Patient Care Coordination

IHE Patient Care Coordination (PCC) domain was established in July 2005 to deal with integration issues that cross providers, patient problems or time. It deals with general clinical care aspects such as document exchange, order processing, and coordination with other specialty domains. PCC also addresses workflows that are common to multiple specialty areas and the integration needs of specialty areas that do not have a separate domain within IHE.

IHE Patient Care Coordination manages the PCC Profiles and the PCC Technical Framework.

Timeline : 2007-2008 Development Cycle

Timeframe	Activity	Scheduled	Location
2006
Oct.	Submit Brief Profile Proposals to Planning Committee (PC)	Oct X - Deadline	E-mail
Nov.	PCC Planning – New profile proposals (Lunch will be served prior to start of ITI meeting)	November 6-8	RSNA
Dec.	TC Review of PC Selected Profiles	Dec 4-5	RSNA
Feb. 2007	PC Selects Final Profiles	Feb ??, 2007	New Orleans (HIMSS)
Mar, 2007	Profile development kickoff meeting (TC Meeting)	Mar 13-17, 2007	Chicago
May, 2007	Profile development meeting: finalize supplements for public comment (TC)	May 14-18, 2007	Chicago
Jun.	Publication of Public Comment Supplements	Jun 3, 2007	www.ihe.net
Jul.	Deadline for submission of public comments of profile supplements	Jul 17,2007	forums.rsna.org
Jul.	Reconciliation of public comments received (TC Meeting)	July 23-27 2007	Chicago
Aug.	Publication of Trial Implementation Supplements	Aug. 10, 2007	www.ihe.net
Aug.	Publication of Final Text Technical Framework	Aug. 10, 2007	www.ihe.net
2008
Jan.	Test implementations at Connectathon	Jan ??-??	Chicago

Roadmap

Legend

Priority: H Essential Now M Essential Future L Nice to Have Prerequisites: List of applicable standards Coordination: Other domains to coordinate efforts with.

Strategy: CP Develop Content Profile IP Develop Integration Profile Res Research Applicable Standards Promote Promote Applicable Standards Development Efforts Year: Earliest Opportunity given prerequisites, priority and skills.

Roadmap

Topic	Pri	Standards/Prerequesites	Coord	Strategy	Year
Referral/Transfer of Care
>Medical Summaries	H	CDA Release 2.0HL7 Care Record Summary		CPPromote	2005
Document Transfer	H	XDSMedical SummariesLinking	ITI	IP	2005
Discharge Packaging (Discharge Back to Ambulatory Care Environment)	H	XDSMedical SummariesLinking		CP	2005
#1 Discharge Packaging (Discharge to Sub-Acute Nursing Facility/ Extended Care Facility)	H	XDS-MSLinking w other clinical reportsPt consent/granting role-based access controls (PCC #8)		CP, IP	2006
Discharge Packaging (Home Health Care Environment)	H	XDSMedical SummaryLinking		CP	2007
Find Provider for Referral	L	Unknown	Finance	Research	2007
Referral Notification/Authorization   (payer focused)	L	X12-837HL7 V3	Finance	Research	2007
Transfer of Care workflowInitiate/accept/reject/follow-up	M	HL7 V3HL7 Care Transfer Messages		IP	2007
Document Types History and Physical Operative Notes Discharge/Transfer Summary (2005) Progress Notes Nursing Notes Flow Sheets Laboratory/Pathology Report Plan to coordinate with IHE Lab activities largely in Europe, Canada, Asia        Radiology Report Cardiology Report Generic data dumps Consultants Report ED Triage Surveillance Report ED Encounter Report	HHM	*CDA Release 2.0 LOINC JCAHO (US) ELINCS [HL7 v2.4]- new transform for lab elements from v2 (using ELINCS as the stnd) to CDA v3 CCR (General, discipline-focused)	Lab/Path (IHE Europe) Radiology Cardiology	Research CP	2006 - 2007
Orders between Providers / Ancillary Services	H	HL7 V3HL7 V2 ORU	ITI Lab Radiology	Promote/ Adapt Existing IPs	2006
Order Sets and Care Plans	L	XDS Non-Patient Documents HL7 Templates [Orders/Obs] HL7 Patient Care HL7 EHR Order Sets [Rad/Labs, Unified terminology/code systems]	ITI Quality	Promote	2008
Pay for Performance Data Aggregation	M	Order Sets and Care Plans HL7 Templates HL7 Orders and Observations Minimum Data Sets Doc-IT	Quality	Research	2008
Query for Medication List from Multiple Providers	H	HL7 V3RxHubJCAHO Med Reconciliation		Research	2007
#2 Pt Created Summary Information Exchange- #1 Payer-provided PHR w pt portal for viewing info Provider-based portal f pts for viewing (lev1); updating (lvl2) info PHR application system exchanging info electronically w EMRs via portal media (USB,CD), pt2pt network, XDS registry)		HL7 EHR XDS-MS CCR ASTM EHR Data Model AHIMA PHR Definition (AHIP PHR Init, Connecting f Health) EHRVA PHR Definition WSRP (Web Services for Remote Portals)	PCD	CP (Model 3)IP referred to ITI domain (Document Interchange Media proposal)	2006
Practice Management System to/from Ambulatory EHR Connection	M	HL7 V2.5 EHR DSTU CCHIT Interoperability	ITI-PAM	IP	2007
Public Health Registries & Surveillance	H	XDS-MS w immunization structure	Quality	Refer to Quality Domain	?
Capture of Clinical Research Data within an EHRability to display Case Report Form for data capture retrieve info from EHR system (Note: Form definition work to be undertaken by CDISK in 2006 independent of ITI RFD profile work)		CDISC’s ODM HL7’s CDA eDCI HL7 CCOW SAFE (Digital Signature) Clinical Trial Care Report Forms	ITI	CP (Clinical Trial Data Capture profile) IP Referred to ITI domain (Retrieve Form for Display)	2006+
#3 PCP to Emergency Dept Referral - #2	H	Data Elements for Emergency Department Systems (DEEDS) v1.0 CDA/CRS (CCR) Pt consent/granting role-based access controls (PCC #8)	ITI	CP	2006
Emergency Medical Services (EMS) to Emergency Dept Data Transfer	M	Data Elements for Emergency Department Systems (DEEDS) v1.0 CDA/CRS (CCR) National Emergency Medical Services Information System (NEMSIS) v2.2		CP	2007
#4 Self-referred ED Event (no pre-announcement of pt arrival)	H	Data Elements for Emergency Department Systems (DEEDS) v1.0 CDA/CRS (CCR) Pt consent/granting role-based access controls	ITI	CP	2006
ED to Surveillance Regsitry	H				2007
ED to PCP transfer	M	XDS-MSCDA R2			2007
#5 IHE CCR Medical SummariesED Use CasePHR Use Case (#2 above)		XDS-MS or CDA/CRS (CCR)HL7 Care Record Query		CP	2006
#6 Pre-Surgical H&P- adds sections for Pt history, Pt physical data at a level 2 to an XDS-MS Submission Set - the beginning of a PCP to Acute Care Profile??		XDS-MS or CDA/CRS (CCR)Radiology Reports (XDS-I)Laboratory ReportsSubmission Set Deployment		CP, IP	2006
Healthcare Document MetaData		CDA R2Standard Document Content Formats (TIFF, pdf, JPEG, MIME)	ITI	Referred to ITI domain	2006
Electronic Image Formats for HealthcareText chart notesGraphs, Charts, Line Drawn diagramsImages (photos, medical images, non-med images)		CDA R2Standard Image Content Formats (TIFF, pdf, JPEG, GIF, PNG)	ITI	Referred to ITI domain	2006
#7 Document Section EncodingPediatrics (Immunizations, Growth charts)Public Health Survelliance (Immunizations, etc)Chronic Disease MgmtRevised to: Immunization, Vital Signs, and Laboratories		CCRCDA R2HL7 V3 Clinical Statement ModelHL7 V3 Patient Care StructuresHL7 V3 PharmacyLOINCJCAHO (what stnds?)		CP	2006
Patient Selection QueryClinical trial qualificationsTransfer to ECF assessmentChronic disease mgmt candidateDisease survelliance candidate		HL7 V3 Care Record Query			2007
#8 Patient Consentfor Access to Medical Records- #3	H	ISO TS22600-1,2ASTM E1762W3C – XaDESISO 22857		CPIP	20062007
Cardiac electrophysiology admission discharge summary for the referring cardiologist (from Harry Solomon)		XDS-MSCDA R2 / CRS	CARD	Refer to Cardio domain	2007

