Care Plan (CP) Meeting Wednesday, July 11, EDT Laura Heermann Langford Stephen Chu *C are Plan wiki: HL7 Patient Care Work Group To join the meeting: Phone Number: Participant Passcode: # With meeting discussion notes

Page 2 July 11, 2012 Agenda  Agenda Review – update as needed  SOA Project – Update from teleconference Jul 9  Linking vs Nesting Storyboard review  Updates on progress towards resources and modeling work.

Page 3 Participants- Meeting of Name Country YesNotes Laura Heermann Langford US x Co-Lead- Care Plan initiative/HL7 Patient Care WG. Intermountain Healthcare. RN PhD,: Nursing Informatics; Emergency Informatics Association, American Medical Informatics Association; IHE Stephen Chu AU x NEHTA-National eHealth Transition Authority. RN, MD, Clinical Informatics; Clinical lead and Lead Clinical Information Architecture; co-chair HL7 Patient care WG; vice-chair HL7 NZ Carolyn Silzle USX American Dietetic Association Susan Campbell USx PhD microbiologist. Principal at Care Management Professionals. HL7 Dynamic Care Plan Co-developer Kevin Coonan US MD. Emergency medicine. HL7 Emergency care WG. Nancy Wilson RomanUSx Enrique Meneses US Serafina Versaggi USClinical Systems Consultant John Farmer USx Chris White USx Luigi Sison USx Information Architect at LOINC and at HL7. Enterprise Data Architect at VA. Developing standard for Detailed Clinical Models (DCM), information models for Electronic Health Record (EHR) Diabetes Project, etc.

Page 4 Past Participants- Name Country YesNotes André Boudreau CA Co-Lead- Care Plan initiative/HL7 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. HL7 EHR WG. Laura Heermann Langford US X Co-Lead- Care Plan initiative/HL7 Patient Care WG. Intermountain Healthcare. RN PhD,: Nursing Informatics; Emergency Informatics Association, American Medical Informatics Association; IHE Stephen Chu AU X NEHTA-National eHealth Transition Authority. RN, MD, Clinical Informatics; Clinical lead and Lead Clinical Information Architecture; co-chair HL7 Patient care WG; vice-chair HL7 NZ Carolyn Silzle USX American Dietetic Association Susan Campbell USX PhD microbiologist. Principal at Care Management Professionals. HL7 Dynamic Care Plan Co-developer Margaret Dittloff US The CBORD Group, Inc.. RD (Registered Dietitian); Product Manager, Nutrition Service Suite; HL7 DAM project for diet/nutrition orders; American Dietetic Association Luigi Sison US Information Architect at LOINC and at HL7. Enterprise Data Architect at VA. Developing standard for Detailed Clinical Models (DCM), information models for Electronic Health Record (EHR) Diabetes Project, etc. Peter MacIsaac AU HP Enterprise Services. MD; Clinical Informatics Consultant; IHE Australia; Medical Practitioner - General Practice William Goossen NL Results 4 Care B.V. RN, PhD; -chair HL7 Patient Care WG at HL7; Detailed Clinical Models ISO TC 215 WG1 and HL7 ; nursing practicioner Anneke Goossen NL Results 4 Care B.V. RN; Consultant; Co-Chair Technical Committee EHR at HL7 Netherlands; Member at IMIA NI; Member of the Patient Care Working Group at HL7 International Ian Townsend UK NHS Connecting for Health. Health Informatics; Senior Interoperability Developer, Data Standards and Products; HL7 Patient Care Co-Chair Rosemary Kennedy US Thomas Jefferson University School of Nursing. RN; Informatics; Associate Professor; HL7 EHR WG; HL7 Patient care WG; terminology engine for Plan of care; Jay Lyle US JP Systems. Informatics Consultant; Business Consultant & Sr. Project Manager Ian McNicoll UK Ocean Informatics. Health informatics specialist; Formal general medical practitioner; OpenEHR; Slovakia Pediatrics EMR; Sweden distributed care approach Maggie Gilligan US Dietician; Owner, Senior Member, Nutra Tech Technology, LLC Kevin Coonan US x MD. Emergency medicine. HL7 Emergency care WG. Gordon Raup US CTO, Datuit LLC (software industry). Elaine Ayres 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 US CDC Immunization

