With meeting notes André Boudreau aboudreauboroanca Stephen Chu mailtostephenchunehtagovau Laura Heermann Langford LauraHeermannimailorg 20110519 Q1 9h00 to 10h30 ID: 760655
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Slide1
Care Plan (CP) Orlando WGM Meeting(With meeting notes)
André Boudreau (a.boudreau@boroan.ca)Stephen Chu (mailto:stephen.chu@nehta.gov.au)Laura Heermann Langford (Laura.Heermann@imail.org)2011-05-19, Q1, 9h00 to 10h30Care Plan wiki: http://wiki.hl7.org/index.php?title=Care_Plan_Initiative_project_2011
HL7 Patient Care Work Group
V4- With discussion
notes
verified
and
augmented as of 2011-06-10.
Includes post WGM meeting comments by Jay Lyle on Dynamic Federated Plan of Care Model.
Includes new slides for Danish model, ISO CONTSYS project, EHR-S FM R1.1 extracts for Care Plans
.
Slide 36
should be filled to ensure that we don’t miss reusable material and do not reinvent contents.
Slide2Agenda - May 19th – Q1- 9h00 to 10h30
Attendance and agenda check – Stephen/Laura (5)
Background: history, need for a Care Plan DAM -André (5)
Approach followed /deliverables – André (10)
Status of Care Plan DAM project - André (5)
Storyboard review: chronic care, home care - Laura (15)
Sample of discussions: models, structures - Laura (15)
Identifying key resources for the Care Plan DAM project – All participants (15)
Material
and
people
from other Patient Care work (Pressure Ulcer, DCM) and other WG (Emergency Care, Care Provision, Care Statement, Structured Document, CDA consolidation, etc.)
Suggestions and concerns of participants - Laura (15)
Close -Laura (5)
Slide3Participants- WGM Meetg of 2011-05-19 p1*
NameemailCountryYesNotesAndré Boudreaua.boudreau@boroan.caCAYesCo-Lead- Care Plan initiative/HL7 Patient Care WG. B.Sc.(Physics), MBA. Owner Boroan Inc. Management Consultin. Chair, Individual Care pan Canadian Standards Collaborative Working Group (SCWG). Sr project manager. HL7 EHR WG.Laura Heermann LangfordLaura.Heermann@imail.orgUSYesCo-Lead- Care Plan initiative/HL7 Patient Care WG. Intermountain Healthcare. RN PhD,: Nursing Informatics; Emergency Informatics Association, American Medical Informatics Association; IHEStephen Chu stephen.chu@nehta.gov.auAUYesNEHTA-National eHealth Transition Authority . RN, MD, Clinical Informatics; Clinical lead and Lead Clinical Information Architecture; co-chair HL7 Patient care WG; vice-chair HL7 NZPeter MacIsaacpeter.macisaac@hp.comAUHP Enterprise Services. MD; Clinical Informatics Consultant; IHE Australia; Medical Practitioner - General PracticeAdel Ghlamallahaghlamallah@infoway-inforoute.caCACanada Health Infoway. SME at Infoway (shared health record); past architect on EMR projectsWilliam Goossenwgoossen@results4care.nlNLYesResults 4 Care B.V. RN, PhD; -chair HL7 Patient Care WG at HL7; Detailed Clinical Models ISO TC 215 WG1 and HL7 ; nursing practicionerAnneke Goossenagoossen@results4care.nlNLYesResults 4 Care B.V. RN; Consultant; Co-Chair Technical Committee EHR at HL7 Netherlands; Member at IMIA NI; Member of the Patient Care Working Group at HL7 International Ian Townsendian.townend@nhs.netUKNHS Connecting for Health. Health Informatics; Senior Interoperability Developer, Data Standards and Products; HL7 Patient Care Co-Chair Rosemary KennedyRosemary.kennedy@jefferson.eduUSThomas Jefferson University School of Nursing . RN; Informatics; Associate Professor; HL7 EHR WG; HL7 Patient care WG; terminology engine for Plan of care;Jay Lylejaylyle@gmail.comUSJP Systems. Informatics Consultant; Business Consultant & Sr. Project Manager Margaret Dittloffmkd@cbord.comUSThe CBORD Group, Inc.. RD (Registered Dietitian); Product Manager, Nutrition Service Suite; HL7 DAM project for diet/nutrition orders; American Dietetic AssociationAudrey Dickersonadickerson@himss.orgUSHIMSS. RN, MS; Standards Initiatives at HIMSS; ISO/TC 215 Health Informatics, Secretary; US TAG for ISO/TC 215 Health Informatics, Administrator; Co-Chair of Nursing Sub-committee to IHE-Patient Care Coordination Domain.Ian McNicollIan.McNicoll@oceaninformatics.comUKOcean Informatics . Health informatics specialist; Formal general medical practitioner; OpenEHR; Slovakia Pediatrics EMR; Sweden distributed care approachDanny ProbstDaniel.Probst@imail.orgUSIntermountain Healthcare. Data Manager Kevin CoonanKevin.coonan@gmail.comUSMD. Emergency medicine. HL7 Emergency care WG. Gordon Raupgraup@datuit.comUSCTO, Datuit LLC (software industry).Susan Campbellbostoncampbell@mindspring.comUSYesPhD microbiologist. Principal at Care Management Professionals. HL7 Dynamic Care Plan Co-developer Elayne AyresEAyres@cc.nih.govUSYesNIH National Institutes of Health. MS, RD; Deputy Chief, Laboratory for Informatics Development, NIH Clinical Center ; Project manager for BTRIS (Biomedical Translational Research Information System), a Clinical Research Data Repository
*: includes on site and teleconference participants
Slide4Participants- WGM Meetg of 2011-05-19 p2*
NameemailCountryYesNotesDavid Roweddavid.rowed@gmail.comAUCharlie Bishopcharlie.bishop@isofthealth.comUKYesWalter Suarezwalter.g.suarez@kp.orgUSPeter HendlerPeter.Hendler@kp.orgUSRay Simkusray@wmt.caCALloyd Mackenzielloyd@lmckenzie.comCALM&A Consulting Ltd.Serafina Versaggiserafina.versaggi@gmail.comUSClinical Systems Consultant Sasha BojicicSBojicic@infoway-inforoute.caCALead architect, Blueprint 2015, Canada Health InfowayAgnes Wongawong@infoway-inforoute.caCARN, BScN, MN, CHE. Clinical Adoption - Director, Professional Practice & Clinical Informatics, Canada Health InfowayCindy Hollisterchollister@infoway-inforoute.caCARN, BHSc(N), Clinical Adoption -Clinical Leader, Canada Health InfowayValerie Leung vleung@infoway-inforoute.caCAPharmacist. Clinical Leader, Canada Health InfowayLuigi Sisonlsison@yahoo.comUSYesInformation Architect at LOINC and at HL7. Enterprise Data Architect at VA. Developing standard for Detailed Clinical Models (DCM), information models for Electronic Health Record (EHR) Diabetes Project, etc.Brett Eslerbrett.esler@pencs.com.auAUYesPen Computer SysCatherine Hoangcatherine.hoang2@va.govUSYesVAHugh Lesliehugh.leslie@oceaninformatics.comYesSeam Heardsam.heard@oceaninformatics.comYes
*: includes on site and teleconference participants
Slide5Background
Slide6History and Need for CP DAM
Care Plan has been balloted some years ago as DSTU. However, it was felt at that time that more work needed to be done in defining care plan, the components of the care plan, identifying use cases and use. Items about Care Planning to be discussed towards a future round of DSTU include: Existing RMIM: does it cover all kinds of care plans and pathways. Definition of care plan The overall structure that has been agreed: Care Plan -> Order set -> Clinical Statement. Discussion about this hierarchy is done in PC, O&O and CDS WG.
Source:
HL7 Patient Care WG Wiki
Slide7Project Scope (2010) – to Be Updated
The Care Plan Topic is one of the roll outs of the Care Provision Domain Message Information Model (D-MIM). The Care Plan is a specification of the Care Statement with a focus on defined Acts in a guideline, and their transformation towards an individualized plan of care in which the selected Acts are added. The purpose of the care plan as defined upon acceptance of the DSTU materials in 2007 isTo define the management action plans for the various conditions (for example problems, diagnosis, health concerns)identified for the target of careTo organize a plan for care and check for completion by all individual professions and/or (responsible parties (including the patient, caregiver or family) for decision making, communication, and continuity and coordination)To communicate explicitly by documenting and planning actions and goalsTo permit the monitoring, and flagging, evaluating and feedback of the status of goals, actions, and outcomes such as completed, or unperformed activities and unmet goals and/or unmet outcomes for later follow up.Managing the risk related to effectuating the care plan, Generally a care plan greatly aids the team (responsible parties – it could be the patient caregiver/family) in understanding and coordinating the actions that need to be performed for the person. The Care Plan structure is used to define the management action plans for the various conditions identified for the target of care. It is the structure in which the care planning for all individual professions or for groups of professionals can be organized, planned and checked for completion. Communicating explicitly documented and planned actions and goals greatly aids the team in understanding and coordinating the actions that need to be performed for the person. Care plans also permit the monitoring and flagging of unperformed activities and unmet goals for later follow up.
