Stream: implementers
Topic: CareTeam
Mark Scrimshire (Oct 25 2016 at 18:50):
I am doing some due diligence around Provider Attribution for Patients. ie. A Patient can actively identify their preferred Provider. I believe a number of payers are already using an API to express this relationship/preference. I wanted to check if there is a FHIR Resource that is being used to declare this relationship.
I am looking at what would be involved to capture a patient's provider attribution preference and express it as a FHIR resource.
- Is there a published API that people are aware of that performs this task?
- Which FHIR resource captures the relationship.
Per @Lloyd McKenzie comments on mapping to coverage resource RelatedPerson covers non-professional relationships.
/cc @Grahame Grieve @Paul Knapp
Lloyd McKenzie (Oct 25 2016 at 18:56):
So a patient's GP is conveyed by Patient.generalPractitioner. And I believe there was going to be an extension to capture their preferred pharmacy, though it doesn't appear to be there yet. If you want more than that, I'd look at CareTeam which allows you to capture all of the practitioners (and other participants) involved in a particular patient's care, along with their roles and timeframes.
Mark Scrimshire (Oct 25 2016 at 20:44):
Thanks @Lloyd McKenzie That helps.
Brian Postlethwaite (Oct 25 2016 at 23:25):
+1 on Lloyds comments.
Michelle (Moseman) Miller (Oct 28 2016 at 22:22):
To twist the question slightly, what about organization attribution for a patient? For example, what if a health plan creates/suggests a relationship between a patient and organization/clinic. It isn't at the practitioner level and it didn't get expressed by the patient. In some cases, the patient may not have had an encounter at that org/clinic, but the org is still deemed to be responsible for the patient. Thoughts on whether this fits the scope of a CareTeam, too?
Robert McClure (Oct 30 2016 at 18:02):
@Michelle (Moseman) Miller There is an ongoing weekly meeting on CareTeam elements (ONC started this) that is populated by mostly HL7 PC folks. Some of what you are aluding to is being discussed there. You (and others interested) should consider attending. Fridays 4p. Info at https://oncprojectracking.healthit.gov/wiki/display/CC/Care+Coordination+Home but you'll need to contact J. Skapik to get access. PM me for more info.
Paul Knapp (Oct 31 2016 at 06:11):
You would want to record the Accountable Care Organization, if present, in the same manner you record the Primary Care Provider.
Mounika (Nov 15 2018 at 11:59):
Hi all,
We want to create extensions like CareTeam Type, CareTeam encrypt type and CareTeam split for CareTeam resource. Is this a right approch can anyone suggest me ?
Lloyd McKenzie (Nov 15 2018 at 12:04):
It would be helpful to have descriptions for each of those elements. In particular, how is CareTeam Type distinct from CareTeam.category?
Mounika (Nov 15 2018 at 12:09):
type refers to is it Teaching or Non Teaching care team.
Where Teaching type care team consists medical student included in team along with Practitioners
Where non teaching doesn't consists of Medical Student along with Practitioners
Lloyd McKenzie (Nov 15 2018 at 12:59):
And the other two?
Mounika (Nov 15 2018 at 13:13):
Care Team Encounter Type which refers to is it Main Team or Co - Management Team or Consultant team with respect to Encounter.
Care Team Split&Share type means - is Care Team involved by single or multiple Team members.
Is this correct way?
Lloyd McKenzie (Nov 15 2018 at 13:31):
Not totally grasping spit& share, but it sounds like they're all appropriate as extensions
Mounika (Nov 15 2018 at 13:44):
@Lloyd McKenzie Thank you
Amna Hashmi (Feb 22 2022 at 22:25):
Hi there,
I'm trying to represent a patient's historical and current care team, which could potentially include multiple organizations and sub-teams within the organizations. For example, let's say that:
- Patient Harry Potter has received care from Hogwarts Health and Hogsmeade Health. With Hogwarts Health, he has received care from the Gryffindor team, which includes Ron Weasley and Hermione Granger. From Hogsmeade Health, he has received care from Abeforth Dumbledore.
In that example,
- Should Harry Potter only have one care team resource, and if so, that care team is dynamic? Or, does a patient have several care teams, and to see the entire village of care team members, you list all care teams with the patient as the subject?
- What happens if an encounter resource includes a reference to a participant that’s a Practitioner, but that Practitioner isn’t in the CareTeam resource?
- How do you prevent duplication of practitioners in the Care Team?
Lloyd McKenzie (Feb 22 2022 at 22:57):
- No 'right' answer. Considerations include: What's in the database - one team or multiple? (or even are you dealing with records in different databases?) Who needs to see what and has access to change what?
- That'll be pretty common. CareTeam is typically used either for a set of people who provide a type of care independent of patient (e.g. "Trauma team 2") or who are responsible for care for a particular patient or condition across encounters (My cancer care team is...). In a typical encounter, there'll certainly be people who interact with the patient who aren't officially on the patient's care team.
- It's possible the same Practitioner might be listed on the care team more than once, perhaps with different periods or perhaps with different roles. You can use business rules to enforce any restrictions you have (e.g. can't be there more than once, all members must be from same organization, can't be more than one nutritionist, etc.)
Yuval Romm (Mar 17 2022 at 13:34):
@Lloyd McKenzie - in an ambulatory setting, we are looking at managing a patient's "preferred practitioners" - a list of 1 or more preferred healthcare providers the patient selects as "favorite".
Could we manage this by creating a "Preferred Team" Profile on the CareTeam resource for "logging" patient choices through our enterprise mobile app?
Lloyd McKenzie (Mar 17 2022 at 15:35):
That seems viable. @Brian Postlethwaite, any comments?
Elliot Silver (Mar 18 2022 at 01:49):
A profile alone isn't sufficient. You want a category indicating "preferred providers". The profile would require that category be used.
Brian Postlethwaite (Mar 22 2022 at 20:58):
Seams reasonable
Last updated: Apr 12 2022 at 19:14 UTC
