LTPAC+Care+Transitions+SWG_2012+04+16

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Attendance
Ann Clarke, Larry Garber, Larry Wolf, Liz Milton, Rhonda York, Steven Cason, Terry O’Malley, Emma Jones, Susan Campbell, Ed Larsen, Shalina Wadhwani, Sue Mitchell, Meredith Lewis, Charlotte Weaver, Kris Cyr, Maria Harr

Meeting Notes
Over 300 people from the S&I Framework groups – LCC work room was very full and participatory Clarified scope and vision for LCC LCP sub work group is going to work on start of care plan (CMS 485, sent to PCP for review/corrections) This starts MDS and OASIS forms as well as the comprehensive care plan The assessment forms are part of the Patient Assessment Summary SWG, these will be sent to whoever needs to see them (e.g. CMS) Data generated around plan of care will be bundled into a transfer document that goes to the patient’s new location (e.g. ED) Really only 5 different transitions of care; setting, diagnoses, medications, treatments, procedures Each data set is a sub set of the next larger data set for the most part Show how the LCC work evolved out of ToC – looking at data sets, many align with the previous scenarios from ToC Group is trying to work with IHE and HL7, each of whom are working on the plan of care, to come up with a vision on how to do it Make the plan of care/care plan fairly agnostic Two sets of goals – general patient preferences and specific physician goals; group needs to make sure these remain separate and very distinct Plan of Care Group (Laura) is at an information model right now; using story boards to determine what content is needed Would like to set up a meeting with Laura this week Larry’s data model – by choosing the data sets that encompass what SNF and Home Care needs, relatively covered all of the data needs of everything else coming and going The initial orders correspond to 485 and then ongoing transaction addresses operational needs around the plan of care LTPAC should be from C-CDA work, other groups may handle work outside the C-CDA
 * Face to Face Update/Overview and Data Sets Discussion:**

Home health should begin to the Use Case and functional requirements for the priority transactions Initially coming up with a lot of the tables that are used to come up with requirements, activity flows Draft will likely be posted today to give people an idea of where the group is going Would like to have rapid input for functional requirements while the support team puts together a first draft of the use case for the work group leads to take a first pass through Update this, then get this to the group as soon as possible (1-2 weeks ideally to begin commenting) Final consensus of baseline use case Want to ensure the data sets being tackled are correct with the correct consensual base After baseline use case, look at specific settings to ensure we are going back and including requirements for different settings (types, medications, etc) Overall baseline use case in 6-8 weeks, then look at what is the next trading partner or how we would like to improve that baseline next At the same time, harmonization would be taking the baseline use case through that process PAS SWG will begin standards analysis process for PAS to try and align with the C-CDA, MDS, OASIS, etc Ensure Keystone Beacon has the appropriate level of input from the S&I Framework when moving through HL7 balloting Start to push information to the wiki and try in the workgroup calls to really get through issues that arise Want to keep everyone in the loop moving forward with the Use Case, be aware of status and when input is really needed from the support team Will likely be another Face to Face in the fall; try to get this in your budget if that is something for which members need to plan
 * Use Case Development:**

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