LCC+HL7+Tiger+Team+SWG

include component="page" wikiName="siframework" page="LCC Header" flat = = The work of this sub-work group is complete. Please refer to the Final Domain Analysis Model Recommendations section below for recommendation artifacts. =Purpose & Objectives= The LCC HL7 Tiger Team SWG has been established to ensure that relevant HL7 ballot artifacts are aligned with LCC objectives. The Tiger Team will provide comments on HL7 Ballot artifacts that are relevant to the work and objectives of LCC. It will also educate the LCC Community on the HL7 processes and framework as well as provide a deep dive into ballot artifacts that we will be reviewing and providing ballot comments for.

The current project is to align the HL7 Patient Care Work Group's Domain Analysis Model with LCC's vision of care plan exchange and workflow. The LCC Tiger Team is currently reviewing the ballot artifacts and will be generating comments to submit to HL7 for the September Ballot. =Meeting Schedule and Agenda= To add these meetings to your calendar, subscribe to the Longitudinal Coordination of Care Calendar. Final Meeting: Review of Balloted DAM (Recommendations that were implemented, recommendations that were not implemented) ||
 * **Weekly Meeting have ended as of 08/14/2013. Stay tuned for other Work Group opportunities!** ||
 * **Date of Next Meeting:** N/A ||
 * **Webinar:** siframework2.webex.com ||
 * **Dial-in:** 1-650-479-3208 | **Passcode:661 790 069** ||
 * **Agenda:**

Past Meeting Artifacts =Ballot Voting Process for Members and Non-Members= The ballot opens for comment on August 16 and closes September 16. See below for information on how to access ballot documentation, sign up for ballot pools and place your vote(s).
 * Both Members and Non-Members must sign up for the ballot pool before September 9, 2013.**

=Final Domain Analysis Model Recommendations to HL7 Patient Care Work Group= The team discussed numerous topics in regard to the PCWG DAM, which resulted in a set of recommendations that were presented to the HL7 Patient Care Work Group on an ongoing basis. The PCWG has received and considered all the Tiger Team's comments and has implemented many of them into the final Domain Analysis Model that will be balloted.
 * NOTE:** If you wish to filter your comments and vote through an HL7 Member, please email Russ Leftwich or Lynette Elliott.
 * Non-Member Voting Process || [[file:accessing_HL7_DAM_ballot_docs.docx]] ||
 * Member Voting Process - See slides 27-40 of this presentation || [[file:LCC HL7 Tiger Team 2013-08-14.ppt]] ||

**The presentation from the final Tiger Team meeting describes the recommendations that were implemented and includes examples from the model of where those recommendations were accounted for.**

The following is a complete list of the Tiger Team recommendations that were presented to the HL7 Patient Care Work Group.


 * Patient and Provider Roles in Plan of Care and Care Plan
 * Discussion: What role does the Provider play and what role does the Patient play in both the Care Plan and the Plan of Care?
 * **Recommend** that DAM should support both the Care Plan and Plan of Care, sequential and multi-threaded workflows; needs to define the buckets of all the information for all of these.
 * **Recommend** adding attribute to Goals that can indicate that the goals have been agreed to by both the Provider and the Patient or that there is not agreement between the two.
 * **Recommend** adding another attribute that supports specific health concern and intervention related goals (who has agreed to these goals).
 * **Recommend** allowing for variance analysis with levels of intervention.
 * **Recommend** adding/supporting an ability to harmonize multiple treatments and Plans of Care and to create a Master Care Plan in the care of complex Patients in complex organizations.


 * Preferences
 * Discussion: How to represent preferences in DAM; how to show changes have occurred in a patient’s preferences
 * **Recommend** adding a separate Advance Directives section that contains all preference information including advance directive preferences, which are linked to a repository or separate document.
 * **Recommend** listing out and defining “Other preferences” under Types of Preferences.


