PCCTech Minutes 2009 11 10

Introductions:

• On-site Attendees

Lisa Spellman (HIMMS) Laura Bright (Bell Canada) Diane Ward (GE) Diane Kessler (GE) Keith Boone (GE) Co-Chair: Tone Southerland (Greenway Medical) Co-Chair: Laura Heermann Langford (Intermountain Healthcare) Marica Veenstra ( ) Tom Kuhn (ACP) Mike McCoy (Physician Technology Services) Anne Diamond (ACOG) Audrey Dickerson (HIMSS)

• Telephone Attendees

Jean Millar - Intermountain Healthcare Lisa Nelson (Apelon) Alan Zuckerman (American Academy of Pediatrics)

Welcome from Lisa on behalf of HIMSS. Thanks to all for all the work contributed. Updates:

• Addressing marketing of IHE activities - looking for help with advertising, letting others know about work happening at IHE. Workshops etc.
• Connectathon and showcase - starting to get more traffic
• Planning Committee - subcommittee looking at Meaningful Use to show IHE applications to MU at the showcase. If anyone is interested in participating in subcommittee - Let Lisa know.
• Staff Change - Yvonne resigned due to family emergency. May be short on staff initially but will be working to hire more assistance soon.

Agenda Review - clarification of the Workflow Profile work. Will be addressed 9-10 on Wednesday. Remove "workflow profile" from the

Overview of Projects to be Addressed

• Post Partum Visit Summary: Care of woman in office and baby in hospital is done. Work to be done this year is the care of mom between discharge and first post partum office visit.

• APR/LDR Completion: Docuemnts sent out on Friday. Antepartum and intrapartum have been worked on over last couple of years - nead a way to tie these together. Current profile work will finish out the linking and grouping of the profiles

• Nursing Summary - Goal this year is to focus on transfers of care, the many transfers of care between nursing and with other discipliens. Elements needed for shift report, unit transfers, facility transfers etc. Some international connections being pulled in for collaboration.

• Chronic Care Coordination: There are organizations that are forming to support patients with chronic conditions (facility, state, national). The would like to be able to communicate the plan of care between all sites and providers and updates to the plan reflecting care performed and findings at each touchpoint. Project suggested by IHE Australia. Project should tie with Care Management.

• PCC Profile Temaplate Update: Have used the ITI template in the past. Tone has updated a version more applicable to PCC. Will review this proposed template

• Workflow Profile: Would like to take all the peices created by IHE and tie them into a workflow. Starting with perinatal care as the first pilot for the work.

• Newborn Discharge Summary: another extension of the ACOG prenatal summary and the maternal L&D record. will focus on normal newborns. Will coordinate data and models already provided in other profiles and adjunct with neccessary items for the normal newborn record. Will be coordinating with the work happening with HL7 (they have a larger scope and are looking at the more complicated cases).

• Joint meeting with QRPH: Will be looking at cross over between projects. Will also address the need to look at only certain issues at times (problems, meds etc.) Address the need for "minimum required".

Overview of IHE Process

(Presented by Tone Southerland, slides available on request)
Specific Dates for 2010-2011 will be determined and updated on wiki site

New Member Orientation Ideas:

• Hold introductory training 0900-1000 on the first day (before general session starts)
• Provide a glossary of all the terms
• Review how to navigate through IHE Processes, Wiki, Website - all the parts and pieces
• Investigate the use of mentors (new person matched with someone on their first day. Someone to go to ask questions, etc. - could even be an electronic connection for email questions, webex chat etc.)
• 2nd edition of the HIMSS glossary will be coming out soon. Unable to release prior to publication, but Audrey is a resource to ask glossary type items.
• Consider an brief update of all projects work completed or in progress during one lunch period per F2F meeting. (where are you at in the cycle and what are you working on...)
• Establish a "starter pack" of recommendations for newcomers on where/how they should spend their energy. *Suggest where an newcomer could get involved. There is so much going on it is overwhelming to new comers on where to go, what to do.

Vocabulary Discussion

-Question re: Why doesn't IHE use UMLS for its vocabulary? Crazy idea or not?
-UMLS is a meta-thesaurus. Concepts are mapped to other relevant vocabularies. IHE wants to cleary identify the concept, but not necessarily the vocabulary. Internationally determining a specific vocabulary may be a barrier due to access, costs, etc.
-Pros: would allow those who may not have access to snomed, or loinc etc could still participate and/or implement a profile. Could make things more interoperable internationally.
-Cons: Would require rework of existing profiles. Is it universally available? We would need to maintain a subset of concept ID's because we are not specifying a distinct concept. Keith and Mike will take this topic on as a planning committee actvity. They recognize that this topic crosses domains and will reach out to others to present the UMLS perspective.

Post Partum Visit Summary

Presentation of Profile by Anne Diamond

• This profile builds on and will complete previous work
• Focus is the outpatient physician office
• This profile refers to all medical care recieved by a woman post discharge for a delivery prior to the first dedicated post partum check up.

APR/LDR Completion

Presentation of topic by Tone Southerland

APR

• Summary: Work started in 2007. Has turned into 4 individual profiles. All fall into the same use case of Antepartuem care. Need to organize them to facilitate storage and queries. Estimate very little new content work.
• Technical work: reuse of a lot of previous work. May create new work such as how to add references.
• Risk: Need to coordinate with ITI and HITSP
• The largest amount of work is related to the LOINC and Snomed requests for codes
• This work may get associated with and/or subsumed into the workflow work.
• The security work will need to address international needs - Laura Bright and Tone Southerland will own this issue going forward. Lisa Nelson will assist as needed as well.

LDR

• Similar to the APR request
• There are 3 profiles created last cycle that need grouped together with this request
• Recommendation - to make it clear in master diagram used which section of the overall workflow the profile is addressing. Team to address the use of the master diagram contained in each document - may be too much effort to maintain currency of all versions of the document with changes over time. (Discussion - have the perinatal workflow contain the diagrams and not replicate in each of the profiles. Have one overall use case in the workflow that addresses each of the profiles.
• Will also look at any comments from the public comment that have not been addressed.

Nursing Summary/Perioperative Plan of Care

Presentation of Topic by Audrey Dickerson and Marcia Veenstra

• Discussion: Need to be sure topic is focused and scoped appropriately for IHE interests. May consider targeting "Transfers" (between units or facilities) as the focal point. International verbage more be more towards "transition" of care. Acknowledge the issue at hand is huge, especially handoffs between nurses at shift change and staff coverage - which may not be the focal area for this project.
• Proposal: should we consider this topic for an off-cycle (or new cycle) to do more of the intial work defining topic then go into a true technical proposal.