Transcript Slide 1
NOTES: Action items can be found on slide 27 This document will be updated and polished over a few meetings. Care Plan Team Meeting (As updated during meeting) André Boudreau ([email protected]) Laura Heermann Langford ([email protected]) 2011-02-09 (1) HL7 Patient Care Work group Participants- Meetg of 2011-02-09 Name email Count ry Yes No André Boudreau [email protected] CA Yes Laura Heermann Langford [email protected] US Yes Stephen Chu [email protected] AU No Peter MacIsaac [email protected] AU No David Rowed [email protected] AU No Adel Ghlamallah [email protected] CA William Goossen [email protected] NL No Anneke Goossen [email protected] NL No Ian Townsend [email protected] UK No Charlie Bishop [email protected] UK No Rosemary Kennedy [email protected] u US Jay Lyle [email protected] US Margaret Dittloff [email protected] US Yes Walter Suarez [email protected] US Yes Peter Hendler [email protected] US yes Ray Simkus [email protected] CA Yes Audrey Dickerson [email protected] US Yes Ian McNicoll [email protected] UK Yes Notes Yes Yes No Page 2 Participants- Profile notes - 1 Name Count ry Organization Notes André Boudreau CA Boroan Inc. (Consulting) Chair, Individual Care SCWG No. 2 (pan Canadian Standards Collaborative Working Group); project manager – standards projects; HL7 EHR and PHR WG Laura Heermann Langford US Intermountain Healthcare RN PhD,: Nursing Informatics; Emergency Informatics Association, American Medical Informatics Association; IHE Stephen Chu AU NEHTA-National eHealth Transition Authority Lead Clinical Information Architect ; co-chair HL7 Patient care WG; vice-chair HL7 NZ Peter MacIsaac AU HP Enterprise Services MD; Clinical Informatics Consultant; IHE Australia; Medical Practitioner - General Practice David Rowed AU Family medicine practice MD; Adel Ghlamallah CA Canada Health Infoway SME at Infoway (shared health record); past architect on EMR projects William Goossen NL Results 4 Care B.V RN, PhD; -chair HL7 Patient Care WG at HL7; Detailed Clinical Models ISO TC 215 WG1 and HL7 ; nursing practicioner Anneke Goossen NL Results 4 Care B.V RN; Consultant; Co-Chair Technical Committee EHR at HL7 Netherlands; Member at IMIA NI; Member of the Patient Care Working Group at HL7 International Ian Townend UK NHS Connecting for Health Health Informatics; Senior Interoperability Developer, Data Standards and Products; HL7 Patient Care Co-Chair Page 3 Participants- Profile notes - 2 Name Charlie Bishop Count ry Organization Notes UK iSOFT Product Manager - Information & Integration ; HL7 Patient care WG Rosemary Kennedy US Thomas Jefferson University School of Nursing RN; Informatics; Associate Professor; HL7 EHR WG; HL7 Patient care WG; terminology engine for Plan of care; Jay Lyle US JP Systems Informatics Consultant; Business Consultant & Sr. Project Manager Margaret Dittloff US The CBORD Group, Inc. RD (Registered Dietitian); Product Manager, Nutrition Service Suite; HL7 DAM project for diet/nutrition orders; American Dietetic Association Walter Suarez US Kaiser Permanente MD, MPH; Director of Health IT Strategy; national priority for transition of care; WEDI- Workgroup for Electronic Data Interchange Peter Hendler US Kaiser Permanente MD; informatics; lead in KP convergent terminology; SNOMED CT Ray Simkus CA Brookswood Family Practice MD; Family medicine; EMR user; active meber various standards WG in Canada; on IHTSDO Contents Committee Audrey Dickerson US HIMSS RN, MS; Standards Initiatives at HIMSS; ISO/TC 215 Health Informatics, Secretary; US TAG for ISO/TC 215 Health Informatics, Administrator; Co-Chair of Nursing Sub-committee to IHE-Patient Care Coordination Domain. Ian McNicoll UK Ocean Informatics Health informatics specialist; Formal general medical practitioner; OpenEHR; Slovakia Pediatrics EMR; Sweden distributed care approach Page 4 Meeting(s) Objectives • • • • • Agree on where we are and where we want to go Agree on the approach to get there Identify what is available and what is missing Identify tasks and develop realistic work plan Agree on roles and mechanics Page 5 Agenda – (multiple meetings) • • • • • • • • • Welcome and roll call Objectives of the meeting Care plan status update Objectives of this phase Methodology to be followed What has been done Gaps Team and roles Conclusion Next steps Next meetings Page 6 CARE PLAN STATUS UPDATE Page 7 Where we are • We have a Care Plan DSTU • We have an approved March 2010 Project Scope Statement Questions were raised and discussed regarding development processes, artefacts to be created and the types of ballots • Use cases and storyboards have been collected Some are on the wiki and HL7 PC WG page Not standardized, not reviewed More would be available o Canada (Blueprint 2015) • We have details on the methodology (see later) • Ask William Goossen for more details (add on next page) Page 8 Where we are (William?) Page 9 Notes from Jay Lile – 2011-02-03 1. INFORMATION: The DAM should inform a constrained model (DIM/DMIM/RMIM), which is then used as the basis for specifications (CDA, message, etc.). If we build a DAM, we'll presumably use it to update the Care Provision DIM. The updated DIM should be in the list of balloted deliverables. (This is much clearer in PSS 4d, but the sections should be in harmony.) 