Blog from March, 2019

Notes from the March 1, 2019 call
Vassil Peytchev posted on Mar 01, 2019
  1. LTC Discussion points
    1. Referral ID - one unique ID per request or one ID per referral intent (i.e. the same ID for all requests for a particular referral)?
      Outcome: At this point one ID per request seems to be a much better approach.
    2. Do we need to have a way to find the facilities with open beds, as a preliminary query or service before the request is sent? How would that fit in the workflow? How likely is it to have facilitates without available beds?
      Outcome: That is not necessary, it is unlikely that the facilities will be full. Additional complexity is not justified for marginal gain.
    3. Do we need to include the patient preference in the request (top preference or ranking preference)?
      Outcome: No, that is not helpful to the SNFs, however, we should note the need for governance on the acute facility side to properly determine how the choice from multiple facilities is to be made
    4. Do we need a light-weight request, the followed by a second transaction with more detailed data only to those who (conditionally) accept it?
      Outcome: No, one of the benefits of electronic referrals is that we can send a well populated request, and it will be either accepted or declined
    5. What is the initial workflow?
      Outcome: Send initial request as populated as possible, respond with committed acceptance, then notification of choice. If not chosen, send Cancel request, if chosen - what do we send? Need a new transaction.
    6. What does it mean to have the initial request as populated as possible?
      Outcome: There seem to be three major determinants for a smooth referral and transition: need for expensive medications (e.g. chemotherapy), need for pain management, or need for specific equipment. If these are in addition to the core data set (demographics, allergies, diagnoses/problem list, key vitals), that should be sufficient for the facility to accept or decline
    7. What other steps do we need to account for?
      Outcome: Sending pertinent information at discharge to the facility, most importantly: reconciled meds. The official, formal discharge summary will likely be created and sent at a later point. 
  2. Follow-ups:
    1. List of red flags (Terry)
    2. Initial write-up and diagram (Vassil)
    3. Start process for IHE change proposals on the base specification (Vassil)
  3. Announcements:
    1. Presentation to the EHRA
    2. EMDI pilot, and adding 360X as a use case