Care Plan (CP) Meeting 90 minutes André Boudreau Laura Heermann Langford Stephen Chu Laura to lead *C are Plan wiki: HL7 Patient Care Work Group To join the meeting: Phone Number: Participant Passcode: # WebEx link (thanks to Canada Health Infoway): With meeting discussion notes

Page 2 Agenda- April 11 th (Lead: Laura) Review EHRS FIM activity model work: business flow and rules (Steve Hufnagel) – deferred Review Care Plan BPMN: Chronic Care Care Plan (Luigi) Review and augment draft of requirements (André)  Coordination of care- deferred  Care management matrix - deferred  Analyze a few past meetings Next meeting agenda

Page 3 Participants- Meetg of p1 Name Country YesNotes André Boudreau CA yes 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 yes 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 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 USyes American Dietetic Association Susan Campbell USyes 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 USyes 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 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 4 Participants- Meetg of p2 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 Serafina Versaggi USClinical Systems Consultant 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 5 CARE PLAN DAM MODELING Luigi

Page 6 BPMN Model (Luigi) Last Meeting: Luigi presented the business process model (BPM) for encounters C and D of the Chronic Condition Care Plan storyboard (SB), and adjusted the model live with other members  See updated versions of the 4 encounters BPM in pdf on the wiki o BPM CC Encounter A and B- Primary Care Physician Initial Visit pdf o BPM CC Encounter C and D - Hospital Admission and Follow-Up Visit pdf Based on Luigi’s work and the discussion, some adjustments should be made to the SB Next step: Luigi will complete the BPM of the Home Care SB. There are many similar patterns in the SBs and we may decide to have a single BPM for all the SB. Class Model  NHS has provided us with a copy of the CONTSYS conceptual model and Luigi has integrated that information into our EA work to facilitate reusability where relevant  We also have started to build a Glossary for our terms  This will continue in parallel to our BPM work Today:  Review of BPM of the Chronic Care SB  Discussion re: o Meaning of the class diagram elements, specifically around the provider o Getting access to HTML and PDF versions for review offline and out of meetings  Next time: o Look at additional (Home Care) storyboard in model form o Have more information regarding the class model element definitions

Page 7 EHRS FIM ON IMMUNIZATION PROFILE Steve Hufnagel

Page 8 Discussion Notes Last Meeting: Steve Hufnagel presented his information modeling work for the EHRS FM R2 IMMUNIZATION MAGAGEMENT PROTOTYPE  He highlighted the fact that the key patterns in the FM consist of encounters, event, lists, documents, registries  A lot of redundancies could be eliminated in the FM  However, other aspects could be added as the work continues for other parts of the FM  A concern mentioned was about the absence of patient and providers in the CIM For the latest version of his deck, see the HL7 EHR Interoperability sub-WG wiki   Version presented: o EHR-S_FIM_Immunization_Management_Prototype_Executive_Summary pptx This Meeting: Workflows  Not available for review.  Topic deferred until further notice.

Page 9 REQUIREMENTS Andre Boudreau

Page 10 Discussion Notes Have reviewed previous meetings Is 1/3 thru capturing minutes into one document to do content analysis looking for requirements that have been stated Have pulled the Care Provision and Care Provision Support items from the EHR FM into our document. Will need to review other sections of the EHR FM as well – we are not confident all Care Plan related items are in the CP and CPS sections. (especially around interoperability/information exchange) Target to use the May 2012 Version of FM for our review.

Page 11 FUTURE MEETINGS Conference calls between now and May 2012 – see wiki 90 min., Wednesday 5-6:30pm US Eastern, fortnightly (every 2 weeks) Starting Feb. 1 st Webex supplied by Canada Health Infoway

Page 12 Next meeting Agenda- April 25th (Lead: Laura) Review Model (Luigi)  Review Business Process Model (BPM) for Home Care storyboard  Review of the class diagram elements and their “meanings” Stephen Hufnagel agenda items Review Care Coordination Requirements (Andre) Plan on meeting May 9 th (usual time) – (Laura to lead) Plan agenda for F2F – Thursday, May 17 th need to clarify with Stephen Chu/William Goossen  Vancouver F2F Meeting o Updates on Progress Storyboard completion (needing completion of Acute Care) Information Model Draft of Requirements Later:  Work done in Manitoba regarding specific care paths and referrals. The care plan is included in their process. (Published on the Infoway Forum). Andre’ will schedule a time with her and ask how best for us to prepare for her presentation.  Discussion - Use of the term: “Plan of care” for work done by MD’s, and “Care Plan” used by nursing and all other ancillary folks.

Page 13 APPENDIX

Page 14 Status of 7 SBs – OwnerSB NameStatusDate for Complete Draft PCCP Final review Kevin CoonanAcute ConditionDraft 1 completed Second draft pending ???Pending André Boudreau Home CareUnder external review DoneFeb 15th Stephen ChuChronic ConditionsReviewed. Third draft completed DoneFeb 29th Susan Campbell -Pediatric Allergy -Immunization Reviewed. Second draft of both Immunization done Allergy done March 14 Feb 29 th Laura Heermann Langford PerinatologyReviewed. Second draft Final: pending DoneFeb 29 th Carolyn SilzleStay healthy/ health promotion Draft 1 completed Final draft distributed DoneFeb 29th

Page 15 HDF- Domain Analysis Overview Source: HDF_1.5.doc, page 37 Last updated: