Card Tech Minutes 2018.04.3-5

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Attendees

Chris Melo, Co-Chair, Tech Committee, Philips Healthcare
Nick Gawrit, Co-Chair, Tech Committee, heartbase
Paul Dow, Secretary, ACC
Antje Schroeder, Siemens Healthineers
Rebecca Baker, ACC
Christine Demur, GE
Scott Jerome MD, University of Maryland
Jeff Westcott MD, Swedish Medical Center
Charles Thomas, University of Washington
Dan Murphy, Epic
Ganesan Srinivasan, ACC
Parag Paranjpe, Health Level
Sophia Chaidez, HCA
David Slotwiner MD, Co-Chair, Planning Committee, Cornell Medical Center
Jerry Serwer MD, Co-Chair, Planning Committee, University of Michigan
Jon Fast, ACC

April 3, 2018, Day 1 Minutes

Welcome, Introductions, Agenda Review
The agenda was reviewed at a high-level. We are still waiting to hear from the Planning Committee Co-chairs to determine a good time to discuss the white paper. A brief overview of CDA concepts for new attendees.
CPN Extensions, Part 1
Charles Thomas reviewed the latest updates to the LAAO and Mitral Clip vocabulary constraints. Our goal is to create one document, stored on the IHE FTP site. We've found the existing templates seems to meet the needs of CPN, but there are some gaps for indications, and complications as new procedure types are created. There are about 170+ terms that do not exist in the vocabulary.
Companion Guide for the CPN profile, Part 1
Rebecca Baker reviewed a PowerPoint with details regarding the suggested workflow with data aggregation and technical aspects of the CPN guide. The discussion moved into more detailed concepts of how the documents are stored in a document repository. Hemo systems may be the low hanging fruit to develop. This document may become a cross-walk to help several levels of healthcare employee understand the complexity, as well as learning how to ask the right questions. A discussion around the length of time it takes to update SNOMED, and LOINC codes. It's a time consuming task to manage these vocabularies. CDA, and XML are not perfect tools for interoperability. FHIR is becoming more popular for granular requests of discrete data elements, but is not optimal for a comprehensive view of a patient clinical history. Rebecca presented an agenda for reviewing the CPN Companion Guide. The group reviewed the cardinality of items with the CPN profile.
CPN Extensions, Part 2
Text

April 4, 2018, Day 2 Minutes

Companion Guide for the CPN profile, Part 2
Discussion opened around the level of detail regarding the descriptions of actors and processes around a CPN implementation. This led to a brief review of the scope of the document, and a reinforcement of the idea that it should not be overly technical and written at the level of understanding and responsibility for each role. A clear use case will be vital for communicating these concepts. The ultimate goal is to publish as a wiki-style document to provide links that are useful for repeated reference. It was pointed out that for clinicians, we'll need to connect how this profile interacts with data and EHRs. Structured data can be esoteric, but providing detail around how this impacts overall workflow to help make the case why this interoperability, and this profile specifically, positive impacts patient care. We don't want to expand the scope to make the case for a consolidated cardiology database, but how this piece of a structured note contributes to improved care as a building block. Describing the key benefits of collect once, use many times will help convey the benefits of interoperability.
  • Next Steps:
  • Rebecca will post a working document via cloud-based tool as a boiler-plate working draft.
White Paper Discussion
David Slotwiner presented the SWOT analysis of IHE prepared by David Slotwiner and Jerry Serwer, and other members of the ACC Informatics and Health IT [IHIT] Task Force.
Companion Guide for the CPN profile, Part 3
Further planning on the document includes the following next steps:
  • Next Steps:
  • Rebecca will upload the drafts to a cloud based solution for document sharing.
IHE Rad - Encounter Base Imaging Workflow
The Radiology Domain is is asking for input on the Encounter-Based Imagine Workflow (EBIW) profile. Without an order, it can be difficult to associate the study with a result and/or a billing. Basically, it asks the question how to make a DICOM object from a free-standing study. Use cases are variable.
  • Next Steps:
  • Antje will distribute the EBIW document for the members to review and comment by April 13th.
CPN Extensions, Part 3
Our goal at the end of the day is have data abstractors become data quality reviewers. We can pare down the number of data elements into "what is the most vital " information.

April 5, 2018, Day 3 Minutes

Companion Guide for the CPN profile, Part 4
Further discussion around the scope of the document occurred. We don't want to create an extensive document that is meant to help creating an RFI. That would have had too many choices to document. The goal is have a highlights of the essential elements necessary for implementation.
CPN Extensions, Part 4
Further review and update to version 3.4 with numerous items for the TC to evaluate for open issues vs. items CP.