Source:
HL7 Patient Care WG Wiki -
Care Plan
Topic
project
(
Archived
)
Slide8Discussion Notes (Background)
Focus on requirements
Do not worry about RMIM for 2 years
Issue
Contents are derivation from RIM components, F class
Should not find anything that is not covered in the RIM
D-MIM is top
Informed by use cases
CP DAM is key to validate our DMIM
Care Provision DMIM is key
Clinical Statement will be used in the future: to be proven
Copy what is useful from past work
Plan Walkthrough of DSTU and other existing material at a future meeting by William (André/Laura to schedule)
Patient Care WG has 18 projects
Slide9Approach and Deliverables
Slide10Approach
The plan for 2011 is to first develop a Domain Analysis Model (DAM) for the Care Plan, and then decide on follow on activities.
The HDF 1.5 (HL7 development framework) approach will be followed.
HL7 PC will work together with various groups including HL7 Work Groups (e.g. EHR, Structured documents), IHE, NEHTA, Canada Health Infoway, and others.
Slide11HDF- Domain Analysis Overview
Source: HDF_1.5.doc, page 37
Last updated: 2011-02-09
Slide12Requirements Document- Structure
Business and clinical context, overall need
Definition of the topic (theme)
Stakeholders and needs
Overall description of processes: contents dynamic, interchange
Interrelationships with other processes
Scope (in and out)
Business objectives and outcomes
Vision Statement
Slide13Discussion Notes (Approach and Deliverables)
Care Plan can be dynamic and also have static moments
Important to be pragmatic to achieve results in reasonable time
Coordination of care is the key
Keep things simple otherwise we will be caught in a lot of complexity
Understand context and stakeholders needs
We will not focus on the process of developing care plan
There are 100’s of ways of developing CPs
But the interoperable info has to accommodate all this
We are modeling only the info, not the process
Slide14Progress and Status of CP DAM Project
Slide15Regular Participants at Weekly Meetings
André Boudreau, Co-Lead
Laura Heermann Langford, Co-Lead
Stephen Chu, Patient Care WG Co-Chair
Susan Campbell
Kevin Coonan
Margaret Dittloff
Adel Ghlamallah
Rosemary Kennedy
Jay Lyle
Ian McNicoll
Danny Probst
Luigi Sison, modeller
Slide16Progress Achieved
We clarified the process we would follow to conduct the Care Plan Domain Analysis
We identified the storyboards required to cover the range of situations to be covered in the DAM
We developed / refined 2 storyboards
Chronic care
Home Care
We discussed and modeled the dynamics of care plans
We looked at and compared the contents of some care plans: Sweden, IHE, NEHTA, Nursing
We started drafting requirements
Slide17Storyboard Review
Chronic Care
Home Care
Slide18List of Required Care Plan Storyboards
Chronic Care
Acute Care
Home Care
Perinatology
Pediatric and Allergy/Intolerance
Stay healthy/ health promotion
Sources: IHE, CHI, HL7, etc.
This is the starter set.
Is it sufficient?
Slide19Guiding Principles for Storyboards
Describe a specific healthcare business problem (or processes) that require(s) the exchange of data/information
By clinicians
Need to
ensure
Readability
Clinical accuracy, validity
Coverage (focus on the 80%, not the exceptions)
Refined as we progress in the DAM process
Remember: storyboards get improved over time, as the project advances
Slide20Sample of Discussions Regarding Care Plan DAM
Slide21Dynamic Federated Plan of Care Model provided by Laura
Slide22Dynamic Federated Plan of Care Model provided by Laura- Discussion
This model illustrates a collaborative care model where the care plan is dynamically updated and maintained by multiple organizations and providers
Referral is connected to the plan
The pink line shows the flow when there is no federated care plan
What is to be transmitted? The whole contents? Or the latest and most relevant data for the target organization/provider?
We need to look at a typical chronic disease case where multiple organizations are involved without a federated care plan and no common system
Sweden is moving to a patient centric model with a central dynamic care plan with greater fluidity of information among providers
Slide23Discussion Notes (Dynamic Plan of Care)
ONC Transition of Care initiative
Care Plan topic: exchange of information and knowledge
Very time driven
HIN-
3 use cases:
2 approved: simple discharge, simple referral from primary care to specialist,
Out for public comment: Discharged from hospital to nursing home/skilled nursing
Slide24Questions by Jay Lyle- Post WGM-20110525
Terminology
I appreciate the distinction between the 'dynamic' and 'static' care plans, but I wonder if they might be better named as a “care plan application” and “care plan interoperability specification.” I think the HL7 spec will describe static documents or messages (interoperability specifications); I don't think it will provide functional requirements for applications.
20110608: these are
different
concepts, so no renaming
“Federated” plan
Is this intended to represent a government-mandated central care plan repository or application that other EHRs can use? In the US, that probably won't fly.
20110608: this is country/organization specific. It is conceptual model, agnostic to implementation
System boundaries
If System A and System B are applications, then there is only one interaction: communicate care plan (from A to B, or vice versa). If System A contains several applications (outpatient, inpatient, home, etc.), then there are many more interactions shown--each of which may have one or more use cases. In a SOA environment, those distinctions begin to blur, but we need to determine what processes (and constituent interactions, and, implicitly, system boundaries) the model should support.
20110608: noted.
Slide25Functional Care Plan System A
Care Plan Query / View System
Functional Care Plan System B
Ancillary System(outpatient, inpatient, home, ED, etc.)
1. View Plan
2. Exchange Plan
3. Place Order
4. Get Observation
View
may support different sorts of queries, possibly for different sorts of clients (pink boxes in slide 19).
Exchange
may support different levels of detail, or possibly a focus area
Should ‘plans’ place orders? Should they use existing HL7 order specifications? 20110608: NODitto #3 for observationsSystem may alert provider based on plan, rule, and date or incoming observation.
Communications System
5. Alert
User
Interface
2a. Synchronize Plan
Candidate simplified context diagram,
Submitted by Jay Lyle, post-WGM, 20110525
Slide26Types of care plans (provided by Stephen)
Dynamic care plansCare plans that are developed, shared, actioned and revise realtime by participating care providers via a collaborative (likely to be web-based) care plan management environment supported by complex workflow management engine.dynamic and organiccoordinated by care coordinator (e.g. GP)shared realtimeupdated/managed realtime by all care providercan contain other care plansdynamic links to relevant patient information (where appropriate and feasible, i.e. privacy and security permit) and evidence-based resourcesInterchanged care plansCare plans that are shared (preferrably via electronic exchanges) and actioned by participating care providerslack support of a realtime collaborative care plan management environmentmaster care plan managed and updated/maintained mainly by a care coordinator (e.g. GP) with contributions from participating care providersinterchanged care plan is essentially a snap shot of the master care plan at a point in timecommunicated often together with referral/request for services to target care providerscan contain other care plans as attachments
Created: 2011-03-09
Slide27Discussion Notes (Dynamic/Interchanged Care Plans)
Charlie Bishop (2011-06-10)
My notes and recall of the discussion are around the need for us to concentrate our efforts in the area that HL7 focuses on – i.e. the information and information structures related to Care Plans rather than the operational processes involved with the generation and use of Care Plans. It was this that brought the two Care Plan ‘definitions’ into the discussion:
Dynamic Care Plans – updated and grow as patient care progresses and are updated and accessible to all carers linked to the patient at any point in time
Interchanged Care Plan – static and communicated for continuity of care purposes
It is the second of these that is of primary concern to our work in developing a small set of generic HL7 v3 information models that can be used to facilitate the many specialist care plan communication scenarios that are required in a multi-disciplinary care environment. HL7 v3 also has a ‘Dynamic’ component but this is not really concerned with how and why information is made available and persisted but how and why it is communicated/interchanged.
There are clearly aspects of Dynamic Care Plans that are relevant to our understanding of the Interchanged Care Plans but this is primarily the information that is used rather than the processes that generate, access and use the information in a care setting.
