With meeting discussion notes To join the meeting

With meeting discussion notes To join the meeting: Phone Number: +1 770 -657 -9270 Participant Passcode: 943377# Care Plan (CP) Meeting Wednesday, July 25, 2012 1700 -1830 EDT Laura Heermann Langford (Laura. Heermann@imail. org) Stephen Chu (stephen. chu@nehta. gov. au) *Care Plan wiki: http: //wiki. hl 7. org/index. php? title=Care_Plan_Initiative_project_2011 HL 7 Patient Care Work Group

July 25, 2012 Agenda/Minutes § Agenda Review – update as needed § Linking vs nesting Storyboard review § Modeling work update Page 2

Participants- Meeting of 2012 -07 -25 Name email Country Yes Notes Laura Heermann Langford Laura. Heermann@imail. org US x Co-Lead- Care Plan initiative/HL 7 Patient Care WG. Intermountain Healthcare. RN Ph. D, : Nursing Informatics; Emergency Informatics Association, American Medical Informatics Association; IHE Stephen Chu stephen. chu@nehta. gov. au AU x NEHTA-National e. Health Transition Authority. RN, MD, Clinical Informatics; Clinical lead and Lead Clinical Information Architecture; co-chair HL 7 Patient care WG; vice-chair HL 7 NZ Carolyn Silzle Carolyn. silzle@choa. org US x American Dietetic Association Susan Campbell bostoncampbell@mindspring. com US Ph. D microbiologist. Principal at Care Management Professionals. HL 7 Dynamic Care Plan Co-developer Kevin Coonan Kevin. coonan@gmail. com US MD. Emergency medicine. HL 7 Emergency care WG. Nancy Wilson Roman US Enrique Meneses enrique@careflow. com US Serafina Versaggi serafina. versaggi@gmail. com US John Farmer Jon. farmer@thrasis. com US Chris White Chris. white@thrasis. com US Luigi Sison lsison@yahoo. com US Clinical Systems Consultant x Information Architect at LOINC and at HL 7. Enterprise Data Architect at VA. Developing standard for Detailed Clinical Models (DCM), information models for Electronic Health Record (EHR) Diabetes Project, etc. Page 3

Linking vs Nesting Care Plan Discussion Notes § Stephen reviewed work done on multi-morbidities-chronic-conditions. Care. Plan-Use. Case 2012 -07 -11 § Team discussion o The need for a glossary identified (to include care plan, care paths, protocols, …) o A diagram of how care plans relate to each other may be helpful (context associations, express the relationship of multiple care plans) o Need to look at HL 7 and ISO definition of care plans o Need to look at the “across-specific point care plans” impacts, in bound and out bound risks Page 4

Modeling Discussion Notes § § § Luigi and Enrique were able to meet face to face Models done to date were reviewed and exchanged Possible approaches to complete were reviewed and discussed Determined to follow the narrative storyboard -> use case-> process model -> information model approach Luigi and Enrique will be splitting the work according to storyboards for the above stated process. o (Luigi = home care, acute care) o (Enrique = pediatric, Perinatal, stay healthy) § Requesting next meeting be 1. 5 hours devoted to modeling work Page 5

