PCC TC Face to Face February 25-March 01, 2019 - Minutes

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Day 1 - Monday 2019 2 25 - IHE PCC Tech Committee F2F RSNA Meeting

Participants: Emma Jones (Allscripts), Michael Clifton (Epic), Amit Trivedi(Himss), Thierry Dart (ASIP Santé) On Phone: George Dixon (Allscripts), Jeff Danford (Allscripts)


Introduction and Welcome


DCTM - Dynamic Care Team Management

  • DCTM Volume 1 and presentation
  • DCTM is a workflow profile
  • Open issue : Shall we combine DCP and DCTM together ?
  • DCP profile has been updated to include DCTM actors, uses cases...
  • Volume 2 discussion : should the participant roles need to be collected when the care team is generated ?


Profile proposal: CDA Care Team Section (with entries)

  • Care Team Section
  • Proposal Editor: Emma Jones, George Dixon, Daniel Venton (Allscripts) / Work item Editor: Emma Jones, George Dixon, Daniel Venton (Allscripts)
  • Domain: PCC
  • A CDA Care Team Section template with structured entries provides the ability to share concise information about a patient’s care team.
  • Purpose : update the "CDA-DSS - CDA Document Summary Sections" profile to add entries to "Care Team Section"


CCG - Computable Care Guidelines (QRPH domain)

  • Meeting with QRPH domain : CCG volume 1
  • CCG is a high level collaboration between WHO, CDC and IHE Int. to make computable guidelines. Uses cases are based on WHO's guidelines (HIV, diabetes, hypertension)
  • Actors of DCP's profile have been incorporated in CCG


Discussion and Documentation of Continuous Cycle

  • PCC domain discuss on ITI continuous development
  • The proposal is to move to a model where new work items can be started at any point in the year. The three 5-day face-to-face working meetings in the first half of the calendar year, plus two 2-day selection meetings in the last calendar quarter, are replaced by four 5-day working meetings evenly spaced through the year.
  • Governance and process are not changing
  • PCC domain agree on:
    • Approved Projects must submit their developed work two weeks prior to Face-to-face meeting (call for proposals).
    • Approved Projects must progress. Any project that misses two face-to-face meetings in a row will be canceled.
    • Projects will not progress each quarter -- more than one quarter without improvement shall be automatic termination of that project.
    • Connectathon is based on face-to-face meeting at-least four months prior to Connectathon.
  • For DCTM and AADC new proposals, as we have no call proposal, PCC domain will discuss on them during this F2F meeting.
  • Decisions
    • PCC domain will make a call for proposal for the Spring meetings (April 29 - May 3, 2019, Oak Brook IL).
    • PCC domain will schedule monthly calls to monitor progress on CPs and profiles

New Business, other projects

  • Most systems only display only the text sections of a CDA. End users only see the documents.
  • The main problem is to better specifying content and uses of data instead of just rendering the data
  • PCC RECON profil speaks about reconciliation uses cases. It gives concepts on reconciliation without technical details. RECON profile have not been tested at the connectathon.
  • How to make "data import from CDA" testable for the connectathon ? Connectathon is a great place to do content tests.
  • Should PCC write a guideline for data import from CDA document ?


Day 2 - Tuesday 2019 2 26 - IHE PCC Tech Committee F2F RSNA Meeting

Participants: Emma Jones (Allscripts), Michael Clifton (Epic), Amit Trivedi(Himss), Holly Miller, Chris Melo, Thierry Dart (ASIP Santé) On Phone: George Dixon (Allscripts), Jeff Danford (Allscripts)


Discussion on QEDm comment

  • Participants: same + John Moehrke, Charles Parisot (GE)
  • John Moehrke has posted a Comment on QEDm in the PCC technical group (22th February 2019):
    • Currently QEDm does not constrain the FHIR Resources. This has been deliberately done due to the limited experience (Trial Implementation) with these FHIR Resources.
    • Such as requiring that Observations must use LOINC where ever possible. etc. See US-Core profile for some good baseline constraints.
    • Is this lack of constraints intended or a missed opportunity to drive good quality FHIR Resource data?
  • Resolution:
    • There will be an effort during the spring and summer of 2019 to add constraints on the FHIR Resources.
    • These constraints will be international, with support for Volume 4 regional constraints.
    • These constraints will be based on original QED use-cases, original QED constraints, HL7 Implementation Guide for US-Core, and regional experience.
    • All are encouraged to participate in this effort. Participate by joining the PCC technical workgroup, and by interacting with the IHE Git Hub


