PCCPlan Minutes 2012 10 30

Referral Matching

Presenter: George Cole

• 4 Basic Issues (Assumption that we are using XD*):
  • 1. Referring system doing the referral knows how to format and where to include a "ReferralId"
  • 2. Works for single or multiple submission sets
  • 3. Receiving system has to know how to handle, turn around the referral
    • using structured or unstructured document, etc
  • 4. Referring system needs to know whether or not it will receive a response, and which response it is receiving
• Use XDS Folders, metadata content
• Use certain pieces of CDAR2 and/or CCDA
• Q: Isn't this XDW?
  • Could be beneficially used in XDW, but this is not about tracking tasks across enterprise, but instead narrowly focusing down on a referral use case
• Look at Perinatal Workflow and ensure alignment
• Keith:
  • Agree that material is there, and this will be helpful to explain how to use it.
  • Will be challenges when dealing with unstructured documents
    • George: use XD* metadata to help deal with this
    • Keith: There is no searching capability within XDS metadata
    • Should schedule joint time with ITI during Dec meeting
• John D:
  • Is this a Transition of Care XDW component?
    • It could become that, a component of XDW
  • Is selection of the referral target out of scope, or pre-condition?
    • yes, either approach. not trying to profile this.
• Wendy S:
  • Are we restricting the idea to only using XDS?
    • Will use XDS, XDM, XDR - XD*
  • Can this be used outside of XD*?
    • the piece of this that profiles CDA content could be used outside of XD*
• Keith:
  • Is unstructured document going to be used to request a referral?
    • we could say unstructured document is off the table...otherwise will be challenges tracking
• Tone - Need to ensure we don't let this profile expand outside of original scope

Order Matching

Presenter: Emma Jones

• Can be meds, or any type of order such as a "wound assessment"
• One of the challenges may be that the communication is about a particular order, but not necessarily a fullfillment of a given order
• Order for referral vs diagnostic study is the same
• committee agrees to combine this with referral matching, to be approached as one profile

Care Management Revision

Presenter: Keith Boone

• Coordinate w/HL7 Patient Care
• Need to consider other related profiles (RCG, RCK, etc)
• Perhaps this is a harmonization or white paper effort
• Concerns w/overlap or competition with current US initiatives (S&I Framework)

Diagnostic Study Request

Presenter: Vincent van Pelt

• Is this work already addressed elsewhere in IHE?
  • Perhaps eReferral Workflow
• Scheduling piece is not addressed here..concerns with trying to tackle that
  • Scheduled component is very lightweight here
• Other Workflow profiles being put forward may have overlap here - XDW-EHDI in particular
• Can this be broadened to "Order request"?
  • Yes, ok so what are the challenges with this approach
  • Consider the concepts presented in State Chart XML http://www.w3.org/TR/scxml/
  • Types of orders that this can also address:
    • Standing/Repeating
• Need to ensure we stay focused on the clinical aspects of this, and not get into Payer models, etc.
• No stakeholders as of yet
  • Ideas for Profile rename
    • Plan of Care Orders
    • Order, Procedure Order
    • Test Order

IC CCDA Harmonization

Presenter: Alean Kirnak

C-CDA Harmonization

• concerns:
  • C-CDA is US-specific
    • Complete gap analysis showing US specific aspects of C-CCDA
    • Change PCC templates such that they harmonize w/C-CDA but exclude US specific aspects as mentioned above
  • XDS-MS, XPHR, EDR, IC (voted in, but not part of the TF yet) are all Final Text
  • Problems and Allergies templates are biggest challenge - breaking changes were made to these templates in C-CDA
  • Template Versioning
    • Currently PCC just creates new templateIds, not a new version of existing template
    • use root and extension
  • PCC should focus on schema and rule changes - not changing templateIds
  • Both short and long term interests - how do we fix it now so that PCC is not competing with C-CDA and how do we handle for new templates going forward

• • Possible Solutions:
    • 1.Introduce new profiles that deprecate existing profiles (e.g. XDS.b over XDS.a)
    • 2.Write CPs

• Areas of Work:
  • 1.Gap Analysis of US Specifics
  • 2.Template Versioning