - US Realm January 2016
  
 
<br>
 
<br>
''Use cases / Scenarios''<br>
 
 
 
<br>
 
''Processes''<br>
 
  
 +
==Diagnostic Track==
  
 +
* Track lead: Rob Hausam
 +
* '''Clinical Scenario'''
 +
: - Type 2 Diabetes patient
 +
:: - PCS instructs patient to perform the following at home as per CarePlan
 +
::: - BSL x 3/day; BP x 1/day; Body weigh x1/week
 +
:: - At follow-up consultation in 4 weeks, PCP reassess patient and requested:
 +
::: - Fasting blood glucose, Fasting lipids
 +
:: - At follow-up consultation, patient also complains of productive cough (greenish sputum) and fever
 +
::: - PCP requested: sputum for microbiology test
 +
* FHIR Resources used:
 +
: Observation, DiagnosticRequest
  
 
<br>
 
<br>
===Clinical documentation===
 
  
* For discussion on: 22 November 2017 conference call<br>
+
==Medication==
  
''Track lead/co-leads'':<br>
+
* Track leads: Melva/John Hatem
: - Russ
+
* '''Clinical Scenario'''
: - Emma
+
: - Type 2 DM patient
: - Stephen (tentative)
+
:: - PCP reviews patient's medication history, performs medication reconciliation where necessary, requests diabetic medications (and other relevant medications, e.g. antibiotics for respiratory infection), updates medication list, medications dispensed by pharmacist, and administered by patient
 +
* FHIR Resources used:
 +
: Medication, MedicationRequest, MedicationDispense, MedicationAdministration, MedicationStatement, MedicationList (List resource)
  
<br>
+
* Questions: what about new instructions to patient? recommendation to prescriber?
''Scope''<br>
+
: Plan medication management in CarePlan resource: medication order through to administration
: - to cover Past Medical History
 
  
 
<br>
 
<br>
''Goals/Objectives''<br>
 
  
 +
==Family Member History==
  
<br>
+
* ''Track lead/co-leads'':Grant Wood/Gil Alterovitz
''Lessons from previous Clinician-on-FHIR''<br>
+
* '''Scenario'''
 
+
: - To be completed
 
 
<br>
 
''Use cases / Scenarios''<br>
 
 
 
 
 
<br>
 
''Processes''<br>
 
 
 
 
 
<br>
 
 
 
===Emergency care, covering===
 
 
 
* For discussion on: 29 November 2017 conference call<br>
 
 
 
''Track lead/co-leads'':<br>
 
: - Jim
 
: - Laura
 
 
 
<br>
 
''Scope''<br>
 
- To include: Condition, Procedure, Referral Request
 
 
 
<br>
 
''Goals/Objectives''<br>
 
 
 
 
 
<br>
 
''Lessons from previous Clinician-on-FHIR''<br>
 
 
 
 
 
<br>
 
''Use cases / Scenarios''<br>
 
 
 
 
 
<br>
 
''Processes''
 
 
 
 
 
<br>
 
===Medication===
 
 
 
* For discussion on: 6 December 2017 conference call<br>
 
 
 
''Track lead/co-leads'':<br>
 
: - Melva
 
: - John Hatem
 
 
 
<br>
 
''Scope'':<br>
 
: - To include: Medication, Medication Order, Medication Dispense, Medication Administration, Medication Statement
 
 
 
<br>
 
''Goals/Objectives''<br>
 
 
 
 
 
<br>
 
''Lessons from previous Clinician-on-FHIR''<br>
 
 
 
 
 
<br>
 
''Use cases / Scenarios''<br>
 
 
 
 
 
<br>
 
''Processes''<br>
 
 
 
 
 
<br>
 
 
 
===Diagnostic Request, Report and Observation===
 
 
 
* For discussion on: 13 December 2017 conference call<br>
 
 
 
''Track lead/co-leads'':<br>
 
: - Rob
 
 
 
<br>
 
''Goals/Objectives''<br>
 
 
 
 
 
<br>
 
''Lessons from previous Clinician-on-FHIR''<br>
 
 
 
 
 
<br>
 
''Use cases / Scenarios''<br>
 
 
 
 
 
<br>
 
''Processes''
 
 
 
 
 
<br>
 
 
 
===Care Plan, covering===
 
 
 
* For discussion on: 01 November 2016 conference call<br>
 
 
 
''Track lead/co-leads'':<br>
 
: - Laura
 
: - Emma
 
 
 
<br>
 
''Scope'':<br>
 
: - To include: Instruction, Care Team
 
 
 
<br>
 
''Goals/Objectives''<br>
 
:- What is the best way to do instruction?
 