Slide28Discussion Notes (Dynamic/Interchanged Care Plans)
Sam: he will send notesSusan: how is the information exchanged: real time?VS CDA nested informationOn a selective basis
Notes by Sam missing
Slide29Care Plan – High Level Processes
Stephen Chu
5 April 2011
Identify problems/issues/reasons
Assess impact/severity:
referral
order tests
Initial Assessment
Confirm/finalize problem/issue/reason list
Determine goals/intended outcomes
Determine Problems & Outcomes
Set outcome target date
Determine/plan appropriate interventions
Determine/assign resources
healthcare providers
other resources
Develop Plan of Care
Implement interventions
Care Plan Implementation
Evaluate patient outcome
Review interventions
Evaluation
Document outcomes
Revise/modify interventions
OR
Close problem/issues/reason/care plan
Follow-up Actions
Goals/Outcomes:
- Optimize function
- prevent/treat symptoms
- improve functional capability
- improve quality of life
- Prevent deterioration
- prevent exacerbation; and/or
- prevent complications
- Manage acute exacerbations
- Support self management/care
Care Plan
This is based on a broad review.
All converge.
May need to revise goals and
outcomes during the process of
care.
Nutrition has similar model. Also use
standardized language
Hierarchy or interconnected plans can
apply.
Every
prof
group has specific ways
to deliver care. Here we focus on
the overall coordination of care.
Is there always a care coordinator?
Patients could be the coordinator of
their own care. They should be
active participants.
This diagram is about process, not
Interactions and actors
Add care coordination activities
in these activities
Need a concept of a master care plan
with all the concerns and problems
Slide30Care Plan – High Level Processes
Stephen Chu
12 April 2011
Identify problems/issues/reasons
Assess impact/severity:
referral order tests
Initial Assessment
Confirm/finalize problem/concern/reason list
Determine goals/intended outcomes
Determine Problems & Outcomes
Set outcome target date
Implement interventions
Care Plan Implementation
Evaluate patient outcome
Review interventions
Evaluation
Document outcomes
Revise/modify interventions
OR
Close problem/issues/reason/care plan
Follow-up Actions
Goals/Outcomes:
- Optimize function
- prevent/treat symptoms
- improve functional capability
- improve quality of life
- Prevent deterioration
- prevent exacerbation; and/or
- prevent complications
- Manage acute exacerbations
- Support self management/care
Care Plan
Care
orchestration
Problem/concern/reason 1..*
Target goals/outcomes
Planned intervention
Assessed outcome
High Level Shared Plan
Detailed Care Plan
Determine/plan appropriate interventions
Determine/assign resources
healthcare providers
other resources
Develop Plan of Care
Refer to other provider (s)
Care
orchestration
Slide31Discussion Notes (High Level Processes)
Versioning must be allowed
Proposed and accepted Care Plans may be different
Required approval by care giver, patient
Implicit approval? Or explicit
Key with static CPs
Ensure that the patient is central to the process
Vs provider centric
Both approaches should be allowed?
Patient control? Preferences?
Financial responsibility implied?
NL mental health: central CP to individual CP
Institution resources
vs
patient needs
Each country has their process
Patient care DMIM: can be author of CP
Slide32Care Plan Development - Principles
High level processes can be used to guide storyboards, use cases and care plan structure development and activity diagram and interaction diagramCare plan should preferably be problem/issue oriented, although may need to be reason-based where problem/issue not applicable, e.g. health promotion or health maintenance as reason. Use ‘health concern’ as encompassing term? (see Care Provision, 2006-7)Care plan should be goal/outcome oriented- to allow measurementInterventions are goal/outcome orientedExternal care plan(s) can be linked to specific intervention/care servicesGoal/outcome criteria are essentially for assessment of adequacy/effectiveness of planned intervention or serviceReason for care plan is for guiding care and for communication among care participants. Need to support exchange of information.
Stephen Chu
5 April 2011
Slide33Sample of Structure and Contents (
xmind
models)
Ian McNicoll
2011-04-06
Slide34Sample of Structure and Contents (xmind models)
Ian McNicoll2011-04-06
Slide35key resources for the Care Plan DAM project
Slide36Material and People
SourceMaterialPeopleNotesPatient Care-DCMPatient Care-CP DSTUPatient care-Pressure UlcerCare StatementCare ProvisionStructured DocumentCDATemplatesEmergency careEHRS FMPHRS FMEHRS FM Profiles
To be filled
Slide37Discussion Notes- Key Resources for the Care Plan DAM Project - 1
DAM for devices
DAM CIC CV (cardio-vascular)
ISO CONSYS work:
see brief descriptive summary on next slide
ISO 13940 Health Informatics: System of concepts to support continuity of care
aka ISO_TC215_N821_NWIP_13940_ContSys
Slide38What is ISO 13940 Health Informatics: System of concepts to support continuity of care?
