Difference between revisions of "Patient Care January 2016 WGM Orlando, Jan 10 to Jan 15"
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The Care Plan takes a multidisciplinary point of view. An order set would contribute to the overall plan for the patient. In the care plan model - the care plan is in the middles with goals, risks, problems and the health care team are associated with the care plan. With an activity will see orders. an order can be a single order or an order set. So, from a care plan view, not repetitive to have a resource for order set. An order set is a natural component of a care plan. Orders may need to be elevated within the model to be more visible. | The Care Plan takes a multidisciplinary point of view. An order set would contribute to the overall plan for the patient. In the care plan model - the care plan is in the middles with goals, risks, problems and the health care team are associated with the care plan. With an activity will see orders. an order can be a single order or an order set. So, from a care plan view, not repetitive to have a resource for order set. An order set is a natural component of a care plan. Orders may need to be elevated within the model to be more visible. | ||
| − | Are there descriptions or definitional items that assist with building order sets? Can discuss the various levels of a care plan. Can have goals related to all issues or one issue. Can have an entire care plan around one condition, or topic. Plans can be nested. The FHIR Care Plan was created without necessarily aligning within the Care Plan DAM. Now harmonizing the two. | + | Are there descriptions or definitional items that assist with building order sets? Can discuss the various levels of a care plan. Can have goals related to all issues or one issue. Can have an entire care plan around one condition, or topic. Plans can be nested. The FHIR Care Plan was created without necessarily aligning within the Care Plan DAM. Now harmonizing the two. Will the FHIR Care Plan go through changes in the next release? This is unknown, but could be likely. For the proposed order set resource -- from a care plan perspective would point to the order set resource. |
| − | |||
| + | Care plan vs. care process model? Could use the care plan model as a care process model. However, current model addresses data only, not authority or process. Is this a point in time or over time plan? It is designed to be both a static plan snap shot as well as a longitudinal plan. Designed to be fluid between care team members. Is it definitional -- e.g. for a patient with Diabetes do this specific plan of care -- can use it in this way. It can also be customized to each individual patient. | ||
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Revision as of 19:13, 12 January 2016
- Back to Patient Care
- Back to 2016 PCWG WGM Agenda and Minutes
Orlando, WGM - January 2016 Patient Care WG Meeting Approved agenda:
Contents
- 1 Orlando WGM - January 2016. Patient Care WG Meeting Meeting Minutes
- 2 Patient Care WGM, Monday, January 11, 2016
- 3 Patient Care WGM, Tuesday, January 12, 2016
- 4 Patient Care WGM, Wednesday, January 13, 2016
- 5 Patient Care WGM, Thursday, January 14, 2016
- 6 Patient Care WGM, Friday, January 15, 2016
Orlando WGM - January 2016. Patient Care WG Meeting Meeting Minutes
- Sunday, January 10 - International Council Meeting
- - No PCWG meeting
Patient Care WGM, Monday, January 11, 2016
- Back to Patient Care
- Back to 2016 PCWG WGM Agenda and Minutes
Patient Care Monday Q1
Attendees Jay Lyle, Russ Leftwich, Elaine Ayres, Emma Jones, Michelle Miller, David Pyke, Larry McKnight, Michael Tan
Minutes
Agenda check
Approval of prior minutes (Atlanta)
David/Emma: 0 -2 abstain – 4 approved
Week's agenda Approval for Elaine to be a co-chair designee for the week. Michelle/Emma: 0-0-7
Anesthesia wants to meet.
Stephen suggested to Anesthesia already, but they may only be here Mon/Tues. Suggested times:
- Monday Q3 (same time as workflow)
- Tues Q5
SDC wants to discuss Health Concern (and PC wants to discuss goals with ONC) SDC can’t attend existing session. Jay will reach out to SDC with options:
- Wed Q2 (Emma, Elaine could attend)
- Wed Q3 (Genomics declined, so FHIR topics such as Questionnaire/QuestionnaireResponse, Clinical Impression)
- Thurs Q1 check with OO to see if PC needs to attend
Elections Please vote!