Current Activity

Contact the PCC Technical Committee if you would like to participate, or watch for Public Comment drafts in mid-July, 2007.

Participation

As a Clinician / Patient Advocate

Get involved in the planning committee. This is where the clinical problems are discussed and prioritized. The planning committee is an open group and is interested in having your input! Bring us your interoperability problems! You can also help by participating in the himss showcase scenario definitions.

You can do this by:

1. Send us a note saying you’re interested so we can get you on the list-serves.
2. Come to face to face meetings, and attend the telephone conferences.
3. Submit your profile proposals by:
   • Fill out this template.
   • Submit the propsal draft to us.
   • Attend the november planning meeting to help clarify and prioritize your proposal
   • Follow up by submitting a the formal proposal
   • Attend the joint planning/technical meeting to explain your idea to the technical committee
   • Any additional resources you can provide toward the problem will help prioritize getting your proposal solidified more quickly.

As a Hospital Administrator

In addition to getting involved in the planning committee, hold your vendor accountable. Put a statement in your rfp that indicates you want the vendor to support the actor in the profile you desire.

As an Implementer

Get involved in the Technical Committee. Help make sure profiles are feasible and will work for you. Implement the profile, and come experience the Connectathon. Send us a note saying you’re interested so we can get you on the list-serves.

Profile Selection

These Brief Profile Proposals were selected by the planning committee for review for the 2007-2008 Development Cycle:

• Research Data Capture Clarification
• EMR Query (RFD Part2) for use with:
  • Public health repository uses (e.g. HRSA)
  • ACC repository
  • Clinical trials (e.g. CDISC)
  • Biosurveillance uses
  • Claims Situational data elements
  • Quality measure data extraction (incl pay for performance requirements)
  • Drug safety
  • Disease registry (overlap with d?)
  • Patient education and literacy tracking uses
  • Patient Selection Query for Clinical Trials
  • Cross System Data Query: CDASH
• Emergency Department Encounter Record / ED to PCP transfer / ED to Surveillance Registry
• Antepartum Ambulatory Prenatal Care Summary
• Care Assessments & Assessment Instrument Content

These White Papers were selected to go forward for the 2007-2008 Development Cycle:

• Case Management for:
  • Public Health Case Management Workflow
  • Cross System Protocol Insertion
  • Quality Report Document

These Detailed Profile Proposals were short-listed and evaluated by the Technical Committee

• ...

These items were selected by the Planning Committee for this Cycle:

Demonstrations & Presentations

Date	Location	Event	Details
2007.02.25-2006-03.01	New Orleans, LA	HIMSS 2007	HIMSS Interoperability Showcase

See Also

PCC Planning Committee

PCC Technical Committee

This page is based on the Domain Template.