Health Concern
Return to: Patient Care
This is a new Health Concern Project initiated October 2013.
This wiki page contains latest contents for the Health Concern Project post September 2013 WGM at Cambridge.
Contents
Introduction
Care Plan has been balloted in 2007 as DSTU. However, a number of ballot issues were not resolved satisfactorily and consequently the balloted contents did not reach DSTU status.
The project plan initiated in 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
- Michael Tan
- Organisation:
- Phone:
- Email:
- Kevin Coonan, MD
- Phone:
- Email: k e v i n <dot> c o o n a n [Gmail and Skype--remove the spaces]
Meeting Information
Insert conference call details here
- Call Logistics- voice
- Phone Number: 770-657-9270
- Participant Passcode: 943377#
- Call Logistics- screen sharing/
- Web conferencing URL:
The meeting number is 239 498 434 No password is required.
Meeting Agendas and Minutes
Health Concern: Concept, Definitions and Related Discussions
Concern
Definition:
- A concern is a matter of interest or importance to someone
Health Concern
Definition:
- A Health Concern is a health related matter that is of interest or importance to someone, who may be the patient, patient's family or patient's health care provider
- The health related matter is of sufficient interest/importance that someone in the health care environment (patient, family, provider) has identified to be requiring some attention and perhaps tracking
- A health concern may be identified from different perspectives:
- - Patient
- - Family member/carer
- - Providers (physician, surgeon, physical therapist, respiratory therapist, nutritionist, health educator, social worker, etc)
- From information management perspective, "health concern" can been considered to encompass two subconcepts:
- - Health Concern Tracker
- - Health Concern Observation
Health Concern Tracker
- A Health Concern (Tracker) contains no semantics beyond that need for tracking, excepting the link between related Conditions (as identified through ObservationEvent or ObservationRisk assessments conveying Event, Clinical Finding, Disorder assertions, etc).
Health Concern Observation
- Health concern observations are observations and evaluations (meta-observations) of matters related to a patient's health that are of interest or important to someone
- The observations and evaluations can be from the perspective of the patient, the patient's family, the carer, or any health care providers involved in the care of the patient
- The scope of observations and evaluations cover health issues, problems, conditions, diagnosis
- Related health concern observations are linked and tracked by the Health Concern Tracker
Working Documents and Project Deliverables
Note: the following list of documents/deliverables will change as the project progresses.
Working documents are found here
Links to Other Related and Relevant Projects
Definitions from C-CDA
Definition of a Health Concern
It is a wrapper for health concerns derived from a variety of sources within an EHR (such as
Problem List, Family History, Social History, Social Worker Note, etc.).
A Health Concern Act can represent a health concern that a patient currently has. Health
concerns require intervention(s) to increase the likelihood of achieving the goals of care for the
patient.
A Health Concern Act can also represent a health concern that is a risk. A risk is a clinical or
socioeconomic condition that the patient does not currently have, but the probability of
developing that condition rises to the level of concern such that an intervention and/or
monitoring is needed.
Definition of a Problem Concern
This template reflects an ongoing concern on behalf of the provider that placed the concern on
a patient’s problem list. So long as the underlying condition is of concern to the provider (i.e. so
long as the condition, whether active or resolved, is of ongoing concern and interest to the
provider), the statusCode is “active”. Only when the underlying condition is no longer of
concern is the statusCode set to “completed”. The effectiveTime reflects the time that the
underlying condition was felt to be a concern – it may or may not correspond to the
effectiveTime of the condition (e.g. even five years later, the clinician may remain concerned
about a prior heart attack).
The statusCode of the Problem Concern Act (Condition) is the definitive indication of the status
of the concern, whereas the effectiveTime of the nested Problem Observation is the definitive
indication of whether or not the underlying condition is resolved
Project Scope
Definition
A Health Concern is any health related issue which is identified by a user of an EHRS as needing tracking. The concept of a Health Concern is agnostic to the specific content or who identified the need to track it. It is principally concerned with the tracking and maintenance of the expressed content. In all cases there will need to be an Observation (a Condition) which names the Health Concern. Condition can be diagnosis, signs, symptoms, risks (of some future undesirable state), risk factors, abnormal diagnostic study, barrier to care, propensity to adverse reaction (aka "allergy"), or patient preference. This is based on a long-standing convention, and has been broadened to accompany the range of Health Concerns. Additional types of Health Concerns are quite possible, if they differ substantially from some existing type.
Additional criteria based on the specific Condition which names the Health Concern
Previous discussion has indicated that a Health Concern requires some sort of action on the part of the care team (which potentially includes the subject and/or record target), based on the specifics of the Condition which names the Health Concern. Thus, there is a Condition specific requirement to be the reason for some action, even if that action is to simply observe. A Condition also implies one or more (prioritized) Goals, i.e. an assertion of what should happen or the desired outcome.
Project Objectives and Outcomes
As per Health Concern Project Scope Statement.
Project Work Plan and Timeline
As per Health Concern Project Scope Statement.
Project Team and Ressources
Primary Sponsor/Work Group is Patient Care WG
