20220511 Q1 PHWG WGM Minutes

https://jira.hl7.org/browse/PSS-2069

Slide Set: 

Project-Physical Activity Alliance, Time to Move- make physical activity assessments, prescriptions, and referrals a standard of care in the US healthcare System

Key Initiative:

• Multi-year project that will empower health care providers to seamlessly integrate physical activity clinical measures into patient care plans and help make physical activity prescriptions a standard of care. Develop measures and then integrate into the healthcare
• Multi-pronged strategy to engage with the HL7 community, Office of the National Coordinator, CMS, AMA and quasi0governmental organizations.
• Idea came from discussions with CDC with regards to data modernization.

Multi-Pronged Plan: 

• HL7 measure standardization
• CMS coverage determinations
• AMA- CPT codes
• National Commission on Quality Assurance- quality and performance measures
• ONC/HIMSS- linking patient generated physical activity device data to the EHR

NEED:

Although there are many ways for individuals to collect and track information about physical activity through apps and devices there isn't a consistent or generally accepted way to represent information on physical activity levels in the EHR and therefore there isn't the ability to use that data to generate triggers or decision support, quality monitoring, public health surveillance, research

Goal:

Create an HL7 FHIR IG that demonstrates how existing patterns and content established by other projects can be used with a standard physical activity and attain vendor and user adoption of the measure in EHRs to enable: 

• sharing of physical activity data amongst patients, providers, and other care team members
• id patients at risk of poor health outcomes due to physical inactivity
• prescription of exercise and referral of patients 
• monitoring changes to a person's physical activity levels over time
• insurance coverage determinations and payment of services 

Discussion:

The ability render assessment tools that can be used to collect information about physical level

Standardize observations that can be in the chart at the point of care, and the plumbing in between. Get linkage to insurance coverage.

Looking for interested parties and people who want to help 

Want to explore synergies with ongoing work in PH

• Uses of physical activity data for public health monitoring
• Intersections with BSeR

Are standards being used to determine thresholds for moderative and strenuous activity? Yes

Trying to marry self reported data with device measures, but need standardized measures for both.

Level of precision – At first, what can be added to the chart that doesn’t create noise for the provider to create alerts/flags, as opposed to precision tool. The initial goal is to trigger the provider to talk with patient about their physical activity regardless of the precision of the data that triggered the discussion. Then work towards actively monitoring and linking to device data.

What is the work product? Headed towards an IG that is similar in scope but with less measures than what’s been done in Gravity. Structured Data Capture into observations into diagnosis into an order and eventually facilitate referrals. Looking to use existing standards that adopts some of the exchanges but limit scope to physical activity and address things that are missing, like assessment tools, vocabulary and profiles that are specific to physical activity.

Possible interaction with BSeR (Thurs Q1), and Gravity and possible reporting to public health. THEMES (SP)- project to create standardized vocabular for exercise measurement.

Work group involvement and support: Patient Care has offered to sponsor the project. American Heart Association has engaged Accenture to support the work. Because we didn't have our normal attendance no motion was made to indicate the PHWGs level of interest at this proposal stage.