LCP+SWG+Meeting+Minutes+05-29-2012

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Meeting Notes

 * Sue has not posted an updated version of the paper to the wiki, but did implement several changes over the weekend
 * The current version includes an introduction and background information detailing the work of the LCC WG, and the CMS and ONC NPRMs
 * The table included in the current draft details the recommendations from HITPC that relate to the care plan.
 * The group will need to determine which components of the NPRMs should be highlighted.
 * We're trying to "standardize" something that hasn't been standardized in the community to date, which is a significant challenge.
 * Bill added new language on page 2 of the introduction that details the challenge we're faced with - "care plans do not typically inform care within a clinical organization"
 * There are so many varying processes, vocabularies and standards, however, there are several fundamental concepts across processes, vocabularies and standards can be identified.
 * Conditions, goals and interventions/actions are the fundamental concepts we're focusing on, according to Larry's diagram that's currently included in the paper.
 * Need to ensure that the concepts align to the introductory text.
 * ONC certification and meaningful use incentive programs have defined a "problem," but it is not defined the same way that we have defined it.
 * Bill completed a "quick lit review" of the NPRMs, which identified that terminology is used in varying ways across ONC and CMS, however there are several concepts that span across the agencies. There is a lack of agreement regarding the component parts. What are we going to stay to the HITPC?
 * Bill's recommendation is that we create some preliminary structures, and then align to existing standards. The leader is the ANA American Nursing Association has taken a lead in aggregating the information, commonly used sets, but even then, we know International Classification of Functions (ICF) is incomplete.
 * The body of the paper will highlight existing gaps in standards. There are problems, issues related to the inability to produce care plans/share care plans across providers, but simply describing it isn't going to solve the problem. We've described the input side exhaustively, but the process side needs to be solved by others.
 * Our deliverable date is rapidly approaching. The paper is eventually going to go to the HITSC and HITPC. The reason we wanted to send them the paper is because our assertion is that there is a problem with how the care plan is articulated in the ONC and CMS rules.
 * If that is still the focus of the paper, then we need to get to the point and be precise. Otherwise, we lose the message and their interest in this activity.
 * Creation, transmission and incorporation of care plans, however, the rules do not consistently define the consistently define the component parts (e.g. problems).
 * This paper is addressing those issues. We're not ready to start defining the necessary vocabularies - that's a layer of complexity that will need to occur later.
 * Bill thinks we need to create multiple views of the care plan (added a new visual with various swim lanes outlining the different inputs).
 * The goal of the diagram is to help people understand the inputs and outputs.
 * What is the relationship between these lanes and Larry's diagram? Are there any gaps?
 * Jennie recommends resolving overlaps between Larry's diagram and Bill's diagram, except for the governance peice (highlight beacuse that deserves a seperate discussion).

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