Tuesday, July 17, 2012

Rethinking the Care Management profile in IHE

Several years ago, IHE PCC developed the Care Management (pdf) profile.  The idea behind this profile was to enable care managers (people) using a care management system to be able to access information from multiple data sources.  We had hoped that by specifying the data of interest (based on a care guideline) in a computable format, we could automate the generation of interfaces between various Health IT systems to the care management system.   The profile never took off because the standards we were using were neither well understood, nor very mature.  However, what I learned from that profile greatly influenced later HL7 work on HQMF.

I suggested that HQMF needs to have a data criteria section that describes the data of interest.  Over time, we made that section even better to support Query Health and HQMF Release 2.0 soon to be out for ballot.   Interest in the Care Management profile surfaced today in the IHE Face to Face meetings happening this week.

Given where the standards are now, it seems like it is possible to specify data of interest in an HQMF, without going any further to specify a measure.  From that, we can generate a CCDA, CCD, or QRDA document from an encounter that includes the necessary data of interest, and submit that to an HIE, Care Management system or other Health IT system managing the care for a patient (e.g., in a medical home or an ACO).

This is a paradigm that is already being used in part in some of the Beacon programs here in the US, and is fairly well understood.  I think it's time to shake the dust off the Care Management profile and rewrite it so that people will implement it.


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