Community Based Health Services SIG Meeting Minutes

July 10, 2006

Call Details:

Date / Time(s) Call is scheduled for 1.0 hour

Mon Jul 10, 2006 01:00 PM (US Eastern Time, GMT -5) Mon Jul 10, 2006 10:00 AM (US Pacific Time, GMT -8) Mon Jul 10, 2006 07:00 PM (Central Europe, GMT +1) Tue Jul 11, 2006 04:00 AM (East Coast Australia, GMT +10)

Call Status This is a call in a recurring sequence (and occurs every two (2) weeks)

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1 Community Based Health Services SIG Meeting Minutes

July 10, 2006

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Attendees:

Name Affiliation Email Richard Thoreson SAMHSA CSAT/cochair [email protected] Rob Swenson Cerner/cochair [email protected] Kathleen Connor Fox Systems, Inc./scribe [email protected] Suzanne Maddux Centers for Aging Services [email protected] Technologies Jim Kretz SAMHSA/CMHS [email protected]

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July 10, 2006 Tom Trabin SATVA [email protected] Mike Morris Ana Denny Morrison Centers for Behavioral [email protected] Health Grady Wilkinson Sacred Heart [email protected] Rehabilitation Center, Inc Kumar Manoj BCBS Florida [email protected] Scott Serich IJIS Institute [email protected] Peter Kress Acts Retirement [email protected]

AGENDA:

I. Call to order

The meeting was called to order by the chair, Rob Swenson, at 12:05 EDT. Kathleen is the scribe.

II. Acceptance of agenda

The agenda as sent to the e-mail list is as follows:

Agenda for the next calls will be continued review and refinement of:

1) Approval of the Agenda 2) Approval of the Minutes 3) Announcements 4) CBHS name, mission statement, and process charter 5) BH Domain scope statement 6) BH Call Times 7) BH Domain project charter 8) Review of data sets provided 9) Prioritizing pilot interaction to develop 10) Action Items review 11) Other Business and Planning for next meeting 12) Adjournment

III. Acceptance of June 26th Minutes – approved without objection

DISCUSSION:

1. MISSION/CHARTER AND NAME:

Draft of changes proposed by Tom, Suzanne, Kathleen and Richard was modified during the call as follows: Mission/Charter

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July 10, 2006 Mission The mission of the Community Based Health Services (CBHS) SIG is to facilitate the development and acceptance of HL7 standards and related activities specific to supporting the provision, management, and coordination of a spectrum of care to individuals [kathleenc1] with chronic, functional, and behavioral conditions. The spectrum of care may include acute, episodic, long-term, habilitation, or hospice care in care-settings ranging from intensive, ambulatory, residential, home, and care in the community. Management in this context includes support for performance and outcome measures, and other reporting requirements of oversight entities. The CBHS SIG will seek to engage domain stakeholders in activities, particularly those activities relating to the identification and validation of domain requirements. Community Based Health Services domain stakeholders are those who are from community and related settings throughout the complete continuum of care. They include but are not limited to providers and consumers of home health care, long term care, hospice care, community health and day therapy centers, mental health, substance abuse and assisted living services. Charter Work Products and Contributions to HL7 Processes The SIG will work with domain stakeholders and members of relevant TCs to further the development of standards, scenarios and profiles that address the requirements of health care provision and related services in community- based and related settings across the continuum of care, by providing stakeholder validation of requirements relevant to domain stakeholders. This process will be both consultative and educational, and includes editing responsibility for Referral Chapter of Version 2 and Version 3 on behalf of Patient Care TC. Formal Relationships with Other HL7 Groups The Sponsoring Technical Committee is Patient Care. In addition, the SIG has specific relationships with the (1) LAPOCT SIG to help in the evolution of the Point of Care Test messages, which are ultimately under the guidance of the Orders and Observations TC; and (2) the EHRs TC for the development of community based health service electronic health record system profiles for various health care fields, including long term care and behavioral health. LAPOCT sponsors the Joint Working Group and the liaisons with POCT1 and IEEE. The CBHS SIG will liaise with other committees on domain specific issues as the need arises or as guided by the Patient Care TC or HL7 Board. Formal Relationships with Groups Outside of HL7 No formal relationship with groups outside of HL7 currently exists.

