PCCPlan Minutes 2012 10 30

Referral Matching

Presenter: George Cole

• 4 Basic Issues (Assumption that we are using XD*):
  • 1. Referring system doing the referral knows how to format and where to include a "ReferralId"
  • 2. Works for single or multiple submission sets
  • 3. Receiving system has to know how to handle, turn around the referral
    • using structured or unstructured document, etc
  • 4. Referring system needs to know whether or not it will receive a response, and which response it is receiving
• Use XDS Folders, metadata content
• Use certain pieces of CDAR2 and/or CCDA
• Q: Isn't this XDW?
  • Could be beneficially used in XDW, but this is not about tracking tasks across enterprise, but instead narrowly focusing down on a referral use case
• Look at Perinatal Workflow and ensure alignment
• Keith:
  • Agree that material is there, and this will be helpful to explain how to use it.
  • Will be challenges when dealing with unstructured documents
    • George: use XD* metadata to help deal with this
    • Keith: There is no searching capability within XDS metadata
    • Should schedule joint time with ITI during Dec meeting
• John D:
  • Is this a Transition of Care XDW component?
    • It could become that, a component of XDW
  • Is selection of the referral target out of scope, or pre-condition?
    • yes, either approach. not trying to profile this.
• Wendy S:
  • Are we restricting the idea to only using XDS?
    • Will use XDS, XDM, XDR - XD*
  • Can this be used outside of XD*?
    • the piece of this that profiles CDA content could be used outside of XD*
• Keith:
  • Is unstructured document going to be used to request a referral?
    • we could say unstructured document is off the table...otherwise will be challenges tracking
• Tone - Need to ensure we don't let this profile expand outside of original scope

Order Matching

Presenter: Emma Jones

• Can be meds, or any type of order such as a "wound assessment"
• One of the challenges may be that the communication is about a particular order, but not necessarily a fullfillment of a given order
• Order for referral vs diagnostic study is the same
• committee agrees to combine this with referral matching, to be approached as one profile

Care Management Revision

Presenter: Keith Boone

• Coordinate w/HL7 Patient Care
• Need to consider other related profiles (RCG, RCK, etc)
• Perhaps this is a harmonization or white paper effort
• Concerns w/overlap or competition with current US initiatives (S&I Framework)

Diagnostic Study Request

Presenter: Vincent van Pelt

• Is this work already addressed elsewhere in IHE?
  • Perhaps eReferral Workflow
• Scheduling piece is not addressed here..concerns with trying to tackle that
  • Scheduled component is very lightweight here
• Other Workflow profiles being put forward may have overlap here - XDW-EHDI in particular
• Can this be broadened to "Order request"?
  • Yes, ok so what are the challenges with this approach
  • Consider the concepts presented in State Chart XML http://www.w3.org/TR/scxml/
  • Types of orders that this can also address:
    • Standing/Repeating
• Need to ensure we stay focused on the clinical aspects of this, and not get into Payer models, etc.
• No stakeholders as of yet
  • Ideas for Profile rename
    • Plan of Care Orders
    • Order, Procedure Order
    • Test Order

IC CCDA Harmonization

Presenter: Alean Kirnak

C-CDA Harmonization

Presenters: Keith Boone, Tone Southerland

• concerns:
  • C-CDA is US-specific
    • Complete gap analysis showing US specific aspects of C-CCDA
    • Change PCC templates such that they harmonize w/C-CDA but exclude US specific aspects as mentioned above
  • XDS-MS, XPHR, EDR, IC (IC voted in to TF, but not part of the TF yet) are all Final Text
  • Problems and Allergies templates are biggest challenge - breaking changes were made to these templates in C-CDA
  • Template Versioning
    • Currently PCC just creates new templateIds, not a new version of existing template
    • use root and extension
  • PCC should focus on schema and rule changes - not changing templateIds
  • Both short and long term interests - how do we fix it now so that PCC is not competing with C-CDA and how do we handle for new templates going forward
  • Possible Solutions:
    • 1.Introduce new profiles that deprecate existing profiles (e.g. XDS.b over XDS.a)
    • 2.Write CPs

• Areas of Work:
  • 1.Gap Analysis of US Specifics
  • 1.5 Decide which gaps are reconciled
  • 2.Template Versioning
  • 3.Apply changes to profiles (via CPs)
  • 4.Create guidance documentation on writing templates going forward

Lead editor: Keith
Co-leads/reviewers: Tone, Wendy S, Laura B, Charles R

• Touch base with Jürgen Brandstaetter - ask Laura B for details

Occupation Data Health

Presenter: Lisa Nelson

• QRPH and PCC agreed to address this by adding a new optional sub-section under Social History section that includes the needed entries.
• Coding/vocabularies that are US specific should not be used in the entries, but instead be specified by the IHE Regional Extension body as needed (in US this is IHEUSA)

EHCP Evolution

Presenter: Lisa Nelson

• This consists of several fixes needed in EHCP sections
• Both PCC and QRPH committees agree to for this to be owned by QRPH domain, but there are sections that originated in PCC so efforts will be overlapped between domains
• PCC will participate in this - scheduling for regular calls will be figured out at Dec joint meeting
• This is a large CP - not a profile proposal

EHDI Workflow Definition

Presenter: Lisa Nelson

• QRPH and PCC agree that PCC will continue with consideration of this profile proposal
• EHDI hearing screening goes to DSR-XD - Vincent
  • take hearing screening as a use case
• EHDI hearing screening referral goes to Order and Referral Matching - George/Emma
  • take hearing screening as a use case
• EHDI Care (treatment) Plan goes to Patient Focused/Facing Care Plan - Laura H.
  • take hearing screening as a use case
• EHDI Workflow - Lisa N.
  • glue together in a workflow