Patient+Assessment+Summary+SWG+Charter

include component="page" wikiName="siframework" page="LCC Header" =Patient Assessment Summary SWG Charter=

Challenge Statement

 * [//A statement of how a standards and interoperability challenge currently limits the achievement of a national health goal//].**

The three progressive stages of meaningful use will define what eligible professionals and hospitals can and should accomplish through the adoption and use of electronic health records (EHRs) over the next five years. Meaningful use is aimed at widespread adoption and information exchange in its first two stages, and will then build to improve health outcomes in the third stage. Effective exchange of information is central to realizing the benefits of EHRs; however, there is no interoperable infrastructure to securely exchange health information nationwide among providers, between providers and patients, and between providers and public health agencies. The work of this SWG contributes to the goals of health care reform to improve the quality, continuity, coordination and efficiency of care, and meaningful use by facilitating the exchange of health information across health and long-term /post-acute care (LTPAC) providers, including nursing homes (NHs) and home health agencies (HHAs).

Each year, about 12 million medically complex and/or functionally impaired Americans receive LTPAC services in NHs, HHAs, or other LTPAC settings. Persons receiving LTPAC services typically have multiple health care encounters with physicians and other clinicians, and multiple transitions to and from LTPAC settings to emergency rooms and hospitals. Interoperable health information technology (IT) and health information exchange (HIE) among providers is increasingly recognized as having the potential to improve the overall quality and continuity of care, and control healthcare spending. Current public policy has focused, through the meaningful use and other initiatives, on accelerating interoperable health information exchange by Eligible Professionals (EPs – e.g., physicians) and eligible hospitals (EHs - e.g., short-term acute care hospitals). Because the national policy priority has been on EPs and EHs, and given the limited interoperable HIE by LTPAC providers, NHs and HHAs are unlikely to be ready to be participants in the nationwide health IT infrastructure unless steps are taken to engage the sector.

Almost all NHs and many HHA providers are required by CMS to complete and electronically transmit specific patient assessment instruments (i.e., records with clinical, demographic, and other information about a patient). Providers and CMS use data from these instruments for payment, quality monitoring and reporting, patient assessment, and care planning. CMS requires NHs and HHAs to respectively complete the Minimum Data Set version 3 (MDSv3) and the Outcome and Assessment Information Set version C (OASIS-C) at prescribed intervals during each patient’s/individual’s stay and that these providers electronically transmit these assessment to CMS each time they are completed using a transmission format specified by CMS. As a result, almost 100% of these providers automate and transmit assessments, however, transmission formats are not interoperable (i.e., they do not adhere to accepted health IT formats and content standards). The lack of interoperable content and exchange standards limits the reuse this assessment content. Further, while some NHs and HHAs have adopted additional health IT functionality, few have robust, interoperable electronic health records systems with the ability to electronically exchange clinical information with other providers.

Because the national policy priority has been on EPs and EHs, and given the limited interoperable HIE by LTPAC providers, NHs and HHAs are unlikely to be ready to be participants in the nationwide health IT infrastructure unless steps are taken to engage the sector.

Goal and Scope
The goal of the SWG is to identify the subset of MDS and OASIS data elements that can be usefully included in patient assessment summary documents. In addition to the identification of data elements, the SWG will identify the standards that can be used to support interoperable exchange between providers, and between providers and patients. The content that is defined will be considered clinically useful to exchange with hospitals, physicians, other LTPAC providers, and/or family members. This list will be further defined during the use case process. The assessment summaries that are considered in scope include the MDS content produced by nursing homes, and the OASIS content produced by home health agencies. The identification of tools to generate the transformation of assessment documents into summary documents are considered out of scope for this SWG.
 * [//A statement of the value the SWG will create, in specific, measurable, attainable, relevant, and time-bound terms//].**

Deliverables & Timeline

 * Patient Assessment Summary Timeline**

This SWG will focus on an approach that leverages the health IT capacity available in almost all NHs and HHAs and the electronic health information that is available for almost all nursing home residents and home health patients. The SWG will support and advance the electronic exchange and re-use of a subset of interoperable MDSv3 and OASIS-C assessment content. The SWG will complete the following activities over the next several months. Updated Rosetta Stone ||  ||
 * **Phase** || **Key Activities** || **Deliverable** || **Timeline** ||
 * Discovery || * Develop specific content (e.g. case study, functional requirements) for inclusion into WG use case, as appropriate
 * Validate and refine, as needed, a subset of MDSv3 and OASIS-C content that could be clinically useful to exchange with hospitals, physicians, other LTPAC providers, and/or family members.
 * Identify the subset of MDSv3 and OASIS-C content that has been validated through discussions with NHs, HHAs, physicians, nurses, hospitals, and representatives of integrated delivery systems can be found at: [] || Crosswalk of Data Elements
 * Implementation || * Review and validate the MDS/OASIS CDA implementation guide and schema work underway by the Geisinger Keystone Beacon Community, in coordination with Lantana Consulting.
 * Review of any gaps in consolidated CDA to support the exchange of MDS/OASIS patient assessment summary documents. || CDA Implementation Guide and Schema ||  ||
 * Pilot || * Identify potential pilot participants to "test" the artifacts of the SWG
 * Provide consultation on the MDS transformation tool being developed by the Geisinger Keystone Beacon Community to transform the non-interoperable MDSv3 and OASIS-C into an interoperable clinical document that can be made available for HIE || Pilot CDA Implementation Guide for MDS/OASIS ||  ||
 * Evaluation || * Identify success metrics || Report on pilot success/ challenges ||  ||

Return to Patient Assessment Summary SWG page

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