 * Priority
 * Discussion: What data elements should have priority attributes and whether interventions should be prioritized, as well.
 * **Recommend** not including Priority in interventions. Actions that were considered and not chosen as part of the intervention should be included elsewhere in the Care Plan.
 * **Recommend** adding a text field with Priority so that comments can be captured with priority rankings.


 * Levels of Association
 * Discussion: Is it sufficient to associate one or more Care Team Members with a data element or should the model include levels of association? If so, what is the value set for those role/relationship levels? How many levels should there be and how are they represented (e.g. primary/secondary,/tertiary, or lead/support, or other)
 * **Recommend** including associations in model for traceability (assignment of responsibility, payment, etc.): provide a bucket for association/responsibility level, bucket for functional role, and bucket for identification of responsible/associated individual or entity
 * **Recommend** that High, Medium, Low be used as association/responsibility level designators for both Health Concerns and Interventions.
 * **Recommend** that association should include individual and organization under functional role (Care Team Members may have more than one role inside an organization)
 * **Recommend** that Health Concerns and Interventions also include type of association (e.g., fee for service, consent, other)


 * Team Member Acceptance/Acknowledgment
 * Discussion: Does the Care Team Member need to accept/acknowledge their association?
 * **Recommend** including the ability in the model for a Care Team Member to accept/acknowledge their association


 * Care Team Member Role
 * Discussion: Current model includes “Role” attribute in Health Concern but not in Health Goal or Plan Activity.
 * **Recommend** establishing a taxonomy to support how the association/relationship will be used (e.g., as a messaging filter to only send information to certain entities and/or showing who is involved and their sub-roles and/or other).


 * Team Member Cardinality
 * Discussion: Can Health Concerns, Goals and Interventions be associated with zero care team members within the DAM (other than the patient, who would be associated by default)?
 * Health Concerns to Team Member
 * **Recommend** Health Concern can be zero to many cardinality, with SHOULD conformance
 * Goals to Team Member
 * **Recommend** Goal can be zero to many cardinality, with SHOULD conformance
 * Interventions to Team Member
 * **Recommend** Intervention (Plan Activity) can be zero to many cardinality with SHOULD conformance

=Deliverables & Timeline=
 * Team Member Responsibility – Care Plan
 * Discussion: Is Team Member’s responsibility for the Care Plan represented in the model?
 * Care Planning
 * Care Plan Governance
 * **Recommend** a way to account for facilitation of the Care Plan (“steward” role or other)
 * **Deliverable** || **Timeline** || **Status** ||
 * LCC Comments for the HL7 Care Coordination Service Ballot || 4/29/2013 || Complete ||
 * LCC Presentation (Dr. Larry Garber) to HL7 Patient Care WG || 5/10/2013 || Complete ||
 * LCC Begin Discussion on the HL7 Care Plan Domain Analysis Model || 5/8/2013 || Complete ||
 * LCC Present Preliminary Comments for the Care Plan Domain Analysis Model to the HL7 Patient Care WG || Ongoing || Complete ||
 * LCC Final Comments for the HL7 Care Plan Domain Analysis Model || 8/5/2013 || Complete ||
 * LCC Present Final Comments for the HL7 Care Plan Domain Analysis Model to the HL7 Patient Care WG || 8/7/2013 || Complete ||
 * LCC Collaboration on the HL7 Care Plan Domain Analysis Model (DAM) Ballot || 9/4/2013 || Complete - [[file:LCC HL7 Tiger Team 2013-08-14.ppt|Presentation Materials Describing Implemented Recommendations]] ||

=Reference Materials=
 * [[file:care_plan_DAM_prefs_priorities_views.ppt|Care Plan DAM Views: Preferences and Priorities]] ||
 * HL7 SOA Care Coordination Service May 2013 Ballot Package ||
 * HL7 Care Coordination Service Wiki ||
 * HSSP Care Coordination Service wikispace ||
 * HL7 Patient Generated Document Informative Document Wiki ||

Leads

 * **Name** || **Organization** || **Contact Information** || **Role** ||

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