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This page will include questions that are discussed during the Patient Care workgroup calls.  We would like to give individuals who could not join the meeting the opportunity to engage and provide advice on some of the technical questions we address.  Please use the comment feature on the confluence page if you have any feedback. Please use the reference number to identify what questions you are addressing. 


Reference NumberQuestionHigh-level discussion or thoughts from the meetingMeeting Minutes Link
1Why is there a category sliced in U.S. Core CarePlan related to AssessPlanUS Core Care Plan was only really required to exchange a text narrative which is why USCID only had narrative mandatory
  • But to develop a more complex dynamic care plan it might not  be useful and may not be the right foundation to start care plans from
Meeting Minutes
2In relation to Extension code, Why is there a value set pointing to just one code assess-planThis question was stated but skipped for the sake of time to go to the next questionsMeeting Minutes
3Should the hierarchy be Record artifact in SNOWMEDThe hierarchy is currently record artifact, Lisa and Monique were thinking it should be regime/therapy
  • If this is international that's fine but they just want to make sure
    • Dave noted he thinks it's not that one or other is wrong but one or the other may be right depending on the context 
Meeting Minutes
4

What is the difference between Title and Description

Do care plans get a name? Should be something more interoperable

 Title is a string and not a codable concept

  • It does seem that it can be named by the user
  • The code for why the plan exist would be the interoperable code 
    • One code might be too limiting
Meeting Minutes
5The MCC care plan needs to be able to identify who a dynamic Care Plan is maintained/managed by (Person and/or Organization - similar to CDA custodian or "ManagingOrganization" in Person Resource, is Author the best mapping for this 

In the resource and US core profile, the author takes on that role of care plan maintained by

For the draft, we'll leverage author but this a discussion we want to continue and  this a data element we may want to mature

  • Maybe during testing and development
Meeting Minutes
6

Actual interventions need to be documented or pulled into the care plan that is relevant to health concerns interventions and outcomes, how should this be done

There is a lack of interventions present in the care plan activity

To address this during March/September (and May) testing - the team planned to point to the Care Plan from Procedure (as per Dave Carlson)

 It would be worth it to differentiate from a procedure and request for the procedure 

  •  request for intervention is more of a service request for a procedure to occur
  • Service Request is different from the procedure, the procedure also has its own status and dimensions related to the completion


Meeting Minutes
7What could we do to a constraint service request on patient referrals 

It would be good to look at what BSER IG defines a profile on the message layer and a value set on service request that has an anchored code on patient referral

  • It would be helpful to look at category
  • Make this a testing priority
Meeting Minutes
8Question/Answer Assessment Scale
  • We going to try to leverage the LOINC codes in the NIH tool to integrate question/answers, rather than create profiles 
  • The question/answer part might be something that is integrated into the care plan
Meeting Minutes
9Should we use the US Core Care plan Profile vs the care plan resource

US Core Care Plan is limiting due to the required category slice " CarePlan.category:AssessPlan". According to Dave Carlson - this means limiting retrieval of data and compromising structured data. May receive text only care plans

The MCC team plans to and use base FHIR Care Plan and will then need to justify (when it comes to ballot why we did not us US Core Care Plan. US Core Care Plan may change by then.

Meeting Minutes
10The discrepancy between recorded date description and definition 

When looking at the resource profile of the chronic kidney disease condition it was noted the description is populated from US core doesn't match the definition which should be Condition record was created in the system, which is often a system-generated date. The MCC posted the issue on JIRA ticket number is 27808

Meeting Minutes
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