Longitudinal Coordination of Care LCP SWG Thursday, May 16, 2013.

Longitudinal Coordination of Care

LCP SWGThursday, May 16, 2013

• S&I Update• Reminders• Use Case 2.0

– Schedule and Outline– 10.3 Functional Requirements – “Incorporate”– Digital vs. Electronic Signature Requirement– David Tao’s Comments on Base Flow, Alternate Flow,

Assumption sections– 9.0 Use Case Diagrams– Appendices

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Agenda

• LCC Collaboration with HIMSS• Request to move LCP WG call to Thursdays 5 to 6pm EST• Call for Pilot Participation!• Register for the 2013 LTPAC HIT Summit

– Date: June 16 to 18– Location: Baltimore, MD– http

://www.ahima.org/Events/EventCalendar/Event.aspx?Id=b88011a0-3d9f-45cc-8454-60837c37baaf

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ONC S&I Update

• The Monday LTPAC SWG calls are being used by Lantana for the development of the C-CDA Implementation Guides

• LCC HL7 Tiger Team SWG: Collaborate on LCC-related projects from HL7. Please join our meetings on Wednesdays at 11am ET

– Information about the Tiger Team can be found on the wiki at: http://wiki.siframework.org/LCC+HL7+Tiger+Team+SWG

• Meeting Reminders (next week)– LTPAC SWG – Monday at 11am ET– LCC HL7 Tiger Team SWG – Wednesday at 11am ET– LCP SWG – Thursday at 11am ET

• Visit the LCC Use Case 2.0 Wiki Page for all current artifacts to review: (http://wiki.siframework.org/LCC+WG+Use+Case+2.0)

– Use the comment form to provide feedback on UC sections (http://wiki.siframework.org/LCC+Use+Case+2.0+Comments)

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Reminders

LCC Use Case 2 Development ScheduleItems in italics will drawn directly from the LCC Project Charter or created offline directly from other sections and will be included in the end-to-end review

Date Item Homework (Due Friday COB)

3/11 – 3/18

10.0 Scenario (User Stories, Base/Alternate Flow, Functional Requirements)

Review: User Stories

3/25 – 3/26

3.0 Use Case Scope (Background, In / Out of Scope, Communities of Interest)

Finalize: User Stories, Base Flows, In / Out of ScopeReview: Communities of Interest, Assumption

4/1 – 4/2

3.4 Communities of Interest Finalize: Communities of Interest, Assumptions, Pre-Conditions, Post-ConditionsReview: Actors and Roles5.0 Use Case Assumptions

6.0, 7.0 Pre-Conditions, Post Conditions

4/8 - 4/11

Finalize: Assumptions, Pre-Conditions, Post-Conditions, Communities of Interest8.0 Actors and Roles

Finalize: Assumptions, Pre-Conditions, Post-Conditions, Actors and Roles

4/15 – 4/18

Finalize: Communities of Interest, Assumptions, Actors and RolesReview: Base/Alternate Flows, User StoriesActivity Diagrams

Review: Base Flows, Activity DiagramsFinalize: Base Flows, Activity Diagrams

4/22 – 4/25

11.0 Risks, Issues, and Obstacles Finalize: Risks, Issues and ObstaclesReview: Sequence Diagrams10.4 Sequence Diagram

5/2 – 5/9

10.3 Functional Requirements Finalize: Sequence Diagrams, Functional RequirementsReview: Use Case Diagrams, Appendices9.0 Use Case Diagrams

Appendices

5/16 Discuss: ‘Incorporate’ Functional Requirements , Digital vs. Electronic Signature RequirementFinalize: Use Case DiagramReview: Appendices

Finalize: Use Case Diagrams, AppendicesReview: Dataset Requirements

5/23 12.0 Dataset Requirements End-to-End Review (preliminary)

