Thursday, October 13, 2011

IHE PCC Planning Week

This week really kicks off the 2012-2013 development cycle for three IHE Domains, Patient Care Coordination, IT Infrastructure, and Quality, Public Health and Research. I was in town for the ITI and PCC meetings. John Moerke already summarized the outcome of the ITI meeting here.

PCC met to review five profile proposals, one white-paper, and a major work item.  We came out with three profile proposals, two white-papers, and one work item to go to the technical committee for final evaluation.

Three of the profile proposals plan on using the new IHE Cross Enterprise Document Workflow profile to define workflows for eReferral, Telehealth Monitoring and Tumor Board scheduling.  Unfortunately, due to scheduling issues and deadlines, we weren't able to review the Tumor Board proposal, so it won't be going forward as a profile.  However, we did extract a white-paper from all the Workflow proposal submissions, and hopefully the authors of that proposal will contribute their knowledge to that white paper.  We also recommended that the Tumor Board profile be resubmitted to the Radiation Oncology domain in IHE, because we felt that they would better understand the requirements of a Tumor Board.

The Workflow white paper will describe the requirements of an XDW Workflow profile, and explain how to document it.  We hope to complete that activity (if approved next month) in time for the February IHE meeting in Paris, France (yes, next year I get to go to Paris), to help inform development of workflow profiles by PCC and other domains.

The Retrieval of Clinical Knowledge profile that I presented got support from a number of different folks, more than I had expected.   QRPH had originally developed the transaction for their EHDI profile, but when that got split into a number of separate content profiles, that transaction needed a new home.  I feel fairly confident that we can find one for it in PCC next month.

Of note, there are NO CDA based profiles in IHE PCC this year.  This is actually rather helpful, because we do have one major work item as a result of the CDA Consolidation Project that HL7, IHE and ONC worked on over the last year.  That work item is to try to figure out how to reinvent our profile documentation to take advantage of MDHT.  That will be a major project that will require transition over several years, I expect.  We will also have to address how to move from CCD Release 1.0 to CCD Release 1.1 and the other changes coming out of that project.  I suspect that there will have to be a transition period like there was in ITI for XDS.a and XDS.b, and given the amount of change, we expect that this will be a multi-year project.  Unfortunately, it will be difficult for us to start until next year because we are still waiting for final content from the CDA Consolidation ballot.  HL7 is still working through ballot reconciliation, and then we need to get the necessary modeling DATA into the tools that will generate the content.  This is absolutely critical for IHE adoption, because we want to move away from PDF and Word as the "source of truth" for the implementation guides.  We want our damn DATA!

Benefits to the International IHE community will be rather large once we get to that point.  Being able to work using model driven profile development tools lowers the bar for people to contribute to the development, makes open source testing and implementation materials more readily available, and means that IHE implementors could immediately at public comment, trial implementation and final text phases, have access to not just profile content, but also source code, testing tools, and schemas necessary to implement them.  Its absolutely critical then, that we get the data into the tools, and use them to generate the content.  I don't want to see another Word version or PDF that doesn't come out of a tool.

The IHE Nursing committee is also working on a white paper (for which they already have 20+ pages of content), explaining the need to get nursing documentation into interoperable exchanges.  The eventual goal here is that the collaborative care team documentation stop being seen as "nursing" vs. "physician" documentation.

We also approved moving forward four IHE profiles to final text.  The last profile PCC moved to final text was XPHR a couple of years ago.  The APS, IC, and two of the EDER profiles are now ready, and have also be not just implemented by products, but many are also being deployed in real world situations.  You should see a release from IHE on that in the coming days.

You can find links to all the presentations given this week top PCC, the minutes of the meeting and the final prioritization of the committee here.


P.S.  I loved Bill Majurski's response to the Documents for mHealth profile proposal I submitted to ITI.  When he was asked his opinion on uptake at connectathon.  "All the cats, and all the dogs,..." he drawled, "will be chasing that squirrel!"

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