PCC TC Face to Face Nov 16-17 2016

Introductions & Agenda Review:

• Present: Amit, Anne, Ioana, Andrea, Thom, Thierry Dart
• Phone: George Cole, Tone, Laura, Elena, Steve Beller, Chris Melo, Brett Andriesen, Manual Metz

ASIP Sante’s Interoperability Framework

• By: Thierry Dart & Manuel

• • French gov agency, GIP-DMP for the dev of a national EhR, GIP-CPS agency for the prod of HC professional smartcards

• • Regulation for improving eHealth, Implementation of shared national services, Promotion and speeding up of use and innovation in eHealth
  • HIS-IF organized in 3 layers
    • Transport
    • Service
    • Content

• • Interoperability mission 1 for improving eHealth, organized in 3 layers (transport, Service, Content)
  • Uses IHE profiles: XDS, PCC MS-Medical Summary, IC – Immunization Content, antepartum, L&D, QRPH Mother & Child Health

• • Modeling tooling Modelio is used, terminology & value sets testing CTS2, mapping modeled data on CDA sections/entries don’t have a tool yet,

• • Search PCC profiles, search TF for section or entries, time consuming if none is found they create a specific section

• • Mapping between modeled data on CDA sections/entries using Art Décor
    • note made that they are not using Art Décor yet because it was slow and there were many issues, will re-evaluate it in 2 yrs
    • developed a mapping tool automation HIS-IF document production, need to parse PCC content modules (in progress)

• • Propose that we publish the tooling on the IHE website to evaluate it, get a better understanding of their process and how PCC can help, constraints with PCC templates for international use

• • Define the common data elements and represent it in the standard

• • Trying to implement a specific implementation, need assistance with tooling, provides end-user with a tool to export all the narrative content is preferable, common way to define where the data is for each standard (CDA v2, FHIR, etc.),

• • No immediate ask, at the board level there is discussion about CDA harmonization, explore other content efforts going on

• • Showed PCC the mapping tool France is using.

Result of the Devices profiles alignment meeting

• Presenting by Denise and Ioana
  • Answered the following questions:

• • RPM - creating a FHIR equivalent bundle to PCD1
  • Other device profile will use PCD01 as is.

• • PCD, Cardiology, VA are interested
• Cross-paradigm
  • HL7 PC work group sponsoring what will be used in volume 4
  • IHE profiles looking at point-of-care tracking

• • • Vote: Denise motion to combine, Ioana second, no further discussion - 0 abstain, 0 against, 17 for

360 Closed Loop Referrals

• Present: Amit, Anne, Ioana, Andrea, Thom, Thierry Dart, Emma
• Phone: George Cole, Tone, Laura, Elena, Steve Beller, Chris Melo, Brett Andriesen, Vassil Petychev, Rob Rose

• • 2012 initiative by ONC State Health Information Exchange Cooperative Agreement Program goal using MU 2 to enable provider exchange for referrals
  • Need a permanent home.
  • Need the national extension
  • Can be referenced in future rule making in CMS
  • Determine the best approach
  • Has a new wiki space with onc
• Goal is to add value for clinicains
• Scope limited to electronic exchanges
  • Pt Care Coordination is a national priority due to changing payment models
  • Gap in available standards to support the Use Cases
  • This is all depended on DIRECT - will DIRECT be around for some time? See it growing to include patients as well. Will see increased numbers of transactions as well. Relationship between XDM, XDR. In relations to FHIR services then this spec can be incorporated in a solution like that.
  • Goals:
    • Standardize the type of data exchange and how data is transported
    • Provide transparency to progress and/or gaps in care until the loop is closed
    • Design a process with a low bar of entry for implementation

• • Technical:
    • XDM
    • XDR/XDM for Direct Messaging Specification
    • XD metadata
    • HL7 v2.x Messaging; HL7 C-CDA (Summary of Episode Note, Consultation Note, or Referral Note preferred)

