PCCTech Minutes 2010 04 28

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Attendees

Onsite

  • Tone Southerland
  • Laura Heermann
  • Audrey Dickerson
  • Thomson Kuhn
  • Jean Millar
  • Anne Diamond
  • Michael McCoy
  • Diane Ward
  • Alan Zuckerman
  • Keith Boone
  • David Stumpf
  • John Eichwald
  • John Donnelly
  • Anna Orlova
  • Terese Finitzo


Call-in

  • Laritza Taft
  • John Hilton
  • Corrine Gower

Newborn Discharge Summary

  • Presented by Alan Zuckerman
  • It has been determined the scope for this year will be content for the NDS only and the workflow issues/data trransfer between APR and LDR and NDS will not be addressed this year.
  • The NDS should also include the AAP Bright Futures Health Supervisoin Visit data forms and goals as one of its key source documents
  • there is a neeed to map the NDS to the PCC-TF vol II v 5.0 Discharge Summary sections and to indicate which are used and which modified such as the newborn physical
  • Issues and progress on the NDS Volume 1/Volume 2 work reviewed and discussed. Questions answered. Issues resolved or tasks assigned to move towards resolution.


Joint with QRPH

Agenda

  • NDS/NBS/PCCP - (Hearing Screening)
    • QRPH would like to have a tighter connection/collaboration of the hearing screening data and the NDS.
      • Next steps -
        • Ensure NDS contains the hearing screening results and the care recommendations from Public Health based on those results.
        • Hearing Screening is a good candidate for a use case in PCCP - but will have a few new alternative and requirements to PCCP workflow
  • RPE/RCG Overlap
    • QRPH recommending we have a new type of content profile that addresses business rule content.
    • QRPH Presented an idea to retrive/discover a process (set of activities/suggestions/collection of things that could be done.) How to decide which ones get done is out of scope, determining which items could be done is out of scope.
    • what comes back in clinical dss is the same as what comes back in RPE. Conceptually the same as with RCG. but going to a generic process is probably not the right thing to do as it misses some of the clinical knowledge and the accountability of who is responsible for what comes back. The output of CDSS is a set of suggestions or assertions. The output of RPE is executable process. The RPE is a process that keeps things going until it reaches a complete state. CDSS and RPE are 2 peices that fit together. RCG assumes there is a clinician (human intervention) that intercedes and is included in the exucution on the plan of care. Ultimately we can get to RPE where there is more automation in terms of executable logic that takes an action and makes it happen to the point of completion.

APR/LDR Completion

  • Working Session with team editing and writing sections of document working towards completion. Some changes made in real time. Notes made for action items that will take more time and offline work to resolve.


Discussion Questions

  1. Should Vital Signs be added to APS Visit Summary Flowsheet?
    1. is not in ACOG and not in Intermountain EHR
    2. It is collected in the APHP, but typically only for the first visit so it is no longer "valid"
    3. Decision: No does not need to be added - is not relevant to care
  2. Add coded results to LDHP - thoughts?
    1. Also existing in LDS - use same LDS description
    2. APHP does not have coded results, and more importantly the coded results that could be there are in a different time frame
    3. But additional labs or other procedures that would result in coded results typically do not occur in this period of care
    4. Decision: Leave out
  3. Move prenatal events from LDS to LDHP
    1. Decision: move it
  4. Add History of Surgical Procedures to LDHP?
    1. Already exists in APHP, but additional surgeries could happen and could be recorded here
    2. Decision: Yes - see item #5
  5. How should we restructure LDHP?
    1. Currently it points at APHP and is very open-ended.
    2. Add grouping to specify which sections needs to be brought over into the LDHP from the APHP.
    3. Use case is that another H&P may not need to be re-done at hospital admission so this data can simply be brought over.
    4. Add all sections to LDHP
  6. Add Braden Score Section LDS?
    1. Decision: no
  7. Add EDD Section to LDHP or leave in LDS? From earlier discussion w/ Dr. Stumpf around need for recording and adjusted EDD in hospital
    1. Decision: yes
  8. Add Event Outcomes to MDS?
    1. Decision: yes
  9. Delete History of Past Illness in MDS?
    1. Decision: yes
  10. How can we approach consolidating Perinatal specific header data elements?
    1. Natural Father of Fetus
    2. Spouse
    3. Ethnicity
    4. Religious Affiliation
    5. Language Communication
    6. Insurance Payer
  11. What is the difference between value sets and level 3 entries with code sets (i.e. Social Hx Obseravtion, Antepartum Flowsheet Panel)?

Post-Partum Visit Summary

  • This time was taken as a small group working session. NDS/PPVS/APR/LDR groups all met to discuss areas of coordination and plans to reach Volume 2 completion.

Patient Centered Coordination Plan

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