PCCTech Minutes 2015 11 12

Attendance:

• In Person: Thom Kuhns, George Cole, Anne Diamond, Elena Vio, Emma Jones, Celina Roth, Denise Downing, Chris melo
• On Phone: Tone Southerland

Introductions:

Proposals Review

• ED Bed Management
  • need to automate the process to support coordination - coordinate the hospital staff and resources
  • need to be able to do analytics
  • interaction with other systems - patient registration, bed management, staffing, EHRs - all these systems have to communicate
  • many folks who end up admitted to the hospital start in the ED
  • lack of interoperability causes inefficiency
  • this profile will increase the interoperability between systems which will reduce delays, errors and increase utilization of the facility resource and improve patient care
  • considered FHIR - however, none of the current systems implementation support FHIR today. Propose use of HL7 V2 rather than FHIR
  • suggestion to make this generic enough to be used at a departmental level not solely for ED
  • why is this important? Identification that this is big gap.
  • can serve as jumping off point to incorporate intra-facility transfers
  • cost savings with improvement in patient wait time; improved care outcomes
  • support predictive modeling in terms of admission - why are patients coming into the ED
  • continue participation from the students
  • call the profile "Bed Management Profile" acronym suggest 'BED'
  • Implementability - using existing stuff. No new messages
  • core content is already written - lot more content but straight forward ADT content.

• Cardiology Consult and Pathology Board
  • In Person: Keith Bone, Thom Kuhns, George Cole, Anne Diamond, Elena Vio, Emma Jones, Celina Roth, Denise Downing, Chris melo
  • On Phone: Cardiology planning committee (Paul Dow, John Donnelly, Charles, etc), Tone Southerland
  • improves interaction between multidisciplinary and dynamic team of healthcare professional
  • currently, xds profile is not sufficient to support this workflow
  • Aim to define a standardize workflow to support and manage the dynamic heart team workflow between care settings. the composition of the care team and change based on the case and the person information is shared with can also change.
  • suggestion is to change the profile title to cardiology dynamic care team
  • solves communication and sharing of information issues and support dynamic enrollment of care team members; supports clinical protocols
  • Standards: XDW (workflow management), XDS (b-1 and b)/DSUB (used for notification when the document is published) - will need xdw actors to be defined (need correlation within PCCP tech other XDW actors)
  • review of the use cases
    • Discussion on simple case Vs Complex case and emergent vs complex case (cardiology suggestion was to modify the second use case to account for emergent situation which is outside the scope of this profile)
    • cardiology is looking for what this means and how to define the differences
      • feedback: looks like this is meant to be generalized to cover all of cardiology - looks like more of a case conference approach - cardiology to cardiology - There is need of this profile in other countries; like the fact that the workflow is nicely structured. Need to explore if there is a way to generalized this across orders.
      • can look at other workflow profiles and follow their approach at generality and how much specificity.
  • Request from cardiology to get an overview of XDW
  • Cardiology have set up the volume 1 t-cons - dates are Jan 20 and Feb 10 (PCC Feb F2F is Feb 15th)

• Dynamic Care Planning
  • In Person: Thom Kuhns, George Cole, Anne Diamond, Elena Vio, Emma Jones, Celina Roth, Denise Downing, Chris melo, QRPH members
  • On Phone: Tone Southerland, Gunther Meyer
  • Lots of different interests in this
  • can group the capabilities
  • Use case - discussion of the differences between the various use cases
  • discussion about the capabilities
  • discussion about the specifics related to the capabilities - many of the sub capabilities can be transactions, some already exists and others will be new
  • creating and manage the plan - FHIR resources and the ability to manage pieces of the care plan at the resource level. Docs will be used but will not be the primary means of managing the care plan
  • discussion about sharing infrastructure and governance domain. Think xds repository - need a capability to define location of all the patients. Should not be as burdensome as putting up an affinity domain. We need to have architecture and infrastructure in place. May need to add them as pre-requisite. Actors need to be define. need to be able to cross reference patient. need to be able to match patient and also match providers. Sharing infrastructure and governance is needed.

Profile voting

• Keith Moved/Thom second - no further discussion. Affirm 9/Abstain 0/Against 0 - vote passed to move all three profiles forward

T-Cons

• • Bed management - will need T-Con scheduled in January (Keith will let Nancy know when to schedule it)
  • Dynamic Care planning - once a week on Mondays 10-11 Eastern. First call is Nov 30

Housekeeping

• BPMN update - went out for public comment. HL7 FHIR 2.1- working on moving in the right direction as it relates to workflows. BPMN on hold for now. Emma will confirm with Nancy that calls are cancelled

CP update and voting 0211 - Move to include changes in the technical framework - moved Goorge/Second Emma/Abstain 0/Against 0/Approve 9 - vote passed

• Question from George - What changes are needed for Connecthathon testing this year. Made aware the Lynn is aware of the changes this profile provides and is accounting for it in her test.

0216 - update CP 0178 - occupational for health data subscetion. Kuhn move we completely remove it from the CDA supplement

• 6.4.1 - Default Binding is US national extensions - is not a UV concept domain - this is US bindings.

Recommendation - Need further discussion with QRPH during the joint meeting today.

ITI/QRPH/PCC Joint

• CP 0216
  • PCC will re-work the table to talk about the concept domain
  • QRPH need work item (with PCC) to discuss US national extension
  • We did not want a CP to create default bindings that was US centric; the default bindings that was chosen is US realm
  • The CP states UV realm but we need to have default bindings that is not realm specific - need to just list examples like how HL7 does it - HL7 process for concept domain have a definition that describes the concept and OIDs are not used
  • Next step is to Work tomorrow to update the CP by generalizing the default bindings
  • Second piece is for QRPH to address the use national extensions if that is what is needed

See ITI page for link to Joint meeting notes [1]