DCP-Dynamic Care Plan and DCTM-Dynamic Care Team management

  • Participants : same + Charles Parisot (GE)
  • Summary of DCP profile:
    • DCP is a FHIR based profile to exchange care plans for a patient.
    • DCP is a "meta-profile" including actors from DCTM profile. DCTM is a separate profile.
  • Summary of DCTM profile:
    • DCTM is a profile to assign care team members to a patient to provide, care, care coordination ...
    • Care team should be structured. When a new care team resource is created, it changes and make inactive the old one.
    • When a patient get discharged, the patient care team will be updated with the new members.
    • This profile is based on HL7's care Team DAM
  • DCP profile work
    • CareTeam Service actor and Care Plan Service actor are kept separate:
      • Because of complexity of Care plan deployment, different systems could implement these two actors : care team service could be implemented by an administrative management system and care plan service by a EMR system.
    • CarePlan Contributor actor and Care team Contributor have been grouped.
  • Next steps : implements the changes and clean up the grouping


Profile proposal: ACDC-Assessment Acquisition and Data Collection

  • Proposed Work Item: Assessment Acquisition and Data Collection
    • Proposal editor : Keith Boone
    • Profile editor : Keith Boone
    • Other contributor : TBA
    • Domain : PCC
    • This profile propose to make assessments instruments (like Glasgow or Apgar score) in a computable form
  • Standard and system : FHIR based profile
    • FHIR Questionnaire, Questionnaire response
    • FHIR Patient reported outcomes
    • FHIR Structured Data Capture (originally CDA based)
  • technical aspects : new Actors
    • Assessment repository
    • Assessment consumer
    • Assessment requestor
    • Assessor
  • A detail proposal will be reviewed on Wednesday.


CPs session and PCC FHIR based profiles update

  • CP-PCC-0273: typo error in the example
    • Assigned to Michaël Clifton
    • Incorporated in CDA Content Module
  • FHIR DSTU-3 PCC profiles need to be updated on FHIR v4 (tracking is in the CP tracking spreadsheet)
    • CMAP assigned to Keith Boone
    • DCP assigned to Emma Jones
    • DCTM assigned to Emma Jones
    • PCS
    • PMDT
    • QEDm assigned to John M.
    • RECON assigned to Emma Jones
    • RIPT



Day 3 - Wednesday 2019 2 27 - IHE PCC Tech Committee F2F RSNA Meeting

Participants: Emma Jones (Allscripts), Michael Clifton (Epic), Keith Boone, Amit Trivedi(Himss), Thierry Dart (ASIP Santé) On Phone: George Dixon (Allscripts), Jeff Danford (Allscripts), Dan Venton (Allscripts), Dr. Holly Miller (MedAllies)


DCP - Dynamic Care Planning

  • Care Plan Service actor and Care Team service actor are not grouped.
  • Additional transactions will be added in volume 2.
  • This profile will be tested at the next HL7's connectathon.
  • Volume 1 will be with the revision marks to help the DCTM update.
  • A update of volume 1 is on the FTP site.
  • Voting session: move DCP Profile Volume 1 forward so Volume 2 can be started.
    • Quorum : 5
    • Attendees: John Stamm, Laura Bright, Derek RItz, Xen Santas, Gift Lyoko, Mustapha Bello, Jenny Thompson, Lori Fourquet, Andrea Fourquet, Nichole Knox, Alex Goel, Emma Jones, James Kariuki, Alaina Gregory, Derek Ritz, Keith Boone, Michael Clifton, Chris Melo, George Dixon, Jeffrey Danford, John Moerkhen, Thierry Dart
    • All for, no abstention, no opposition


CCG - Computable Care Guidelines (QRPH domain)


CDA Care Team Section (with entries)

  • No new actor, no new transaction
  • Risk : DAM is work in progress (call on Tuesday 4pm)
  • It will be a CP of the "CDA-DSS - CDA Document Summary Sections" profile
  • Use of ArtDecor
  • Update the metrics for DCTM and CDA Care Team Section
  • Voting : motion to move forward CDA Care Team Section (with entries)
    • Quorum : 5
    • Attendees: Emma Jones, Georges Dixon (Allscripts), Michael Clifton (Epic), Chris Melo (Philips), Thierry Dart (ASIP Santé)
    • All for, No oppose, no abstention


AADC-Assessment Acquisition and Data Collection

  • Facilitating exchange of assessment instruments
  • FHIR profile
  • Risks :
    • Coordination with HL7 implementation guide being developed by AHRQ and ONC
    • Overlap with DCP and CCG
  • Voting : motion to move forward AADC
    • Quorum : 5
    • Attendees: Emma Jones, George Dixon (Allscripts), Michael Clifton (Epic), Keith Boone, John Donnelly, Dr. Holly Miller (MedAllies), Thierry Dart (ASIP Santé)
    • All for, no opposition