This ISO/TC215 Health informatics New Work Item Proposal (NWIP) N821 is intended to merge the previous work items 13940-1 System of concepts to support continuity of care Part 1 Basic concepts and Part 2 Healthcare process and workflow. This International Standard seeks to identify and define those processes which relate to co-operation between all parties involved in health care provided to human beings (to the exclusion of other living subjects). Given the definition of health as agreed by the World Health Organization (WHO), this International Standard will include those aspects of health care that rely on the acts of other actors than simply health care professionals. This International Standard specifically addresses aspects of sharing information related to a subject of care that is needed in the process of health care. This International multi-part standard addresses topics including: health care actors and other parties; organisational principles of health care, including co-operation between actors; health issues, health conditions and their management; time-related concepts like contacts, encounters, episodes of care and periods of care; concepts related to process, workflow and activities; concepts related to decision support, use of clinical knowledge and quality; concepts related to responsibility and information flows within the clinical process, like health mandates and their notification; concepts related to health data management. Whenever continuity of health care delivery implies social care activities as part of, or in support to, the process towards health recovery, these are to be mentioned wherever relevant in the process and workflow. In order to establish a common conceptual framework for continuity of care across national, cultural and professional barriers, all of these concepts are defined in this document, and their inter-relationships identified.
Note: this was prepared by Canada Health Infoway at ballot time.
Slide39Discussion Notes- Key Resources for the Care Plan DAM Project - 2
Danish washing machine project
http://www.openecg.net/WS1_slides/S3_3_kvrneland/S3_arne.pdf
See next 2 slides
Slide40Extracts: National IT-strategy in the Danish Health Care System, Arne Kverneland, MD, National Board of Health
Link various patient contacts around one episode of care
Slide41Extracts: National IT-strategy in the Danish Health Care System, Arne Kverneland, MD, National Board of Health
Where care plans fit
Slide42Discussion Notes- Key Resources for the Care Plan DAM Project - 3
In the EHR-S FM and the PHR-S FM there are functionalities about the care plan. Maybe its helpful to have a look at it, because it says something about the behavior of the system
See summary model prepared by Anneke, next 3 slides
This is based
on
R1.1 version
We need to look at the draft R2
material (see HL7 EHR WG)
Slide43HL7/ISO EHR-S FM R1.1 Care Plan Elements: Direct Care 1.6, Care Plans, Treatment Plans, Guidelines, and Protocols
Statement and Description of 2 functions
Provided by Anneke Goossen
Slide44HL7/ISO EHR-S FM R1.1 Care Plan Elements: Direct Care 1.6, Care Plans, Treatment Plans, Guidelines, and Protocols
Conformance Criteria for DC 1.6.1- Present Guidelines and Protocols for Planning Care
Provided by Anneke Goossen
Slide45HL7/ISO EHR-S FM R1.1 Care Plan Elements: Direct Care 1.6, Care Plans, Treatment Plans, Guidelines, and Protocols
Conformance Criteria for DC 1.6.2- Manage Patient Specific Care and Treatment Plans
Provided by Anneke Goossen
Slide46Discussion Notes- Key Resources for the Care Plan DAM Project - 4
ISO standard for the Care Plan: definition, see Care Plan- option 3 on the wiki PC Glossary
http://wiki.hl7.org/index.php?title=Patient_Care_Glossary
This definition may be updated by the current CONTSYS work underway
Slide47Suggestions and concerns
Slide48Suggestions and Concerns
Australia project
Uses DSTU material
Some issues: what are they? Specific functions and attributes
DAM work is good
Need clarification of static
vs
dynamic
Slide49Conclusion
Slide50Concluding Notes
Reminder: Care Plan DAM
weekly meetings
Wednesday, 17h00 EDT, 1.5 to 2 hours
= 11h00 PM in NL
All are
welcome
See wiki below for phone number and
webex
.
HL7 Wiki: Patient Care WG/ Care Plan Initiative
2011
http://wiki.hl7.org/index.php?title=Care_Plan_Initiative_project_2011