• • • Two New Actors: Referral Initiator, Referral Recipient
  • Specific to the US.
  • Is unsolicited in scope? Only support the referral request that is accepted or declined
  • Exception requirements are considered but will be added at a later point.
  • Open Issue – Relationship with other Profiles, haven’t looked at the Actors in ROL, will do that
  • Get a vendor list who are interested in this profile, is DIRECT here to stay? Do we see it growing? Yes, there is additional pts and HCO signing up, interest is increasing with the number of transactions, and this **profile has a generic referral and for specific referrals can add additional content as an extension
  • Provider directory target for the referral, but not a requirement

RPM

• Present: Amit, Anne, Ioana, Andrea, Thom, Thierry Dart, Chris Melo, Emma
• Phone: George Cole, Vassil Petychev, Rob Rose

• • Want to adopt it and there is a market demand, supporting it in PCHA and keep it consistent with RPM

• • PCD-01 replaced with a FHIR bundle

• • Semantically similar to PCD-01 and semantically similar to FHIR, use FHIR Resource for a Push

• • The profile adds different transactions using FHIR
  • Interested in the profile? Countries are interested, Scandinavian development work is being tested at FHIR Connect-a-thon, do not know the list of vendors for the IHE Connect-a-thon

HL7 Update Project Scope for Cross Paradigm IG for Medical Device Interoperability – PSS

• Present: Amit, Anne, Ioana, Andrea, Thom, Thierry Dart, Chris Melo, Emma
• Phone: George Cole, Vassil Petychev, Bret Andriesen, Brian Reinhold
  • Project sponsored by HL7 Patient Care work group. This project need to be aligned with and it informs the Device profile work.
  • Plan on a HL7 May 2017 ballot for domain analysis DCM

POCMDM – Closed Loop Referral Whitepaper for EDHI

• Present: Amit, Anne, Ioana, Andrea, Thom, Thierry Dart, Chris Melo, John Stamm, Ghia Gdong
• Phone: George Cole, Vassil Petychev, Rob Rose, Serefina Versaggi, Nicohle, Lori Fourquet, Gila Pyke, Elena, Diana Warner, Tone

• • Discussed the proposed Whitepaper, suggested other PCC profiles to look at ROL, Dynamic CP, EDHI for reference

• • Will QRPH need PCC time? – yes, will put some time on the schedule to discuss further.

Pt Registration Content Profile

• Present: Amit, Anne, Ioana, Andrea, Thom, Thierry Dart, Chris Melo, Emma
• Phone: George Cole, Nicohle, Lori Forquet, Gila Pyke, Elena, Diana Warner, Tone , Laura Hermann-Langford

• • Registration data not in a standardized format, only talking about content in the profile

Discharge to EMS Transport

• Present: Amit, Anne, Ioana, Andrea, Thom, Thierry Dart, Chris Melo, Emma
• Phone: George Cole, Nicohle, Lori Forquet, Tone , Laura Hermann-Langford, Dr. Greg Mears, Diana Warner

• • Discussed needing a standard way to exchange transport instructions, new functionality, embed into the workflow.
  • Will fit on the Zoll 2018 roadmap
  • Open Issue: Where is the value add for a business driver?
    • Care Team Management
    • Advertise it as a support for Direct, Support for Payers

Patient Centric Data Element Location Services (QED on FHIR)

• QED implemented by very few vendors. Are there vendors interested? There are people doing QED but in their own proprietary way
  • Plan in using QED grouping for the type of data that will be queried.
  • Value add is to standardized the queries instead of people starting from a different point
  • Thin QED - pick a subset of what is in QED
  • Use DSTU view of argonaut as a starting place
  • Volume one QED had a single transaction. In volume 2 the single transaction has multiple options.
  • Two ways of doing the profile: Could have a QED profile with a set of V3 options and a set of FHIR options or have 2 profiles - one with QED and the second for FHIR
  • QED is trial iimplementation
    • Could retire QED
  • Volume 2 work - page 46-81
    • Transactions were structured by function in the query. Uses V3 transactions.
    • Some of the QED returns are in FHIR, some are not.
  • Need PCC input for the search criteria in volume 2
  • Will use the argonaut list in volume 1 as the starting point.