• 1.0 Preface and Introduction**

• 2.0 Initiative Overview– 2.1 Initiative Challenge Statement**

• 3.0 Use Case Scope– 3.1 Background**– 3.2 In Scope– 3.3 Out of Scope– 3.4 Communities of Interest

• 4.0 Value Statement**

• 5.0 Use Case Assumptions

• 6.0 Pre-Conditions

• 7.0 Post Conditions

• 8.0 Actors and Roles

• 9.0 Use Case Diagram

Use Case Outline

•10.0 Scenario: Generic Provider Workflow– 10.1 User Stories– 10.2 Activity Diagram

o 10.2.1 Base Flowo 10.2.2 Alternate Flow

– 10.3 Functional Requirementso 10.3.1 Information Interchange Requirementso 10.3.2 System Requirements

– 10.4 Sequence Diagram

•11.0 Risks, Issues and Obstacles

•12.0 Dataset Requirements

•Appendices

– Related Use Cases– Previous Work Efforts– References– Glossary

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** Leverage content from Charter

Draft sections complete

Content available for review

• Show Jim’s Word Doc

Jim Thompson’s Comments on “Incorporate” in the Functional Requirements section

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• Based upon Jim’s information on the ONC 2014 Final Rule, I agree 100% with Jim that the word “incorporate” is not the correct verbiage for us to use in Table 9 as it stands right now. The term definitely implies that the data elements are being integrated into the EHR.

• Prior to finalizing any text, I would recommend that we agree on the action we would like implementers to take.

– #1 – The original Care Plan needs be stored in the EHR system so it can be referenced. (“Store the Care Plan for retrieval”)

– #2 – The Care Plan data elements supported by the EHR should be incorporated into the EHR as appropriate. (“Incorporate Data Elements”)

• This statement requires additional explanation in order for it to stand. Here are my recommendations:

– Assumption: EHR Systems shall incorporate the data elements from the Care Plan into EHR as supported by the System

– In-Scope: Incorporation of supported Care Plan data elements into the EHR – Out of Scope: It is understood at this time that most EHR Systems are not capable of

incorporating all of the Care Plan data elements. Although it is the long-term desire for all of the Care Plan data elements to be incorporated into the EHR, it is not a requirement of this Use Case that additional Care Plan data elements be incorporated by the EHR.

Cindy Levy’s Response to Jim Thompson’s “Incorporate” Comments

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• It is possible to include a Digital Signature directly in a CDA. There is a RIM field for this (signature_text) which could be introduced as an extension in Consolidated CDA. The Consolidated CDA ballot will describe the field, and will reference the sister ballot being developed by Bob Dieterle and Security WG. – Bob Dieterle also remarked that given the convergence between LCC’s

work and that of the HL7 security work group, the “prospects are good” for a successful ballot (of the esMD standard) in Sept 2013 timeframe.

• CDA already has an electronic signature solution. So we'll be reviewing and also using that.– Summary: the care plan (including HH PoC) standard will be developed to

accommodate both an electronic and digital signature. This approach will support the near-tem interoperable exchange of care plans, and also support CMS requirements as they evolve.

• Bob Dieterle can join the S&I LCC calls on Thurs. from 11:30 to 12:00. We should try to (i) save signature discussions until he joins and (ii) get an update from him about esMD activities when he joins.

Digital vs. Electronic Signature Requirement

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• Show Use Case 2.0 document– 10.1.2 – Multi-member care team– 10.2.1.1 – Base Flow for Scenario 1 comments– 10.2.2 – Alternate Flow Text comments– 5.0 – Assumptions (already modified)

David Tao’s Comments from the Wiki

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• http://wiki.siframework.org/file/view/LCC%20Care%20Plan%20Use%20Case%20Diagrams%202013-05-01.pptx/430346374/LCC%20Care%20Plan%20Use%20Case%20Diagrams%202013-05-01.pptx

Use Case Diagrams

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• http://wiki.siframework.org/file/view/Appendices%202013-05-06.docx/430346584/Appendices%202013-05-06.docx

Appendices

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