March 1, 2011 CBCC Conference Call

Community-Based Collaborative Care Working Group Meeting

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Attendees

• Bill Braithwaite, MD

• Suzanne Gonzales-Webb CBCC Co-chair

• Mary Ann Juurlink
• John Moehrke Security Co-chair
• [mailto: Ken Salyards]
• Ioana Singureanu
• Serafina Versaggi
• Tony Weida
• Craig Winter

Agenda

1. (05 min) Roll Call, Approve Minutes & Accept Agenda
2. (15 min) SHIPPs Update
3. (15 min) Input needed from CBCC attendees on CBCC Mission and Charter
   1. Agreement from CBCC members for addition proposed?
   2. Comment received from James McClay of ECWG: Emergency Care will approve the charter if CBCC includes Emergency Care in the final paragraph as an important discipline for transitions of care from the community.
4. NEW PROJECT Proposal HL7 Confidentiality Codes - review and update (Suzanne)
5. (15 min) Request for items for May 2011 Working Group Meeting in Orlando, Florida. Please contact Suzanne to add to agenda
6. (5 min) Other Business

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Minutes

1. Action Items

Action Item: Topic for discussion in May meeting - Confidentially codes

Action Item: Preliminary discussion about confidentially codes prior to May meeting

3. Updates/Discussion

May 2011 Ballot Cycle: Notification of Intent to Ballot (NIB)

Final touches to Ballot Announcement

• Draft for comment
• Domain Analysis Model (DAM section)
• Consistency of name in NIB and PSS
• Mary Ann to receive voting notifications. This is a preview only e.g. will know who is voting
• Consolidate spreadsheet will be sent by HL7 once ballot closes

CBCC Mission and Charter

We received one negative Comment received from James McClay of ECWG: Emergency Care will approve the charter if CBCC includes Emergency Care in the final paragraph as an important discipline for transitions of care from the community.

• How is emergency care defined? ER in hospitals, ambulance, EMR, EMT, First responders
• Huge scope, there is a separate WG for Emergency Care
• We believe it must be about clarifying transitioning from emergency to community
• Which paragraph is James expecting ‘Emergency Care’ to be added to?
• Important to be very clear of the scope for each working group otherwise a work item may be given to 2 different groups
• The CBCC Mission and Charter states:

**Formal Relationships with Other HL7 Groups

The Community Based Collaborative Care Working Group participates in the Domain Experts Steering Division. We have a joint privacy vocabulary project with the Security Working Group.

CBCC also has strong links with the Structured Documents, Patient Care, Public Health and Emergency Response, Clinical Interoperability Council and Services Oriented Architecture Work Groups, based on the common goal of interoperability across sectors and disciplines within Health Care and Human Services.

-Or-

**For example e.g. Emergency Care intersects with this community

The concept of HHS includes health promotion, disease prevention, assisted living, home health, long term custodial care, hospice, community health centers and day treatment centers, as well as office-based behavioral and physical health care services. HHS may also include other human services and skill training for consumers to the extent that these other services affect needs for and outcomes of health care services (e.g. parenting and other basic occupational skills training).

NEW PROJECT Proposal HL7 Confidentiality Codes - review and update

• Initiated by Mike who asked for a list of confidentiality codes (Suzanne & Ioana)
• Kathleen developed these codes before as part of the RBAC project
• Mike and Ioana agreed that these needed to be reviewed and updated; apparently this is a small list
• Mike also said on the previous call, Security, that when he presented at HIMMS they did find some issues with the current confidentiality vocabulary. Previous discussions questioned if some of the codes are really confidentiality codes or sensitivity labels. We need to take another look, from the viewpoint of what would be logical confidently codes, in light of the current Security and Privacy DAM. We may come up with new ways to understand the Meta data.

Issues:

• Currently we don’t have a strategy on how the confidentially codes are dealt with in the context of the Security and Privacy DAM.
• Some of the confidentiality codes are; psych, HIV and we don’t want to include these as it defeats the purpose.
• Is someone actually using these codes e.g. HIV and the problem it might present in using them.
• When we talk about creating a new project what are we looking to do here? Are we making recommendations to deprecate certain values sets in this process? What happens if some of these codes are already in use? We need to know what we want to do here.
• Not make it a new project, if we review and update we will need to ballot it.
• The confidentiality codes are vocabulary and they are not balloted they need to be harmonized

We need to create a strategy for dealing with the confidentiality codes. Once we have a strategy then we can make proposals to the harmonization committee.

• Conduct research to find out who is using the value sets
• Review the possibility of deprecating some of the codes
• Make recommendation e.g. if we deprecate psyche notes, how do we deal with them?

In a previous meeting we discussed confidentiality codes; November 30, 2011

• 5 recommendations made at that time
• Confidentiality codes discussed
  • Sensitive related data based (ConfidentialityByInfoType)
  • Role based (ConfidentialityByAccessKind)

Before we move forward with a proposal for harmonization, we want to have a plan regarding confidentiality codes, vocabulary and objectives that meet the needs of both CBCC and Security. How the vocabulary needs to be modifies as the formal output. In the past we’ve discussed confidentiality from the sensitivity value but no long term strategy for where we are going.

• Joint work between Privacy and Security concerns. We need the confidentiality codes to differentiate between the different types of data just purely from an RBAC perspective
• Is it CBCC’s work item or Security’s work item?
• If Security moves forward on this item CBCC will support.
• Is there a formal work item …project on this?
• What is the urgency of this work item?

Action Item: Topic for discussion in May meeting - Confidentially codes

Action Item: Preliminary discussion about confidentially codes prior to May meeting

• Bring the list of confidentially codes up in CBCC meeting, examine what is there and move forward on a strategy on how they should be used. We need to be able to answer the question: Does the list that currently stands work for the Security and Privacy Domain Analysis Model?

Meeting adjourned at 2:54 PM Eastern