Discussion during the call

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July 10, 2006 Rob led a discussion of different perspective of the participants. Rob pointed out that in Australia community based health care means the full spectrum of the care continuum provided to individuals with chronic, functional, and behavioral conditions in a wide variety of care settings. Peter stated that he was concerned that “continuum” connotes a tightly coupled, integrated, and coordinated care delivery system, which is not the typical use case addressed by the committee. He characterized the sense that the authors of the current mission statement meant to capture is a more or less coordinated spectrum or constellation of care. Peter stated that the CBHS SIG’s goal is to be a recognizable “home” for providers and stakeholders of community based health care; to facilitate articulation of business requirements for supportive electronic interactions, and to advocate for the inclusion of those business requirements in the use cases that guide the development of HL7 standards. He does not favor changing the name, and not sure that we need to rewrite the charter to accommodate the BH care delivery unless it is fragmented, and needing coordination across a variety of settings. Jim Kretz agreed with Peter, and noted the decreased use of acute or institutional care. Tom differed stating that we need to let acute psychiatric and substance abuse institutions know that we are working on standards and encourage them to participate. Mike wants to make sure that mission statement incorporates the need to support reporting for oversight purposes. If it is not contained in the name, it needs to be included in the mission statement. His customers’ main concern is to develop standards that would encourage uniform reporting and eliminate duplicate data entry. Denny agreed that this is a key concern. Peter suggested that the current name and mission statement is sufficiently comprehensive and that the BH contingency needs to make sure that any BH project charter include a statement about the particular focus being reporting for oversight. Rob stated that he was okay with a name change if it continued to connote who would be included so that future attendees would know from the name that this is the appropriate SIG for them. He suggested that we wait until we see the BH project scope statement and charter, and then evaluate any gaps. He noted that he had not seen these documents. Kathleen will resend. Tom reiterated his concern that the mission/charter is broad enough to include the work BH needs to pursue. He stated that while it may be true in Australia that “community based health care” means the full spectrum of care for behavioral health disciplines, it does not mean that in the U.S. Although institutional care may be declining or stabilized, those providers are still an important set of stakeholders. Although the name is not as important as the mission and charter, the name connotes a much more limited scope in this country. Denny agrees with Tom. He wants explicit liaison functions with other HL7 TCs and SIGs to ensure that the BH requirements regarding oversight reporting and hospital setting interoperability are addressed. Tom is concerned that we need to be more explicit about our connection with hospitals.

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July 10, 2006

Denny supports Tom’s point, citing the need for med-surge facilities to support psychiatric care in their EHRS. Grady suggested that we minimize reference to any particular care setting and instead make broad inclusive statements that did not limit the types of care settings that might be involved. This might not however assist those who do not consider themselves part of community based health care to recognize that the SIG was a place in which their business requirements related to chronic and functional conditions could be met. Tom and Peter discuss the meaning of the term of “continuum”. Peter understands the term to be analogous to continuity of care where Tom views it more in terms of more or less coordinated care across, as Peter termed it, a varied spectrum or constellation of care setting. Scott Serich from the IJIS Institute discussed the data standards that groups associated with justice have developed for interfacing with the BH community. He said that that group may be interested in collaborating with us. Kathleen will follow up with him about obtaining their specifications and data dictionary for possible inclusion in the development of a BH Domain Model. Kathleen will draft a rewrite for group’s review. Call ended with group interest on continuing refinement of a name and mission statement.

2. Call Schedule Max requested that we change call times so that he can participate from Australia. We agreed to move from 1PM Eastern to 4PM Eastern. Rob requested that the biweekly calls be scheduled for the 1st and 3rd Mondays. He noted that this would be the case until December anyway, so the decision was to continue the biweekly sequence we have going. Kathleen will reschedule the calls, pending discussions with Isobel Frean about times that might work for her.

3. Next Call Scheduled for Monday July 24th at 4PM unless notified otherwise. The Agenda will include finalizing the name and mission statement issues, review of the SIG governance; finalizing BH Domain project scope statement, and review of the BH Domain project charter. Also, we need to begin planning for the September meeting.

ACTION ITEMS: Kathleen will send out minutes, redraft of mission statement, BH domain project scope statement and charter drafts.

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