* Communication does not seem to meet the needs of what is needed (demonstrate why. meta data? what is missing).
 
* Careplan.activity.... does not seem to mee the needs (demonstrate why, what is missing?)
 
 
 
<br>
 
''Lessons from previous Clinician-on-FHIR''<br>
 
 
 
 
 
<br>
 
''Use cases / Scenarios''<br>
 
:- define what is meant by instruction
 
* Discharge instruction (Take this med, get this follow up, follow this activity or diet)
 
* Care activity instruction (medication
 
:-a. Diet: Diabetic low salt diet
 
:-b. Medications: Take prescribed medications as advised.
 
:-c. Appointments: Schedule an appointment with Dr Seven after 1 week. Follow up with Outpatient facility for Immunosuppression treatment.
 
:-d. For Fever of > 101.5 F, or onset of chest pain/breathlessness contact Emergency.
 
 
 
:-a. Appointments: Schedule an appointment with Dr Seven after 1 week. Follow up with Outpatient facility.
 
:-b. In case of fever, take Tylenol as advised in plan of treatment.
 
 
 
 
 
<br>
 
''Processes''<br>
 
 
 
 
 
<br>
 
 
 
==ClinFHIR Tool Review==
 
 
 
* Date: 3 January 2017 Conference call
 
<br>
 
 
 
* Details - TBA
 
  
  
Line 282: Line 139:
 
<br>
 
<br>
 
The HSSP community is running a project, which is a FHIR based Care Coordination Service. <br>
 
The HSSP community is running a project, which is a FHIR based Care Coordination Service. <br>
The project:
+
Details about this project are available at the Clinicial-on-FHIR planning notes wiki page:
+
* [[January 2017 Clinician-on-FHIR Planning Notes]]
- plans to define services and profiles that allow care coordination across clinical teams for a patient (e.g. manage teams, care plans, etc)
 
- expects to use FHIR resources, profiles, operations etc to define a "Care Coordination Service"
 
- has use cases, and some preliminary architecture
 
- plans to hold a connectathon track at the January meeting
 
- is working towards an initial submission date of Feb 2017, and is being lead by AllScripts
 
 
   
 
   
The project is seeking participation from the FHIR community, including all those that are already working on (or have in production) solutions around coordinated care, both inside USA and outside as well.
+
* What's new for the January 2017 Technical Connectathon?
 
+
: - There will be a small team of clinicians working alongside the FHIR developers to test how well the clinical workflow may work alongside the technical workflow
A proposal has been initiated for a Care Plan track to be run at the Jan FHIR connectathon (technical connectathon) that would focus on testing CarePlan, CareTeam, and Goal.  And any any profiles that are available or proposed at that time, e.g. US-Core profiles and the IHE Dynamic Care Plan IG.
+
: - The CarePlan track has been selected for this new joint initiative
 
+
: - Care Plan test data created by the Care Plan team will be used in this track
More details about the proposal can be found at this link:
+
: - Lessons learnt from the technical connectathon will be used as inputs into the Clinician-on-FHIR CarePlan track in the Friday event
 
 
http://wiki.hl7.org/index.php?title=201701_Care_Plan
 
 
 
  
 
<br>
 
<br>

Latest revision as of 00:17, 31 January 2017

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Return to: FHIR Clinical Resources - PCWG
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Return to: Clinician on FHIR 2017

Introduction

The January 2017 Clinician-on-FHIR event will be hosted on Friday January 20, 2017.


Weekly preparatory conference calls are being hosted on Tuesdays at 5:00 - 6:00 pm US Eastern.

First Clinician-on-FHIR call starts: Tuesday October 4, 2016

Conference call details: please see HL7 email broadcast


Planning

Master Plan for San Antonio Clinicians on FHIR - January 2017 - draft - date: 2016-10-25

Tracks to be addressed

  • Care Plan
  • Emergency care, covering:
  • Medication
  • Diagnostic Request, Report and Observation
  • Family Member History - Clinical Genomics


- Details of planning notes for each track can be accessed through the following wiki page:

- January 2017 Clinician-on-FHIR Planning Notes


  • Goal = create at least one (or more if possible) meaningful example(s) (actual JSON resource instance) for each FHIR resource otherwise the limitation of the FHIR resource is identified.