2. SCOPE ISSUE: We will also need to determine whether the DAM scope should be restricted to the care plan or should reverse-engineer the entire Care Provision DIM. 3. PSS (Project Scope Statement) UPDATE: The Scope section (4a) discusses semantic scope, but it does not lay out the scope of work. I'd suggest that the text currently in 2a be removed from 2a, expanded, and added to 4a. 4. GUIDELINE: The term "DSTU" is being used to refer to deliverables. I find that confusing: DSTU is a status, not an artifact. It would be clearer to me if artifacts were referred to as messages, cda documents, DAMs, and DIMs, and ballot status were used to modify those artifacts. E.g., "the purpose of this project is to develop a Care Plan CDA document, with all necessary antecedent artifacts [list them], and to ballot this document as DSTU." 5. DELIVERABLES: Modeling the information space will almost certainly be useful, but I'm still in the dark about the use cases. Under what circumstances is it necessary to communicate a care plan? For what business purpose are organizations paying their employees to volunteer and develop this standard? 6. PSS UPDATE: External collaboration (6) could use more detail. That would also make it less necessary to mention this slightly distracting information in previous sections. Page 10 WHERE WE WANT TO BE (TARGET) Page 11 Objectives of this phase • Get more familiar with HL7 chain of deliverables (HDF) • Consolidate and clarify business and clinical requirements Under what circumstances is it necessary to communicate a care plan? Include clinical guidelines Distributed care planning as in Sweden: meta data needed For what business purpose are organizations paying their employees to volunteer and develop this standard? • Scope: decide whether the DAM scope should be restricted to the care plan or should reverse-engineer the entire Care Provision DIM • Assemble use cases and analyze • ?Develop DAM • Update objectives once we have a better handle on our methods Page 12 Deliverables (to be updated after a few weeks of travel…) • NB: Care Plan wiki to be used for all documents Laura and André to manage? • See HDF Domain Analysis- later • Project Scope Statement Eventually… • DAM storyboard, use cases, structural models, dynamic models • Care Plan CDA? • Care Plan v3 message? Page 13 METHODOLOGY: HOW TO GET THERE Page 14 Guidelines • Use approved HL7 methods: HDF- DAP All agree • We need to familiarize ourselves with the approach • Resources HDF_1.5.doc (Jan 2010) CIC DAM Development Guide HL7 PC Cambridge 2010.pptx Format for use cases, storyboards, activity diagrams and interaction diagrams - HL7Wiki.mht • Examples EMS Domain Analysis Model VOORBEELD.pdf Page 15 HDF- Domain Analysis Overview act 3: Domain Analysis Ov erv iew Business Requirements Source: HDF_1.5.doc, page 37 Project Approved Analyze Use Cases Analyze Business Context (from 3.4.2 Use Case Analysis) «outcome» (from 3.4.1 Business Context Analysis) «outcome» Use Case Analysis Story board (from 3.7 Artifacts) (from 3.7 Artifacts) Analyze Process Flow (from 3.4.3 Process Analysis) Process Flow (from 3.7 Artifacts) Glossary Analyze Information Exchanged (from 3.7 Artifacts) (from 3.4.4 Information Analysis) Information Model (Analysis) (from 3.7 Artifacts) Analyze Business Rules «optional» Business Rules Description (from 3.4.5 Business Rules Analysis) (from 3.7 Artifacts) Business Trigger Analysis (from 3.7 Artifacts) Publish DAM DAM Approv al Page 16 WHAT HAS BEEN DONE Page 17 What do we have (assets) • • • • Approved PSS that needs revision when we are ready Use cases and storyboards (next page) Glossaries: HL7, EHR WG CEN Continuity of care P1 and P2 CEN docs are published Information model and processes and workflow • • • • Care plan DSTU of 2007 IHE models of the PPOC (Patient Plan of Care) To be updated with a good inventory (see next page) NB: we need all the assets in one location (or at least links to other locations would be found in that spot) Page 18 Use Cases and Storyboards on Hand • • • • • • Care Plan Storyboards - HL7Wiki.mht Care Plan Use cases - HL7Wiki.mht CarePlanPneumoniaStoryboard.doc Goossenetal2004Jamia-nursingprocessHL7-186.pdf Care coordination usecases v-9 IHE Australia.doc CarePlanTopicUseCasesDiabetesCare22-112010.doc • IHE-PCC_ProfileProposal_Chronic_Care_Coordination-1-AU.doc • To be updated Page 19 GAPS AND WORKPLAN Page 20 Gaps Page 21 Workplan • High level here, comprehensive on Excel • There was a work plan PC CarePlanTopic Planning & Controllist_v02.xls Page 22 TEAM AND ROLES Page 23 Team and Roles (WIP) Name email Role André Boudreau CA [email protected] CP Co-Lead Laura Heermann Langford US [email protected] CP Co-Lead Stephen Chu AU Peter MacIsaac AU David Rowed AU Adel Ghlamallah CA William Goossen NL Anneke Goossen NL Ian Townsend UK Charlie Bishop UK Rosemary Kennedy US Jay Lyle US Notes WG Co-Chair WG Co-Chair, DCM ETC. To be augmented Page 24 Team and Roles- Notes • Resource issue - the need to fill the roles of HL7 modeling and vocab facilitators to progress the works Page 25 CONCLUSION Page 26 Concluding notes • Approach is OK • Have 1 or 2 or 3 more calls to sort ourselves out • Weekly calls at 17h00 ET Page 27 Issues/Questions as of 2011-02-09 No. Date Issue Name Comments Owner Status 1 2 3 4 Page 28 Action Items as of 2011-02-09 No. Action Items By Whom 1. Clarify procedure and obtain rights for André/Laura to update CP wiki William? 2. Do an inventory of use cases and storyboard on hand Laura (student) 3. Ask William for an update (add in a diff colour to the appropriate pages) André 4 Prepare summary of the steps from HDF to produce the DAM André 5 Obtain and share the published version of the CEN Continuity of care P1 and P2 Audrey For When Done Page 29