Workgroup Health Good job! Keep an eye on
- Decision making processes
- SWOT
- Charter
- Harmonization - Rob H. was designee
- 3 year plan – list of projects that are in the register (some are active, proposed, linger); review and see if any can be closed out;
3 yr planning Jay will own cleaning up this week. Send Dave Hamill an email.
- Detailed Clinical Models Release 1 (320) - not an open project, just needs to be recirculated
- Care Provision: Assessment Scales Topic (664)– never got published, ask William about that
- HL7 Care Coordination Service (CCS) (924) – ready for publication; Laura will clean up and submit it for publishing; publish for HL7 members only for 90 days before publish to the public
- Care Plan Initiative (932) – DAM not published; take all story boards, except one, and move them to the appendix; Laura owns that action item
- V3 Allergy and Intolerance Clinical Models (1004) – published and available for comments; project is done; close project
- Care Plan Clinical Models (1085) – check with Laura to see if it can be closed
- PCWG Develop FHIR resources and profiles for the second DSTU release.
New projects None
FHIR Update from Sunday’s Q4 meeting
- Maturity Review - what to ballot when (2.1 in May 3 in Sept?) – need work groups to look at resources and find out which resources are projected to have which maturity levels by next release; FHIR health –DSTU comments – check that the changes were made; any outstanding issues?
- Need clarification in FHIR maturity model to know if there is production use (instead of production systems) and/or what constitutes a connectathon
- Naming – FHIR could be dropping DSTU label because it isn’t part of ANSI’s process; FHIR is thinking about calling it informally a “working” standard, but Patient Care’s concern is credibility about losing the “draft standard” label. The maturity levels are per resource, not for the entire standard.
- David will own drafting Patient Care’s statement/response back to FHIR
- Error list in FHIR build – confirm with Lloyd that he is fixing any errors on Patient Care’s error report
Adjourn 1/11/2016 at 10:33am Eastern
Patient Care Monday Q2
No PCWG meeting
Patient Care Monday Q3
No Patient Care hosted meeting; Patient Care attending FHIR Infrastructure - Workflow meeting
Patient Care Monday Q4
No Patient Care hosted meeting; Patient Care attending FHIR Infrastructure - Workflow meeting
Patient Care Monday Q5: Placeholder for extra meeting if necessary
Present:
Minutes:
Patient Care WGM, Tuesday, January 12, 2016
- Back to Patient Care
- Back to 2016 PCWG WGM Agenda and Minutes
Patient Care Tuesday Q1
Present:
Minutes: Overview of CIMI provided by Stan Huff
Patient Care Tuesday Q2
Present:
Minutes:
Health Concern vs Problem
Patient Care's view
- A concern is a higher level abstraction than the problem (ex. concern of obesity) that connect problems into a concern
- A concern connects events and tracks progress over time (what started with and what it has become) - Example: back pain grows worse into hernia
- DAM is sufficiently abstract such that it supports knowing who expressed concern; DAM can handle either objective or subjective
- Patient Care DAM is saying concern is greater than problem; problem can be a subset of concern
- Concerns are both Problems and Additional Health Concerns - and each is represented in its own CDA section
Structured Doc's view based on ONC's proposal (attachment in Patient Care listserv [1] )
- Active problems are in the problem concern section
- The "Additional Health Concerns" section is used for additional concerns, such as concerns from the patient or other care team members
- Clinician owns the problem list whereas concerns are open to others, such as chaplain
- Note: Unhealthy family relationships and drug/alcohol abuse could be concerns, but may not be endorsed by patient
- Clinicians don't need to reconcile additional health concerns, but there is no legal requirement for the clinician to reconcile problems on the problem list - yet they should reconcile a concern of sick parent after parent is deceased
- Goal is to allow the patient and other care team members to express concerns (e.g. financial instability, homeless) to flow into the longitudinal care plan
- The MU requirement is to allow health concerns to be entered into the record
- Intent is that additional health concerns are viewable, clinician considers them, clinician follows them, but clinician doesn't necessary endorse (or agree with) the concern; The clinician should ask patient about concerns, but not the clinician's job to agree or disagree with patient.
- The Problem concern is more objective whereas the Additional Health Concern section is more subjective
- The Additional Health Concerns section is not intended to duplicate the concerns in the problem concern section
Vote
- Motion is for Patient Care agrees that the ONC proposal (attachment in Patient Care listserv [2]) is not in conflict with the DAM
- Jay/Larry: 0-abstain; 0-negative; 22-approval
- Motion to recommend that SDC modify the ONC proposal: When the document contains both a Problem Concern and a Health Concern section, then the section title will be the "Additional Health Concerns" and keep the same LOINC code.
- Jay/Brett: 1-abstain; 1-negative; 20-approved
Patient Care Tuesday Q3
Present: Laura Heermann Langford - Chair, Elaine Ayres - Scribe
Minutes:
AGENDA -
- Care Plan and Order Set Resource
- Updates to C-CDA and updates to CQI products
- Care Plan and Order Set Resource**
The Care Plan takes a multidisciplinary point of view. An order set would contribute to the overall plan for the patient. In the care plan model - the care plan is in the middles with goals, risks, problems and the health care team are associated with the care plan. With an activity will see orders. an order can be a single order or an order set. So, from a care plan view, not repetitive to have a resource for order set. An order set is a natural component of a care plan. Orders may need to be elevated within the model to be more visible.
Are there descriptions or definitional items that assist with building order sets? Can discuss the various levels of a care plan. Can have goals related to all issues or one issue. Can have an entire care plan around one condition, or topic. Plans can be nested. The FHIR Care Plan was created without necessarily aligning within the Care Plan DAM. Now harmonizing the two. Will the FHIR Care Plan go through changes in the next release? This is unknown, but could be likely. For the proposed order set resource -- from a care plan perspective would point to the order set resource.
Care plan vs. care process model? Could use the care plan model as a care process model. However, current model addresses data only, not authority or process. Is this a point in time or over time plan? It is designed to be both a static plan snap shot as well as a longitudinal plan. Designed to be fluid between care team members. Is it definitional -- e.g. for a patient with Diabetes do this specific plan of care -- can use it in this way. It can also be customized to each individual patient.
Patient Care Tuesday Q4
Present:
Minutes:
Patient Care WGM, Wednesday, January 13, 2016
- Back to Patient Care
- Back to 2016 PCWG WGM Agenda and Minutes
Patient Care Wednesday Q1
Present:
Minutes:
Patient Care Wednesday Q2
Present:
Minutes:
Patient Care Wednesday Q3
Present:
Minutes:
Patient Care Wednesday Q4
Present:
Minutes:
Patient Care WGM, Thursday, January 14, 2016
- Back to Patient Care
- Back to 2016 PCWG WGM Agenda and Minutes
Patient Care Thursday Q1
Present:
Minutes:
Patient Care Thursday Q2 (PCWG, SDWG, Template Joint meeting)
Present:
Minutes:
Patient Care Thursday Q3
Present:
Minutes:
Patient Care Thursday Q4
Present:
Minutes:
Patient Care WGM, Friday, January 15, 2016
- Back to Patient Care
- Back to 2016 PCWG WGM Agenda and Minutes
Patient Care Friday Q0: PCWG Co-Chairs meeting
NOTE: co-chairs to determine whether this will be moved to Thursday Q-Lunch
Present:
Minutes:
Patient Care Friday Q1
(1) Template WG meeting
- - PCWG representative(s) to attend
(2) Agenda: open
- - Possible: Clinical Connectathon
Present:
Minutes:
Patient Care Friday Q2
Agenda: open
- Possible: Clinical Connectathon
Present:
Minutes:
Patient Care Friday Q3
Agenda: open
- Possible: Clinical Connectathon
Present:
Minutes:
Patient Care Friday Q4
Agenda:
- No Clinician-on-FHIR session (to be concluded Friday Q3)
PCWG will meet if there are topics of interest
Present:
Minutes:
