1. Collaborative Care Messages For people who care Max Walker Co-Chair CBHS SIG DHS (Vic) Australia

2. Who Care? General Practitioners Hospitals Primary Care Providers Allied Health Providers State Health Authorities Federal Health Authorities

3. Who Collaborates? General Practitioners Hospitals Primary Care Providers Allied Health Providers State Health Authorities Federal Health Authorities Others?

4. CCM - Collaborative Care Message When sharing isn’t transferring care Population Information?

5. We’ve got some patient data

6. We’ve got a complete clinical history

7. We’ve got some patient visits

8. We’ve got a complete drug chart

9. We’ve got problems

10. And Goals

11. And Pathways

12. And of course, we’ve got REL

13. We’ve got the lot

14. CCR – Collaborative Care Referral CCM with extra bits Bits of REF_I12 Reason for referral and providers A Clinical Order And multiple patients

15. The bits from REF_I12

16. The Clinical Order

17. And multiple patients

18. But if you care, you really care And you want to know what’s happening You want to know if the referral has been accepted or rejected You want to know how the patients are going You want to know when treatment is complete

19. CCU – Collaborative Care Unsolicited Update Notification from the receiver, to the sender, that something has happened. Includes a Clinical History of treatment related to the referral CCR without Clinical Order

20. CCQ – Collaborative Care Query CQU – Collaborative Query Update Demand an update on your referral And if thing’s aren’t going well, then there’s CCR Modify and CCR Cancel

21. Uses for CCR Collaborative Care Referral differs from Collaborative Care Message because it implies workflow. CCR lets you order stuff in an informed way

22. The CCM Suite Trigger Event I21 – Collaborative Care Message – Information from one Health Care Provider to another e.g. Discharge Summary, Registry Notification I16, I17 & I18 – Collaborative Care Referral – Implies a Transfer of Care – I16 is the Referral for a single or group of patients(?). Expect a Collaborative Care Update (CCU) back – I17 Modify CCR (expect CCU back) – I18 – Cancel CCR

23. The CCR Suite cont. I20 – CCU – Asynchronous Collaborative Care Update (ACK) I19 – Collaborative Care Query/Update – A trigger that sends sufficient information to find a previously sent Referral & hence generate a CCU I22 - Collaborative Care Fetch – Sends query to provider, repository, registry etc, on patient and returns Collaborative Care Information which is equivalent to a Collaborative Care Message