Patient Care TC Minutes

Baltimore, MD; Oct. 2, 2002

Attendance for Q1 and Q2 / Attendance for Q3 / Attendance for Q4
Rosemary Kennedy
Dan Russler
Judy Warren
Heath Frankel
Amy Danko / Rosemary Kennedy
Dan Russler
Judy Warren
Heath Frankel
Charlie Mead
Amy Danko
Irma Jangeneel
Kai Heitmann
Ganesh Ganesan
David Rowed / Rosemary Kennedy
Dan Russler
Judy Warren
Heath Frankel
Charlie Mead
Amy Danko
David Rowed
Heath Frankel
Irma Jangeneel
Ganesh Ganesan
Louis Gordon
James Frater

Bob Barker

John Firl

Q1-Q2

Follow-up with goal CMETs Dan Russler

Developed definitions for the following concepts

Definition of the Mood—Goal:

Expectation to make a specific observation with a desired value at a predefined future time;

Partial completion code

A subjective measurement of the progress of the act that is transitioning from the state “active” to the state “completed”

Vocabulary for partial completion

None: N (0%)

Minimal extent: MI (about 1-20%)

Some extent: S (about 21-40%)

Medium extent: ME (about 41-60%)

Large extent: L (about 61-80%)

Great extent: G (about 81-99%)

Set goal

Is an act of determining the expectation to make a specific observation with a desired value at a predefined future time

Goal variance calculation

Is a meta-observation derived from calculating the difference between the value of the goal and an observed value of an observation (goal minus observed value)

Condition

Experience or observable finding persistent over time that tends to require intervention or management; more complex than a simple observation made at a point in time; may exist before an observation or intervention is made; Examples: a health risk, a financial risk, public health risk, pregnancy, health maintenance, illness

Condition node

Observation on a condition at a point in time that includes any observations or procedures associated with that condition as well as links to previous conditions nodes on a related condition

Clone of Act_relationship

(a) Links encounters into episodes of care and (b) links conditions or episodes of illness

Dan Russler will complete the Vocabulary submission forms for the above definitions and submit them to the Vocabulary TC. Heath will assist Dan when this goes to Harmonization. When we do goal messages, be sure to capture state transition.

Q3

Episodes work from The Netherlands—(episode of condition)

Irma Jongeneel presenting

NICTIZ institute for ICT in healthcare—develops information structures

Domain of study is perinatalogy

Constructed domain information model based on 10 pathways

DMIM

Next will do RMIM

Specifications for information interchange—HMDs and XML schema

Different episodes—pregnancy, delivery, maternity, neonatal—developed a pattern for representing an episode; more specification was then modeled for each episode

Models were presented and discussed.

Will send PowerPoint file to Patient Care TC Listserv; also has a linkable version in IE; will send to Charlie Mead for use as an example in the HDF

Issues:

How to balance horizontal vs. vertical standard specifications and implementation guidelines

Conclusions:

Good enough to create DMIM

Vocabulary very difficult, both clinical and HL7 codes (need more explicit semantics; type codes, class codes)

Q4

Request by Community Health SIG concerning legal status and consent by Ganesh Ganesan--Will send me a report for the minutes

Request legal status and consent codes; will add to January agenda

Discharge/referral messages as requested by Community Health SIG David Rowed

See document posted on Patient Care TC listserv

Requested changes made to V 2.6 for discharge, referral, and pathways; committee recommended using V 3 modeling techniques so that the work can move there rapidly; proposal also needs to go to Orders and observations

David Rowed moved that he would proceed with edits to Chapter 12 to reflect their proposal. This will be brought to the San Antonio meeting for a change to V2.6. Seconded by Health Frankel. 1 abstention, no negatives, 13 positives—passed.

Meeting times: go to Tuesday and Wednesday with overlap Community Health SIG on Wednesday

Agenda for San Antonio in January 2003

  1. Consent CMETs Dan Russler and Kay Avant
  2. Legal status Ganesh Ganesan
  3. Discharge/referral David Rowed
  4. Vocabulary issues for WorkingList Kay Avant
  5. Review of vocabulary domains for Patient Care Kay Avant
  6. Follow-up with modeling of Diet class Karen Nocera
  7. Patient education intervention Amy Danko and Rosemary Kennedy