Page 5 Past Participants- Name Country Yes Notes David Rowed AU MD. Family GP.; Was chair, 2005, Electronic Communications Working Group of the AU General Practice Computing Group Charlie Bishop UK Steve HufnagelUS Peter Hendler US Ray Simkus CA Practicing Family GP, Vancouver, BC. User of EMR. Intense interest and involvement in EHR and EMR standards, functionality and terminology Brett Esler AUPen Computer Sys Catherine Hoang USVA Hugh Leslie AU a General Practitioner ; Chief Medical Officer, Ocean Informatics Seam Heard Thomson Kuhn US Sr. Systems Architect at American College of Physicians Russell Leftwich US Md, Allergist, internal medicine; Chief Medical Informatics Officer, Office of eHealth Initiatives, State of Tennessee Michael Tan NL Publishing Facilitator, Care Provision, PC WG; Senior Project manager, Nictiz, NL Corinne Gower NZ Senior Business Analyst at NZHIS; Senior Advisor at Ministry of Health New Zealand Susan US Medical Informaticist at 3M Health Care; Chair Elect of the SNOMED CT Nursing Special Interest Group at IHTSDO; Vocab Facilitator for Patient Care TC at HL7 Standards Audrey Dickerson 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 US Senior strategist at Cerner Corp, Ken Rubin US Co-Chair, HL7 Service Oriented Architecture Work Group; Chief Architect, Federal Healthcare Portfolio, HP Enterprise Services Mark Shafarman US Member of HL7 since Co-Chair, HL7 Template WG; Shafarman Consulting Inc.

Page 6 SOA Project Discussion Notes  John, Chris, Enrique and Laura met on July 9 th and discussed writing Project Scope Statement for SOA project. It was determined more modeling work needed to be done in order to clarify the specifics of the Project Scope Statement. Recommendation made for SOA team knowledgeable in modeling to assist the Care Plan team in completing modeling work. The modeling work will be done under the existing scope statement for this project. The goal is to make progress more quickly on the modeling to move on to the SOA project.

Page 7 Modeling Discussion Notes  Jul 11, 2012 o Luigi presented work completed so far on modeling the Chronic Care Storyboard. Enterprise Architect diagrams of actors, use cases and information model in progress shared with the team. o Discussion held on how to complete the diagraming work for the Chronic Care Storyboard. Luigi will continue working on that storyboard. o Discussion held on what next steps need to be taken regarding the other storyboards. Two options identified. 1 – Review the current models with reference to each of the other storyboards and make comments on where each storyboard differs from the existing chronic care model 2- Complete modeling process done for the chronic care storyboard for each of the storyboards then compare resulting diagrams an make comments on similarities or differences. o Challenges with audio connection of the call made it difficult for discussion of the two options. An additional call will be arranged to accommodate both Luigi and Enrique to determine which approach to take. o Discussion held regarding access to PDF’s and full EA versions of the current diagrams. Luigi will provide PDF’s of current EA diagrams. Stephen and Laura will work via to get them posted on the Care Plan Initiative wiki site in an organized manner. Requirements and sharing of EA diagrams will be addressed in the additional call to be set up regarding the modeling approach. o Proposal made for creation of a project plan regarding the modeling work yet to be completed, with dates and ownership of responsibilities made. This too will be addressed during and after the modeling approach is determined in next call.

Page 8 Linking vs Nesting Care Plan Discussion Notes  Jul 11, 2012 Topic postponed until next time….  June 27, 2012 Plan from last meeting…. o Susan has created and offered to share a document related to the discussion of the similarities and differences of these terms based on broad discussion and literature review she has done. o This topic will remain on the list of work to be done for our working group with the goal of having documentative artifacts created as part of the DAM. o Stephen will draft a storyboard/use case articulating the differences between “nested” and “linked” care plans. Laura, Kevin and Jon agreed to preliminary review of draft prior to next call if draft available.

Page 9 FUTURE MEETINGS Conference calls between now and September 2012 – see wiki 90 min., Wednesday 5-6:30pm US Eastern, fortnightly (every week) Will be using Mikogo for screen sharing Next meeting July 25, 2012

Page 10 Next meeting - July 25 (Lead: Laura) Agenda for July 25, 2012  Linking vs nesting Storyboard review  Modeling work update 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 11 APPENDIX