PCCTech Minutes 2012 07 17

Attendees: Laura Heermann Langford, Laura Bright, Vincent van Pelt, Emma Jones, Anne Diamond, Denise Downing, Thom Kuhn, Keith Boone, Tone Southerland, Mauro Zanardini, Saccavini Claudio, Charles Parisot, Vassil Peytchev,

Call in Attendees: Karen Witting, Guilherme Del Fiol, Howard Strasberg, Erik Pupo, Chris Melo

Nursing Workflow

• Review of comments submitted facilitated by Denise. Changes made to document with discussion.

Change Proposals

• Reviewed each of the incoming change proposals and assigned those accepted.

Request for Clinical Knowledge

• Review of comments received. Discussion conducted with those who submitted comments to clarify (Karen, Guilherme, Howard).
• Changes made to document according to discussion and group consensus.

Telehome Monitoring

• Continue reviewing comments received and changes made to profile to address the comments.
• Item related to Oasis HumanTask Standard will need to be discussed with the joint meeting with ITI

eReferral

• Continue reviewing comments received and changes made to profile to address comments.
• Several comments deferred until Charles P available

Tumor Board

• Continue reviewing comments received and changes made to profile to address comments.

Workflow Document Refinements

• Discussion with Charles regarding issues and solutions to issues found in the workflow document template. Changes made to template as discussed and agreed upon.

Joint Meeting with QRPH

• Several Issues related to LDS have come out of their public comment review. Larger group review required to determine actions to questions.

Decisions from this meeting:

1. Retain Coded Detailed Physical Examination, to include Coded Vital Signs (cf Vital Signs Organizer), physical assessments (e.g., Apgar Score under General Appearance), Birth Weight and Height, et cetera (as Simple Observations).

Using The Vital Signs codes already present, but adding a methodCode to indicated a finding at time of birth. The code values to use for methodCode shall use the LOINC codes for these measurements at birth. For the body weight vital sign: 3141-9 the methodCode would be 8339-4 or in the case of stillborn, 57067-1 Weight of fetus

1. Take the same approach for the mother's deliver weight and pre-pregnancy weight.
2. The additional Coded Vitals Signs section in Newborn Delivery Information Section can be removed.
3. Coded Event Outcomes is staying
4. Address breast feeding my putting the appropriate codes on the problem list.
5. Only include top level sections in a document definition.

1. In labor and delivery events, discussed Adding: R2 Medication Administered, R2 Active Problems, R2 Replace Event Outcomes with Coded Event Outcomes. In discussion:

We do not want separate medications sections because it increases chances of error during medication reconciliation. We would prefer that observations be recorded to indicate stage of birth.

For Active Problems and Medications Administered is that there shall be only one section of these types in the record, to ensure patient safety.

In the labor and delivery events in the coded event outcomes section, include observations for times of entry into particular stages of labor (e.g., onset, delivery, delivery of placenta, et cetera). These can be modeled as simple observations with an appropriate value set, with the value being of type TS.

1. RE: First prenatal care visit, last prenatal care visit, count of prenatal care visits

Discussion: We've told you what we know. Please count them and use the information that you have.