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There is plan to hold a Clinician-on-FHIR day (Friday 20 September) at the September 2019 Atlanta HL7 Workgroup Meeting.

Useful Resources

http://clinfhir.com/

https://fhirblog.com/Tools:

clinFHIR Graph Builder  (use this for building scenarios for each track)

ClinFHIR (use this to launch the Graph Builder (second tab: <<Experimental Modules>>) - see demo video)

Demo video

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ConnMan - for Atlanta CoF event (Do not use)


FHIR Blog


Planning

September 2019 Clinician-on-FHR planning confluence page

Tracks

The following tracks are proposed to be featured at the September 2019 Clinician-on-FHIR day:

  1. Care Coordination, dynamic care planning, guidelines/protocol, CQF - clinical quality framework
  2. Emergency Care (Screening)
  3. Pediatric Care (Special Health Care Needs)
  4. Medication Management
  5. Clinical Assessment/Problem List

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Clinical-on-FHIR Event Friday 20 September 2019, Atlanta Clinician-on-FHIR Event - Clinical Storyboard

(ClinFHIR/ConnMan preparation:  add the patient and clinical data below in the tools for us to use as needed.  Note which servers will be used especially - CoF Sandbox R4 and ???.  Also need to add the pediatric patient for Mike Padula's track, )

Mrs. Patricia (Pat) Chess, a 42-year-old full time office assistant, was involved in a road accident while driving through a busy intersection after work. Her car was struck on the driver’s side by a pick-up truck running a red light.

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  • Care coordination
  • Emergency care
  • Clinical assessment

Track 1: Dynamic care planning & care coordination

Track leads

Emma Jones

George Dixon

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Can the Dynamic Care planning pick up on the MVA patient described in the Clinical Assessment below?  

This track will be focused on clinical discussion around the workflows rather then much work in ClinFHIR or ConnMan this time.  


Track 2: Emergency care

Track leads

Laura Heermann

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Consider pain management - opioid use.  

Track 3:

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Children with Special Health Care Needs

Track leads

Michael Padula

Clinical scenarios/storyboard

A 6 month-old ex-25wk preterm infant with h/o bronchopulmonary dysplasia, complex device needs

  • 6 month-old with post-hemorrhagic hydrocephalus (PHHC) s/p ventriculoperitoneal shunt (VPS), bronchopulmonary dysplasia (BPD) home on nasal cannula oxygen (1/4Lpm 100% oxygen)
  • s/p Nissen and g-tube: gastric-tube feedings: Neosure with additives 85 mL bolus q 4 hour during day, continuous feeds 25mL/hr for 10 hours overnight 
  • presents to (non-primary) Emergency Department with fever & respiratory distress
  • Encounters (scenarios):
  • Discharge from hospital
  • -document device characteristics (tracheostomy, g-tube, VPS), problems (diagnoses), procedures (surgeries), feeding regimen, etc...
  • -medications: chlorothiazide, KCl, Poly-Vi-Sol with Iron
  • Primary Care Physician appointment (could fold this care plan into the hospital discharge)
  • -capture contingency plan
    • BPD: If respiratory distress - check x-ray, consider diuretics (furosemide)
    • Hydrocephalus: If fontanelle tense and/or head circumference increased - pump shunt, consider imaging (x-ray shunt series or MRI)
    • Fever: If febrile, consider aspirating shunt for CSF evaluation
  • -capture primary and subspecialty providers
  • -show care in medical home (capture details, preferences) --> how care plan is developed
  • Infant presents to outside Emergency Department with Respiratory Distress and Fever
    • Vital Signs: T 38.9 C, RR 75, HR 145, BP 90/50, POx 92% on 1.5Lpm NC (up from baseline 1/4 Lpm)
    • Labs: Notable for hyponatremia (Na 130), WBC 24K (8% bands, 70%  Neutrophils, 12% Lymphoctyes), Hgb 9.0, PLTs 120K
    • Assessments:
      • G-tube site: redness and induration with granulation tissue at 3 o'clock (CIMI wound)
      • Resp Distress: tachypneic, subcostal retractions, rales
      • Fontanelle: full, mildly tense with some redness tracking along shunt site
  • -review devices, problems, medications, and contingency plans


Resources:  Patient, Condition, Procedure, Medication, CareTeam, CarePlan, NutritionOrder, Observation, ClinicalImpression  



Track 4: Medication management

Track leads

Melva Peters

John Hatem

Clinical scenarios/storyboard

Discussions during this Connectathon will focus on any of the Pharmacy resources, but more attention will be placed on the new Medication Knowledge resource and the topic of Medication Lists.  

Pharmacy resources:   MedicationRequest, MedicationDispense, MedicationAdministration, MedicationStatement, Medication, MedicationKnowledge

Track 5: Clinical assessment

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