June 12, 2018 CBCP Conference Call

Community-Based Care and Privacy (CBCP) Working Group Meeting

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Meeting Information

Dial-in Number:  (515) 604-9861;  Access Code: 429554
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Attendees

Meeting Recording - https://fccdl.in/QJiuGUlmTb Temporary

	Member Name		x	Member Name		x	Member Name		x	Member Name
.	Johnathan ColemanCBCP Co-Chair		x	Suzanne Gonzales-Webb CBCP Co-Chair		x	Jim Kretz CBCP Co-Chair		x	David Pyke CBCP Co-Chair
x	Kathleen Connor Security Co-Chair		x	Mike Davis		.	John Moehrke Security Co-Chair		x	Diana Proud-Madruga
.	Chris Shawn		.	Neelima Chennamaraja		x	Joe Lamy		.	Greg Linden
x	Irina Connelly		.	Saurav Chowdhury		x	Dave Silver		x	Francisco Jauregui
.	Irina Connelly		.	Amber Patel		x	Becky Angeles		.	Jennifer Brush
.	Mohammad Jafari		.	Ali Khan		.	Ken Salyards		.	Ken Sinn
.	David Staggs		x	Mark Meadows		.	Ioana Singureanu		.	Beth Pumo

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Agenda

1. Roll Call, Agenda Review
2. Meeting Minutes approval: (still in process)
   • FHIR CPs for review
   • FHIR Consent CPs are located: link to ALL Consent Change requests
3. eLTSS Update - Irina / Becky
   • eLTSS gForge folder: https://gforge.hl7.org/gf/project/cbcc/docman/eLTSS%20-%20%20ONC%20Electronic%20Long-Term%20Services%20and%20Supports
   • Latest PSS posted to gForge TEFT eLTSS Supplemental ATL F2F
4. FHIR Security Project Update - Johnathan / John Moehrke
   • Weekly meeting on Tuesday - 2 PM Eastern
   • https://www.freeconferencecall.com/join/security36; Phone Number: +1 515-604-9567. Participant Passcode: 880898

Meeting Minutes DRAFT https://fccdl.in/kMPknMwAeV Meeting recording (temporary)

‘’’eLTSS update’’’

• latest draft for volume 2 and volume 3
• homework to look at, respond to Irina will discuss in detail next week

• Suzanne to forward to the next group up for (May deadline missed); to cc Becky, Irina/co-chairs on confirmation that project can go forward with current project deadlines

‘’’FHIR Security Project’’’ - John Moehrke

• not updated in about a month and a half

Johnathan

Actively walking through the ONC API paper - additional improvements to the spec

• four that will probably work through today; what do those four mean (to assist editor)
• quality check
• moving slowly

GDPR supergroup Monday 7am PT

• moving slowly relative to GPR priority
• getting group beyond storming stage
• =confluence tooling is getting in the way for progress
• writing paper that expresses essentially that we have baked into FHIR a significant S&P interoperability capability that emit beyond. there are a few obscure gaps that have been identified that we might be able to further develop with stakeholder interest
• kicked off at Cologne meeting - informal project at this time.

FHIR CP

• still looking to see if we can get output from ONC work for patient choice
  • mapping stalled due to mission reviews
• looks like CCDA on FHIR is linked to the contract on FHIR resource; we'd like to move over... as this is not the official position on consent (?)
• consent on FHIR is not owned by 'any one' WG - we're trying to get it moved over to CBCP so that we can own it and resolve the disparity between the two systems
• not a lot of CPs that require action at this time.
• contract resource in a fairly good state, need to look at other (privacy) through the other use
  • treatment, adv directives, research
  • lots of work done on pt choice, and…. (other named projects)
  • start mapping against consent resource from data received
• not a lot of forward motion but looking ahead to great things

Jim - Piper Ranallo

• clarification requested on latest
• asked question of Jim/Ioana on e-mail, may not know enough CCD specifications to
• there is a group SNOMED - mental health clinical group)?) want to update content in snomed--how do we approach priorities
  • discussion: important for us to know--what kind of findings are clinicians collecting for clinical care
  • we have a data sets that contain types and section heading for MH notes
  • we thought we would pull these heading for those data types captures
  • it is important that this work happens in collaboration with CCDA
    • there is nothing happing with CCDA and BH note is the template set... no further work was to be happening (?) is this correct
    • per Piper response to person raised … what sections are defined for CCDA is that there are no sections beyond the standard history of present illness, social history... it would not get any more granular than that
    • that granularity includes ICD10, SNOMED… that level of detail can certainly be added
• overview: the CCDA
  • there is an IG, with specific sectioning the operative note, the BH note does not have any specific content section in front clinical note... is that correct? content would be coded with SNOMED/LOINC… so content would be limited to those codes
  • there is nothing in the CCD in note/note types... a generalized note section in CCD (there is no such thing as a BH CCD) =CCD
• the diagnosis, assessment... using the standard coding schemes whether they include BH items or not, they are all there. The entire DSM5 is encoded, SNOMED is available, so that the question that you are dealing with.
  • does the snomed code need to be proliferated in some way--if that's the case then that's a problem you would deal with snomed

document/section level templates...? there are templates, but they are not system specific... they are specific to record BP then they are expecting xxxxx-xx digits

the person who raised this question, did work on the operative notes... it looks like there is a diagnostic note, discharge note, etc... ([Jim: these are different flavors of the CCD--used for different kinds of things, not specific to a specific body system]

understood; if a discharge summary / procedure summary / use those templates and detail out the MH/BH items I got a feeling they created more granular sections...

• who deals with CCDA? which working group - structured docs
  • Piper will reach out to Structured docs with questions (0002)

• we would need to sponsor the project, but work in conjunctions with Structured docs
  • maybe an update to IG to add MH/BH items rather than an entirely new project

Meeting adjorned at 0934 Arizona Time