PCCTech Minutes 2013 03 18

Attendees: Laura Heermann Langford, Laura Bright , Vincent, Thom Kuhn, Emma Jones, Keith Boones, Lisa Nelson, George Cole, Charles Rica, Federica Sandri, Valentina Ferrarini,

Phone: Denise Downing, Anne Diamond, Eric Larson

Support Staff: Celina Roth, Nancy Ramirez

Order and Referral Matching

• Review by George Cole
  • Discussion re: actor options, option names,
    • decision: will have two - Referral Creator and Referral Consumer. These will be the actors and each will be a content creator and and content consumer. (the content creator and content consumer will be the groupings)
    • IHE actor names to use would be order placer, order filler - this aligns with the radiology team, pharmacy team and HL7.
    • Need to make it clear in the profile while it is not XDW. It is not because XDW to date does not manage where the order number and how to send the order number. It is clear that this profile could be included within XDW and used outside of XDW. A paragraph to this will be added to section X in the profile.
    • work left this week - fairly well in shape for the week to complete volume 1

Patient Focused Care Plan

• Review Emma Jones and Denise Downing
  • Name changed to PtCP for Patient Care Plan. (found the word "focused" was confusing and unnecessary)
  • put the business actors into workflow participants in an appendix in (e-referral workflow profile for example) X.2 or x.3 (workflow participants and Process Flow.
  • also add workflow participants to the glossary.
  • Need to look at the care manager profile specifically the clinical practice guideline area.
    • Need to address in the scope area a high level description of the relationship with the Care Manager profile, guidelines, the output of the workflow that is the care plan.
  • Put the note regarding the profile that will be needed for the guideline work in the open issues
  • write to the different methods of sharing the content (could be implied in the profile - but is likely helpful to call out for the state of the union for care plan.

CDA Harmonization

• Review by Keith Boone
  • Discussion regarding state changes: When you change the state you change the version.
  • Discussion re: how can a receiver of the document know what is "contained" in the document? Answer - include a line in each profile that indicates which version of the technical framework will need to be "known" / "understood" to implement this profile.
  • Review of the rest of the document, answering a few short editorial questions along the way.

EHDI

• Review by Lisa Nelson
• Joined by QRPH for this discussion - Didi Davis, Amit Popat, Michelle Williamson, Lori Fourquet, Landon Bain,

Ken Poole, Xidong Deng, Patty Craig, Jen Foltz, John Eichwald, John Stamm, Anna Orlova, Mauro Z

• • Overview - clarify participants
  • Review nature of a WD profile
    • Clarify XDW workflow participant actor
    • clarify workflow document

• • Review Actors
    • Workflow participant - for this it should be actors - they are not referring to humans but to systems (systems = actors, participants = human). Lisa's slide is correct the pictures are all participants which may play multiple actors. The actor has a particular set of capabilities, The workflow participant supports the roles in the table (workflow participant with columns of different profiles)

• • • • 1A Birthing Facility
      • !B State Public Health
      • 1C Medical Home (PCP)
      • 1D Hearing Specialist
      • 1E Federal Public Health (2013 silent)

• • • Document Repository/Registry

• • • Newborn Screening Device (2013 silent)

• • • Workflow Monitor (not needed)

• Diagram - change state (Jurisdiction EHDI program, EHDI Program Manager) and federal (jurisdiction EHDI reporting, EHDI overseer) (whoever facilitates the screening is the creator..)

• • Words thrown out....) screening, confirmatory diagnostics, intervention, coordination, quality oversight and management.

• • Motion made - the workflow actor will refer to the system...... time ran out - motion not carried.... need to continue the conversation. Issues now related to definition of actor and participant between workflow and content profiles......

Diagnostic Study Request

• Review by Vincent Van Pelt
  • Discussion surrounding the difference of this profile from other lab or radiology request profiles.
  • Each step of the workflow would need each of these Per Step: ( request, plan, perform, analyze, report)
    • • Care Plan (screening) Diagnostic
    • XBer vd BSR-WD = BSR-WD is more specific for diagnostic studies.
  • "Hefty Discussion throughout time period. Assignment to Vincent at end of time was for him to go look at how to combine the steps in XBer-WD and BSR-WD.

Change Proposals

• Incoming:
  • Typos in oids. assign to Keith.
  • task name not schema compliant. assign to Mauro
  • Labor and delivery changes - can be rejected. this was accomodated by several smaller CPs earlier in the year (last fall).
  • bad section ref in XDS-MS. assign to Laura Bright
  • missing RCK transaction numbers - assign to Laura Bright
  • move BFDR to QRPH (wrong options in XPHR - Assign to Laura Bright to ask what profile is being address XDR wrong options if PHR.
  • EDES format codes - assign to Keith
  • Medication route and null flavor - assign to Keith
  • Transport effective time - assign to Keith
  • Care Plan Section OID - assign Lisa and Laura Heermann
  • EHCP Section Conformance - assign to Laura Bright
  • Steve's EHCP care plan - is a duplicate
  • XTB - assign to Vincent.

Austrian CDA Implementation Guide

• Jurgen Brandstatter
  • Differences between the Austrian Implementation Guides for Discharge Summary and the IHE Patient Care Coordination Content Profiles.
  • The Austrian Government has mandated all systems must be IHE compliant.
    • First goal is to make clinicians happy, second goal is to apply international standards.
    • Need to make ELGA (the implementation guide in English) and ....Currently all structured in Word and handwriting. Interop levels (not CDA Levels) 3 levels, basic, enhanced and full support.
  • review indicates at least 80% is reusable.
  • e-Nursing Summary is not reusable outside of the US. Don't want to create something on the nursing process - we just want to make a document.
  • several issues related to not having coding schemas available
  • example - Discharge medications (are these the meds at DC or the meds after DC?)
• Next Steps
  • Jurgen will send us the document
  • Keith will review the document and bring into his CDA harmonization work as appropriate
  • Nursing Sub-Committee will review the document and make accommodation as appropriate in the Care Plan work.