Other Discussion Notes • Susan mentioned work done by Marshfield clinic re: the use of data for quality improvement – dsahboard, drill down into underlying data etc. Marshfield Clinic (Wisconsin) homegrown E. H. R. that is quality data driven. https: //fedgov. webex. com/ec 0605 ld/eventcenter/recording/record. Action. do? the. Action=poprecord&actname=%2 Feventcenter% 2 Fframe%2 Fg. do&apiname=lsr. php&renewticket=0&actappname=ec 0605 ld&entappname=url 0107 ld&need. Filter =false&&isurlact=true&entactname=%2 Fnbr. Recording. URL. do&r. ID=15818342&r. Key=bc 14120 d 8 f 6 fb 9 a 1&record. ID=15818342&r nd=3161672308&siteurl=fedgov&SP=EC&AT=pb&format=short ü CMS Page listing coordinated care model source information http: //www. innovations. cms. gov/areas-of-focus/seamless-and-coordinated-care-models/ ü • Susan/Laura agreed to update team on work occurring at the US ONC S&I Framework 2 meetings from now. • Email update from Susan § The ONC group working on this is located at: http: //wiki. siframework. org/Longitudinal+Coordination+of+Care. § LTPAC and Longitudinal Care Plan are the two most related. LTPAC has the data elements. LCP is basically beating around the bush to do what we are trying to do in this group in HL 7. We are currently working on a white paper to try do describe what a longitudinal care plan is. Unfortunately, it doesn’t work from first principles and grow logically. Instead it uses the Home Care Plan of Care as the starting point because that is what CMS wanted. Page 6

FUTURE MEETINGS • Conference calls between now and September 2012 – see wiki • 90 min. , Wednesday 5 -6: 30 pm US Eastern, fortnightly (every week) • Will be using Mikogo for screen sharing • Next meeting August 8, 2012 Page 7

Next meeting – Aug 8 (Lead: Laura) Agenda for Aug 8, 2012 § Modeling work Agenda for Aug 22 § Update on US ONC S&I Framework Other topics: o Follow up on documents related to requirement work done by Andre is needed. o Stephen/Laura will look to see if Andre’ has posted his documents and if not will contact him to obtain copies. Schedule TBD o Requirements Definition o Stephen Hufnagel: EHRS FIM on Care Plan Items Page 8

APPENDIX Page 9

Past Participants. Name email Country Yes Notes Co-Lead- Care Plan initiative/HL 7 Patient Care WG. B. Sc. (Physics), MBA. Owner Boroan Inc. Management Consultin. Chair, Individual Care pan Canadian Standards Collaborative Working Group (SCWG). Sr project manager. HL 7 EHR WG. André Boudreau a. boudreau@boroan. ca CA Laura Heermann Langford Laura. Heermann@imail. org US X Co-Lead- Care Plan initiative/HL 7 Patient Care WG. Intermountain Healthcare. RN Ph. D, : Nursing Informatics; Emergency Informatics Association, American Medical Informatics Association; IHE Stephen Chu stephen. chu@nehta. gov. au AU X NEHTA-National e. Health Transition Authority. RN, MD, Clinical Informatics; Clinical lead and Lead Clinical Information Architecture; co-chair HL 7 Patient care WG; vice-chair HL 7 NZ Carolyn Silzle Carolyn. silzle@choa. org US X American Dietetic Association Susan Campbell bostoncampbell@mindspring. com US X Ph. D microbiologist. Principal at Care Management Professionals. HL 7 Dynamic Care Plan Co-developer Margaret Dittloff mkd@cbord. com US The CBORD Group, Inc. . RD (Registered Dietitian); Product Manager, Nutrition Service Suite; HL 7 DAM project for diet/nutrition orders; American Dietetic Association Luigi Sison lsison@yahoo. com US Information Architect at LOINC and at HL 7. Enterprise Data Architect at VA. Developing standard for Detailed Clinical Models (DCM), information models for Electronic Health Record (EHR) Diabetes Project, etc. Peter Mac. Isaac peter. macisaac@hp. com AU HP Enterprise Services. MD; Clinical Informatics Consultant; IHE Australia; Medical Practitioner - General Practice William Goossen wgoossen@results 4 care. nl NL Results 4 Care B. V. RN, Ph. D; -chair HL 7 Patient Care WG at HL 7; Detailed Clinical Models ISO TC 215 WG 1 and HL 7 ; nursing practicioner Anneke Goossen agoossen@results 4 care. nl NL Results 4 Care B. V. RN; Consultant; Co-Chair Technical Committee EHR at HL 7 Netherlands; Member at IMIA NI; Member of the Patient Care Working Group at HL 7 International Ian Townsend ian. townend@nhs. net UK NHS Connecting for Health Informatics; Senior Interoperability Developer, Data Standards and Products; HL 7 Patient Care Co-Chair Rosemary Kennedy Rosemary. kennedy@jefferson. edu US Thomas Jefferson University School of Nursing. RN; Informatics; Associate Professor; HL 7 EHR WG; HL 7 Patient care WG; terminology engine for Plan of care; Jay Lyle jaylyle@gmail. com US JP Systems. Informatics Consultant; Business Consultant & Sr. Project Manager Ian Mc. Nicoll Ian. Mc. Nicoll@oceaninformatics. com UK Ocean Informatics. Health informatics specialist; Formal general medical practitioner; Open. EHR; Slovakia Pediatrics EMR; Sweden distributed care approach Maggie Gilligan mmgilligan@gmail. com US Dietician; Owner, Senior Member , Nutra Technology, LLC Kevin Coonan Kevin. coonan@gmail. com US Gordon Raup graup@datuit. com US CTO, Datuit LLC (software industry). Elaine Ayres EAyres@cc. nih. gov US NIH National Institutes of Health. MS, RD; Deputy Chief, Laboratory for Informatics Development, NIH Clinical Center ; Project manager for BTRIS (Biomedical Translational Research Information System), a Clinical Research Data Repository Rob Savage hzv 3@cdc. gov US CDC Immunization x MD. Emergency medicine. HL 7 Emergency care WG. Page 10

