HL7 FHIR Connectathon Care Plan Track Outcome Summarywiki.hl7.org/images/c/c7/CarePlanTrackSummary_September-2017.pdf · HL7 FHIR Connectathon Care Plan Track Outcome Summary September

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HL7 FHIR Connectathon

Care Plan Track Outcome Summary

September 2017, San Diego, CA Track Lead: Dave Carlson (VA)


Participation

n  All testing with FHIR Release 3 (March 2017) n  Organizations:

Ø  Academy of Nutrition and Dietetics Ø  Allscripts Ø  Datuit Ø  InterSystems Ø  PatientLink Enterprises Ø  Rdnote Ø  SAMHSA (Substance Abuse and Mental Health Services

Administration) Ø  VA (U.S. Department of Veterans Affairs) Ø  And others..

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Use Case Scenarios

n  Three Veteran “personas” with care plans Ø  Working with VA clinicians to validate and expand

n  Meghan (post 9/11): TBI & Seizures, PTSD, Depression, Pregnant

n  Byron (post 9/11): PTSD, Substance Abuse, Suicide risk n  Dan (Vietnam): PTSD, Diabetes, Hypertension

n  Nutrition Orders and Care Plans Ø  Adding nutrition orders to Dan’s care plan

n  Behavioural Health care plans and coordination n  Exchange FHIR Care Plans between multiple

vendors and servers

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HSPC Sandbox Test Server n  https://api-stu3.hspconsortium.org/careplantest/open

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Using clinFHIR Scenarios

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clinFHIR view for Meghan

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Plan Definition and Care Plans

n  Using PlanDefinition and ActivityDefinition Ø  Order sets Ø  Clinical practice guidelines Ø  Protocols

n  Create new Care Plan for a patient

n  Work by AllScripts and Stephen Chu

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Activity Request e.g. ProcedureRequest

PlanDefinition e.g. DM Type II

Activity Event – uses action resources e.g. Procedure

definition

initiates

ActivityDefinition ActivityDefinitio

n ActivityDefinition ActivityDefinitio

n ActivityDefinition

ActivityDefinition library

Protocol/Template/orderSets

Care Plan

Patient specific basedOn

Health Concern

Health Goal

addresses

identifies

fulfils

PlanDefinition

First Line Monotherapy Metformin HCL 500 mg ….. description: Metformin HCl 500 MG Oral Tablet; TAKE one TABLET Twice daily with meals; 60 tablet; 2 refills purpose: Defines a guideline supported prescription for the treatment of DM Type II usage: This activity definition is used as part of Diabetes Mellitus, Type 2, Adult +MU care guides approvalDate: 04/28/2017 lastReviewDate: 05/04/2017 effectivePeriod: 05/04/2017 --> 05/04/2018 ….. Diet Recommendation – follow a 1500 calories diabetic diet ….. description: Diabetes diet, specified calories; Follow a diabetic diet with 1500 calories. purpose: Defines a guideline supported patient instructions for the treatment of DM Type II usage: This activity definition is used as part of Diabetes Mellitus, Type 2, Adult +MU care guides approvalDate: 04/28/2017 lastReviewDate: 05/04/2017 effectivePeriod: 05/04/2017 --> 05/04/2018 …..

actionDefintion (group)


Conclusions and Next Steps

n  Continue to expand sample CarePlan resources with clinically valid data Ø  Expand Veteran care plans with validation by VA clinicians

n  Next Steps: Ø  Continue work on PlanDefinition & ActivityDefinition Ø  Continue creation of NutritionOrder examples and

relationship with Care Plan Ø  Subscription to care plan changes

n  Set up test environment on HSPC servers Ø  Reconcile and integrate multiple care plans Ø  Integrate with cds-hooks

n  Evaluate progress toward care plan goals

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Care Plan Track References

n  Connectathon track wiki, September 2017 Ø  http://wiki.hl7.org/index.php?title=201709_Care_Plan

n  Sample FHIR resources for Veteran patients with care plans Ø  JSON transaction bundle files Ø  https://github.com/clinical-cloud/sample-data

n  HSPC Sandbox test server Ø  https://api-stu3.hspconsortium.org/careplantest/open

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HL7 FHIR Connectathon Care Plan Track Outcome Summarywiki.hl7.org/images/c/c7/CarePlanTrackSummary_September-2017.pdf · HL7 FHIR Connectathon Care Plan Track Outcome Summary September

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