Stream: Care Plan/Care Coordination
Topic: CarePlan challenges
Jose Costa Teixeira (Dec 23 2020 at 19:28):
I have some questions about CarePlan, and @Gay Dolin advised me to chat here:
Jose Costa Teixeira (Dec 23 2020 at 19:33):
- I need to capture things like when did patient abandon or changed treatment, or added some new treatment. Those activities are unplanned and I see a big difference in what is supported for planned activities (where we have a lot of information - status, statusreason, instantiates, location...) and what we have for performed activities (planned or not). Can't this be simpler i.e. more consistent?
Jose Costa Teixeira (Dec 23 2020 at 19:40):
- in another project, I want Dr. A to request from Dr. B the initiation of a e.g. a hypertension protocol which is a couple of meds and a few measurements. I don't know what is the recommended way to do this (I'd need a ServiceRequest for the "ordering/authorization" part. This is likely not (only) a CarePlan issue, but would be good to hear what is being done or what was thought
Jose Costa Teixeira (Dec 23 2020 at 19:41):
- Do we still need CarePlan.plannedActivityDetail.product[x]? (which btw if we do, should be a codeableReference)? I think we're better served by having a medRequest, deviceRequest, nutritionOrder reference there.
Jose Costa Teixeira (Dec 23 2020 at 19:43):
(that's it for now, I have other questions from previous projects where I got stuck, but #1 and #2 above are on my desk, and #3 I just noticed. I'm happy to discuss any alternatives and can take some work if we need to clarify or alter the resource)
Gay Dolin (Dec 23 2020 at 19:43):
I believe these all can be captured using FHIR Care Plan. It is not straightforward however. Some diagrams that might help: CarePlanDiagramWithActivityFocus.png ExampleInstanciatedFHIR_CarePlan_Goal.png FHIR_MCC_Care_Plan_FinalForDraft.png
Gay Dolin (Dec 23 2020 at 19:44):
Suggest not using activity detail, but always reference
Gay Dolin (Dec 23 2020 at 19:45):
signing off for the holidays :-) but would love to have you join Patient Care Care Plan calls on Wed 5 ET and also the PC Tracker call Thursdays at 5 ET
Jose Costa Teixeira (Dec 23 2020 at 19:45):
Gay Dolin said:
On this diagram it looks much better than in the reality. For the planned activities we have a lot of details (some of which will be in the actual request resources). For the unplanned stuff, it is not clear whether that is supported
Jose Costa Teixeira (Dec 23 2020 at 19:45):
oh ok, thanks. Have a GREAT holiday, and we'll continue. I'm in Europe but will try to join one of the calls
Joe Bormel (Jan 05 2021 at 20:13):
Jose Costa Teixeira said:
- in another project, I want Dr. A to request from Dr. B the initiation of a e.g. a hypertension protocol which is a couple of meds and a few measurements. I don't know what is the recommended way to do this (I'd need a ServiceRequest for the "ordering/authorization" part. This is likely not (only) a CarePlan issue, but would be good to hear what is being done or what was thought
Jose,
Regarding the hypertension protocol, take a look at CPG-on-FHIR, here http://build.fhir.org/ig/HL7/cqf-recommendations/ .
When care planning is "informed by" or "faithful to" a clinical practice guideline, formalized in a protocol, there is vital information (for example service request's intent content) that would be lost if that provenance was not referenced. CPG-on-FHIR is at low maturity but is part of a larger, coherent framework with computable conformance related to evidence, appropriate measurement (eCQM), clinical decision support, etc.
Thank you for bringing your questions here. I'm learning a lot from Gay, Emma and Rene that you have stimulated.
Last updated: Apr 12 2022 at 19:14 UTC
