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Event Information

The next C-CDA Implementation-A-Thon is scheduled for Wednesday, July 29th.  It will be a full-day virtual event and promises to be one of the most relevant implementation-a-thons to date.  Topics will be led by experienced implementers seeking to drive progress for CDA-based information exchange.  The community will be tackling issues that cause challenges for implementers today.  Many of the topics address new data classes in the US Core Data for Interoperability  (USCDI) , like clinical notes and data provenance. Some of the topics explore deeper questions to help implementers starting to create encounter summary documents as well as patient summaries address and handle document lifecycles. As a participant you'll learn how to represent life and death in C-CDA documents and get direction about populating information in the Payer Section under many different scenarios.  You'll find out about a new CDA Schema extension that offers an alternative type of identifier useful in CDA documents and better aligned with FHIR identifiers. There's even a topic to demonstrate how clear Use Cases can be used to accelerate adoption of C-CDA based exchange.

Register:  Virtual HL7 C-CDA Implementation-a-thon Registration Page  SAVE THE DATE!  Wednesday, July 29, 2020   Time: 10:00am ET - 6:00pm ET

Submitting WG: Structured Documents

Justification and Objectives: Improve consistency and quality of information representation in C-CDA exchange documents

Clinical input requested (if any):

Proposed Track Leads:

  • Lisa Nelson (MaxMD) lnelson@max.md

  • Jean Duteau (Duteau Design)  jean@duteaudesign.com

  • Joginder Madra (Madra Consulting)

Agenda

Time (ET)TopicLeaderLink to Downloads and Slide Deck
10:00am - 10:15amOpening Remarks

Jean Duteau

HL7

10:15am - 11:00am

Topic 1: Life and Death in C-CDA (specifically documentation of death, death reason and birth/pregnancy, but not at the same time for the same patient 😊 )

What problem are you trying to solve?
EHRs have historically approached C-CDA documents as tools in care transitions but increasingly they are used for secondary uses. Having a consistent way to document death and pregnancy helps with quality measurement, disease reporting (i.e. COVID-19) and research. Both death and pregnancy documentation issues observed in the real-world which could be improved.

What actions do you want attendees to do before or what samples or examples do you want them to bring to the session?
Just reviewing a few different templates from IGs and what they do in their systems (both C-CDA production/consumption)  

What actions are you expecting to happen as a result of your session?
Improved interoperability! Specifically we’ll have more consistent examples about these issues which currently inconsistently implemented.  

John D'Amore

Diameter Health

Break (15 mins)


11:15am - 12:00pm

Topic 2: Payer Section in CCDA Documents

What problem are you trying to solve?

Alignment around how to send Payer data in this section.  Discussion of the remaining challenges – identifying the Payer, how to share additional payer identifiers like Group, RXBIN, RXPCN, etc.

What actions do you want attendees to do before or what samples or examples do you want them to bring to the session? 

Bring samples of how you currently populate the Payer section – specifically in these scenarios:

    Patient is the subscriber to the insurance

    Patient is the dependent on an insurance policy

    Patient has multiple insurances

    Patient is self pay

    Patient is a child and parent is paying

    BONUS points:  1. Patient has Medicare but they are not covering service provided, 2. Longitudinal CCD showing coverage for several encounters

What actions are you expecting to happen as a result of your session?  A) Unification of how payer data is shared in a CCD B) Recommended changes for template changes if needed C) Clarification on how we could clearly identify payers and identifiers

Linda Michaelsen

Optum

Break (45 mins)


12:45pm - 1:30pm

Topic 3: Extending CDA to add more useful identifiers

What problem are you trying to solve?

Address current data provenance and matching problems. C-CDA document receivers can’t know the meaning of id elements in CDA documents without difficult (and often not feasible) OID discovery processes. 

What actions do you want attendees to do before or what samples or examples do you want them to bring to the session?

Familiarize themselves with how their current id usage works.  Review the value sets for identifier uses in FHIR and V2.

What actions are you expecting to happen as a result of your session?

Determine if there is support for requesting an update to the Companion Guide to add guidance on how to use the new extension that SDWG will be spearheading.  Suggest the use cases and examples would be most valuable to include when introducing its use in C-CDA documents. Show where consensus exists so that ONC can plan accordingly.

Jean Duteau

SDWG





1:45pm - 2:30pm

Topic 4: Implementation Considerations When Generating C-CDA Encounter Summary and Patient Summary Documents

What problem are you trying to solve?

A number of pain points related to the intersection of querying for documents, dynamic generation of documents based on the state of data in the EHR/HIE, and consistency of formatting in the C-CDA. Important to note that my topic will reflect work that the Joint Carequality-CommonWell Content Workgroup has already done around lifecycle and versioning for encounter and patient summaries. 

What actions do you want attendees to do before or what samples or examples do you want them to bring to the session?

Bring document examples that reflect the issues identified or potential solutions.

What actions are you expecting to happen as a result of your session?

Generate support for additional relevant examples that would be further refined through examples task force to complete them.

 

Joe Lamy

Carequality/CommonWell

Break (15 mins)

2:45pm - 3:30pm

Topic 5:  Implementing Clinical Notes

What problem are you trying to solve?

When to differentiate the use of Clinical Note, Annotated Comment and Unstructured Document

What actions do you want attendees to do before or what samples or examples do you want them to bring to the session?

Collect and bring examples they have implemented or have come across.

Confirm your organization's intentions for consuming Note Activity content.

6) What actions are you expecting to happen as a result of your session?

Participants will be more informed about what type of content can be exchanged using the clinical notes templates.

Develop clear examples that show and explain when to use each: Clinical Note, Annotated Comment and Unstructured Document

Emma Jones

Allscripts

Break (15 mins)
3:45pm – 4:30pmTopic 6: Mapping Author Participation Information to FHIR US CDI Resources Derived from C-CDA Documents

What problem are you trying to solve?  

It is currently unclear how to map C-CDA Author Participation data FHIR resources derived from C-CDA documents. 

What actions do you want attendees to do before or what samples or examples do you want them to bring to the session?

  • Bring your current rules for producing and/or consuming C-CDA Author Particiaption and Performer Participation.
  • Bring your current state mappings of C-CDA Author Particiaption & Provenance Author Participation to FHIR Resources.
  • Find examples of C-CDA Author Particiaption that are less than desirable.
  • Find examples of C-CDA entries that have multiple instances of Author Participation associated with them.
  • Find examples of C-CDA documents that have multiple instances of Author Participation associated with them.

What actions are you expecting to happen as a result of your session?

  • Evolve the proposals.
  • Build consensus around best practices for mapping of C-CDA Author Participation & Provenance Author Participation to FHIR Resources. 
  • Push for these proposals to inform a future Companion Guide update or additional C-CDA Examples

David Riddle

Cerner Corporation

Break (15 mins)


4:45pm - 5:30pm

Open Discussion

  • Solidify next steps and plan for future C-CDA IATs


5:30pm - 6:00pmFeedback, Questions, and Parting Thoughts

Jean Duteau

HL7


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