TOC+Implementation+Guidance+SWG+Meeting+Minutes+5-21-2012

include component="page" wikiName="siframework" page="TOC Header"

**Meeting Agenda:**

 * = **ID** ||= **Key Discussion Items** ||= **Duration** ||= **Presenter** ||
 * = 1 ||= Welcome & Announcements ||= 05 Minutes ||= Meredith Lewis ||
 * = 2 ||= Review of ToC A,B,C Priorities ||= 10 Minutes ||= Dr. Holly Miller ||
 * = 3 ||= Review of Clinical Scenario 1 ||= 75 Minutes ||= WG Leads ||

Attendance
Ashley Swain, David Tao, Ed Larsen, Emma Jones, George Cole, Holly Miller, Robin Barnes, Russell Leftwich, Russell Ott, Shalina Wadhwani, Susan Campbell

Action Items

 * **#** || **Action** || **Owner** || **Status** || **Due Date** ||
 * 1 || Crosscheck all references in the spreadsheet to CCDA || David Tao & Support Team ||  ||   ||
 * 2 || Speak with Lantana for perspective on whether Longitudinal Care Team Members should be included in closed-loop referrals || Support Team ||  ||   ||
 * 3 || Reach out to nutrition community to validate requirements on Diet and Nutrition || Russ Leftwich ||  ||   ||
 * 4 || Move all requirements included in MU2 to Column A on the spreadsheet || David Tao & Support Team ||  ||   ||
 * 5 || Validate "A" priority data elements in Column C || Volunteers ||  ||   ||

Meeting Notes

 * Announcements**:
 * There will be no meeting on Monday, May 29th (Memorial Day)
 * Rescheduling the June 4th meeting because of availability – updates will be posted on the wiki


 * Clinical Scenarios:**
 * Scenario 1 focuses on a closed-loop referall, when a primary physician requests a referreal by a specialist for a patient; the message is sent from the PCP, is received, and when the patient comes in for the appointment, the specialty physician composes the consultation messages and send it back to the PCP
 * Scenario 2 focuses on a discharging physician that sends a message to the PCP pertaining to their hospitalization
 * Scenario 3 focuses on the discharing physician in a hospital setting sending a discharge message to the patient
 * Scenario 4 focuses to an ambulatory setting when a patient has seen a specicialist for info
 * Scenario 5 focuses on an ambulatory care setting where a PCP sends information to the patient; this should be a fixed scenario since it is so patient centric


 * ToC Key Information Exchange Workbook**
 * David Tao conducted an analysis of MU2 requirements and determined how they are related to CCDA (commonly referred to as "the floor”)
 * Priority definitions:
 * An "A" priority definition means the object index is included in every transition of care
 * A "B" priority definition means the object index is important and would frequently be included in messages
 * A "C" priority definitely means the object index is either less frequently included or was important, but is not currently shared in ToC electronic messages
 * Today, the SWG will look at B and C priority data elements to see if there was general agreement that they were classified properly
 * Because there are about 150 A priority data elements, participants will review elements for the next meeting and will inform the leads if there is any disagreement on its priority classification
 * The support team will send out a reminder with a link to the ToC Key Information Exchange Workbook
 * The SWG Leads will also conduct an offline analysis on the availability of B priority data elements in an EHR, not on their importance (to determine if they were or weren't captured CCDA)
 * Some of the data elements classified under A, B, or C priorities in the ToC Information Exchange Workbook are also MU requirements
 * Any of these elements will be moved to the MU2 requirements column (column A), so that column B shows datamelements important for ToC, but not required for MU2
 * The support team will do this offline


 * Review of "B" and "C" Priority Data Elements**
 * No objections to “B” priority classifications were found with Social History, Vital Signs, Invasive and Non-Invasive Procedures, General Results, and In Reason for Consult Request
 * No objections to "C" priority classifications were found with Behavioral Health
 * Data sets that will be discussed in later scenarios are Admitting and Discharging Diagnoses, Patient Instructions, and ‘Encounter’ Care Team Members/’Longitudinal’ Care Team Members
 * Edited data sets include Request Reason (specialist to PCP), Consult Assessments and Plans Recommendations (PCP to specialist), Diet and Nutrition (include all to closed loop referrals except discharge diet), Encounters (all X’s removed for closed loop referrals)
 * For an HL7 perspective, the support team will speak with Lantana to get their recommendations on whether Longitudinal Care Team Members would be included in closed loop referrals (for both PCP to specialist and specialist to PCP)
 * Russ Leftwich will reach out to the nutrition community to validate requirements for Diet and Nutrition
 * The support team will double check all references in the spreadsheet to CCDA

include component="page" wikiName="siframework" page="space.template.inc_contentleft_end"