Past Participants. Name email Country David Rowed drowed@bigpond. net. au AU Charlie Bishop charlie. bishop@isofthealth. com UK Steve Hufnagel Notes Yes MD. Family GP. ; Was chair, 2005, Electronic Communications Working Group of the AU General Practice Computing Group US Peter Hendler Peter. Hendler@kp. org US Ray Simkus ray@wmt. ca CA Practicing Family GP, Vancouver, BC. User of EMR. Intense interest and involvement in EHR and EMR standards , functionality and terminology Brett Esler brett. esler@pencs. com. au AU Pen Computer Sys Catherine Hoang catherine. hoang 2@va. gov US VA Hugh Leslie hugh. leslie@oceaninformatics. com AU a General Practitioner ; Chief Medical Officer, Ocean Informatics Seam Heard sam. heard@oceaninformatics. com Thomson Kuhn TKUHN@acponline. org US Sr. Systems Architect at American College of Physicians Russell Leftwich Russell. Leftwich@tn. gov US Md, Allergist, internal medicine; Chief Medical Informatics Officer, Office of e. Health Initiatives, State of Tennessee Michael Tan tan@nitctiz. nl NL Publishing Facilitator , Care Provision, PC WG; Senior Project manager, Nictiz, NL Corinne Gower Corrine@paradise. net. nz NZ Senior Business Analyst at NZHIS; Senior Advisor at Ministry of Health New Zealand Susan Matney samatney@mmm. com US Medical Informaticist at 3 M Health Care; Chair Elect of the SNOMED CT Nursing Special Interest Group at IHTSDO; Vocab Facilitator for Patient Care TC at HL 7 Standards Audrey Dickerson adickerson@himss. org US HIMSS. RN, MS; Standards Initiatives at HIMSS; ISO/TC 215 Health Informatics, Secretary; US TAG for ISO/TC 215 Health Informatics, Administrator; Co-Chair of Nursing Sub-committee to IHE -Patient Care Coordination Domain. Gaby Jewell gjewell@cerner. com US Senior strategist at Cerner Corp, US Co-Chair, HL 7 Service Oriented Architecture Work Group; Chief Architect, Federal Healthcare Portfolio, HP Enterprise Services US Member of HL 7 since 1992. Co-Chair, HL 7 Template WG; Shafarman Consulting Inc. Ken Rubin Mark Shafarman Mark@Shafarman. net Page 11