Supporting Tool and Information

  • Tool
- Participants registered for the Clinician-on-FHIR event are strongly recommended to familiarise themselves with the clinFHIR tool
- A new user interface has been created to support creation of clinical story built from a set of FHIR resources based on the clinical scenario described in the Tracks section below
- Logon to the clinFHIR site:
- [clinFHIR.com/]
- Connect to the FHIR servers by selecting the appropriate Data Server (e.g. Public HAPI DSTU3), Conformance Server and Terminology Server
- click on the "Tool" icon on the top right hand corner of the clinFHIR page and select "simple builder" option
(Note - "simple builder" will soon be changed to "scenario builder")
  • Supporting Information
- Dr David Hay has provided some very useful information on this new "simple builder" ("scenario builder") tool.
- clinFHIR "simple builder" Getting started guide (created by Emma Jones)
- Information on this tool can be accessed from his blog:
- Building a set of Resources in FHIR


Clinician-on-FHIR Tracks

Care Plan

  • Track lead: Emma Jones/Laura
  • Clinical Secenario
- Patient with Type 2 Diabetes managed by multi-disciplinary care team with PCP as care coordinator
- Multi-disciplinary care plan created by PCP after discussions with patient to coordinate care management
  • FHIR resources used in this track:
- CarePlan which references the following resources:
CareTeam, Goal, Condition, Observation, DiagnosticRequest, ReferralRequest, MedicationRequest
+/- Vaccination
Issue to be resolved - what to use for Patient Instruction?


Emergency care

  • Track lead: Jim McClay/Laura
  • Clinical Scenario
- Patient presents at ED suspected of exhibiting communicable disease signs and symptoms
- ED intake/triage workflow is initiated
- Physician/Nursing evaluation workflow is initiated
- Travel history screening, Observation and diagnostic tests, triggering CDC communicable diseases management protocol
  • FHIR Resources used:
Questionnaire, QeustinnaireResponse, Observation, DiagnosticRequest, DiagnosticReport, ClinicalImpression, Condition
+/- MedicationRequest, ReferralRequest
  • ED Workflow information: Refer to HL7 Domain Analysis Model: Emergency Care Release 1 - US Realm January 2016


Diagnostic Track

  • Track lead: Rob Hausam
  • Clinical Scenario
- Type 2 Diabetes patient
- PCS instructs patient to perform the following at home as per CarePlan
- BSL x 3/day; BP x 1/day; Body weigh x1/week
- At follow-up consultation in 4 weeks, PCP reassess patient and requested:
- Fasting blood glucose, Fasting lipids
- At follow-up consultation, patient also complains of productive cough (greenish sputum) and fever
- PCP requested: sputum for microbiology test
  • FHIR Resources used:
Observation, DiagnosticRequest


Medication

  • Track leads: Melva/John Hatem
  • Clinical Scenario
- Type 2 DM patient
- PCP reviews patient's medication history, performs medication reconciliation where necessary, requests diabetic medications (and other relevant medications, e.g. antibiotics for respiratory infection), updates medication list, medications dispensed by pharmacist, and administered by patient
  • FHIR Resources used:
Medication, MedicationRequest, MedicationDispense, MedicationAdministration, MedicationStatement, MedicationList (List resource)
  • Questions: what about new instructions to patient? recommendation to prescriber?
Plan medication management in CarePlan resource: medication order through to administration


Family Member History

  • Track lead/co-leads:Grant Wood/Gil Alterovitz
  • Scenario
- To be completed



Technical Connectathon


The HSSP community is running a project, which is a FHIR based Care Coordination Service.
Details about this project are available at the Clinicial-on-FHIR planning notes wiki page:

  • What's new for the January 2017 Technical Connectathon?
- There will be a small team of clinicians working alongside the FHIR developers to test how well the clinical workflow may work alongside the technical workflow
- The CarePlan track has been selected for this new joint initiative
- Care Plan test data created by the Care Plan team will be used in this track
- Lessons learnt from the technical connectathon will be used as inputs into the Clinician-on-FHIR CarePlan track in the Friday event