There is plan to hold a Clinician-on-FHIR day (Friday 20 September) at the September 2019 Atlanta HL7 Workgroup Meeting.
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)
ConnMan - for Atlanta CoF event (Do not use)
September 2019 Clinician-on-FHR planning confluence page
The following tracks are proposed to be featured at the September 2019 Clinician-on-FHIR day:
- Care Coordination, dynamic care planning, guidelines/protocol, CQF - clinical quality framework
- Emergency Care (Screening)
- Pediatric Care (Special needs careHealth Care Needs)
- Medication Management
- Clinical Assessment/Problem List
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.
Initial trauma “work up” investigations (abdominal, peripheral, and chest and spinal X-rays and CT) showed a closed undisplaced comminuted fracture left mid shaft femur, fracture left ribs 6-7 with spleen and liver contusions. No fracture vertebrae detected.
- Care coordination
- Emergency care
- Clinical assessment
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
Consider adding the ED part to the Clinical Impression piece here.... have the same patient that comes in from the MVA and do the multiple screenings for that patient? Could include the SDoH items?
Focus on Nursing Triage - screenings and then look at the clinical impression for the abdominal issues and liver contusion.
Consider pain management - opioid use.
Children with Special Health Care Needs
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
- 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
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