Patient Care

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Background

The Patient Care TC was formed as a SIG in 1993. A small group of individuals were brought together with the objective of assessing the current HL7 specification, and bringing forward recommendations for extensions to support a variety of activities related to direct patient care. Over a series of meetings and discussions, the conclusion was reached that the current HL7 model did not adequately support the needs of the patient care community, particularly in the areas of patient goals, problems, care plans/critical paths, assessments, and histories and physicals. The group developed, as a SIG, a set of new segments and messages, and the decision was made in the fall of 1995 to establish Patient Care as a Technical Committee. A new chapter (twelve) was produced and approved as part of HL7 Version 2.3.

During the past decade, Patient Care has become more involved in v3 messaging, and the static and dynamic modeling that can be used and reused in different HL7 formats. For instance the core of patient care work is the Care Provision D-MIM, deploying the clinical statements and dynamic model, which was established as Draft Standard for Trial Use in 2007.

Mission

The goal of Patient Care Working Group is to define the requirements and solutions to support the needs for communicating information regarding the creation, management, execution and the quality of care provision.

Charter

Formal Relationships With Other HL7 Groups

Existing relationships with other HL7 Working Groups

Patient care has a long tradition of maintaining relationships with other working groups within HL7. This stems from the creation of Special Interest groups for clinical specialties, which have obtained the Work Group status in the organisational changes in 2008. In addition, some other Work Groups have similar interest or work items for which it is effective to join efforts or the work crosses domains.

In particular the following relationships exist:

·         Clinical Statement Work Group (CSWG). The clinical statement pattern is a cross domain design pattern, which is at the core of the Care Provision Domain Model. Patient Care contributes to the maintenance of this pattern and several change request will also go through this channel. Patient Care3 monitors the changes in clinical statement pattern in order to keep the Care Provision Domain Model.

·         Domain Experts Steering Group, as part of the new hierarchical structure of HL7 as organisation.

·         CBCC Community Based Collaborative Care. This group has a focus on care in the community / non-hospital based care and domain content often overlaps with Patient Care.

·         Emergency Care

·         Structured Documents SDWG

·         CIC

·         PHER

·         EHR WG

·         RCRIM

·         Templates

·         Terminfo project

·         Vocabulary WG, via our vocabulary facilitator

·         MnM, via our modelling facilitator

·         CDS: the Order Sets model is one item of common interest with Clinical Decision Support

External relationships:

Informal relationships exist with the following external groups. The work is more or less harmonizing efforts via information exchange. IHE is using Care Record in one of their profiles. ISO and HL7 in future will file the DCM work as JIC project.

Listing of external projects in which HL7 Patient Care WG is collaborating:

·         IHE nursing profile, different profiles

·         ISO DCM work

Scope

The scope for Patient Care is a subset of the healthcare delivery and management processes. The scope includes activities related to assessing and evaluating the patient/client/member, establishing the diagnosis/problem, developing and managing a plan of care/service/action, administering care or treatment based on the plan, documenting the administration of the plan of care, managing compliance and exception reporting, and reporting of clinical results/outcomes. The scope also includes defining how clinical information and  pathways/protocols, are supported in the communication. As well as support of data exchange for concurrent/retrospective quality and/or outcomes analysis and management.

The scope does not assume stewardship of messages generated by external HL7 workgroups. A goal of this committee is to continue to take advantage of and extend messages developed by other HL7 committees rather than develop redundant and independently maintained communication artifacts.

Scope Examples:

The following subjects have or will be reviewed for potential message construction:

  • Assess Patient
  • Manage Service Plan (establish goals, create/update plan etc.)
  • Deliver Services (create worklist, request scheduling of activities, etc)
  • Manage Quality (manage case, manage care quality)

Further information on these items can be found in the patient care working group section on the website HL7.org and in the Care Provision ballot materials.

Further ongoing responsibilities, projects and new ideas can be found in the Patient Care WG business plan, formalized in the 3 year plan. The idea of the Working Group is that this three year plan is updated regularly in order to manage the projects.

Decision Making Practices

Decision Making Practices

Date of Last Revision

October 6, 2009