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Survey was sent to the mailing list, received some responses:

• needed to add newer participants to mailing list
• more responses were sent during call

Looking at the responses, and considering the e-mail from Terry O'Malley, the LTC to acute care was the front-runner for our next use case.

We had more discussions on the various options, and next step.

In addition, the ONC Tech Forum will take place virtually on August 10-11. They will have an "exhibit area", and we are expecting that the 360X project will have presence there. Details will be coming over the next few meetings. Based on that, our focus for the general meetings should be on getting our documentation in the best shape possible for August 10.

Discussion focused on what use cases to consider:

• Current workload - based on following, we may take one new use case, and possibly a second.
  • finish publication of 360XL
  • Improve documentation
    • Insurance and prior authorization description - update IG and finish change proposals
    • Use of Argonaut FHIR scheduling - update IG
• Possible new use cases:
  • LTC facility outbound transfer - to acute, to another LTC faciltiy, to home care
  • eConsult - a consult based on documentation only, no patient visit (in person or tele-)
  • Referrals related to Social Determinants of Health (SDH)
• Additional discussion:
  • Patient involvement - this needs to be better documented (add to current workload)
  • Payer interactions - this needs to be better documented
    • prior authorizations (already in workload)
    • in/out of network (add to current workload)
• Followup - create a survey of the following use case options and send to mailing list
  
  • LTC to Acute
  • LTC to LTC
  • eConsults
  • SDH referrals

Discussions on the relevance of 360X and the COVID-19 pandemic, and future development of the specification:

• Nursing homes/LTC faciltities are hot-spots, what can be done to help care givers?
  • LTC to acute referrals/transfers
  • Acute to nursing home re-admits (Note that the re-admit may not be to the same facility that originated the referral)
• Extra-clinical services, can we extend 360X there?
  • different context for content, C-CDA has too much information, most of it not useful for the referral recipient.
  • BSeR has initial work in that area, as well as the Gravity Project

It seems that looking at LTC to acute referrals is a logical next step.

Discussion to continue next week, June 19th. 

No call today, due to a demo for the VA/DoD

The call was repurposed for demo testing for the Direct Trust Summit testing.

Note: Next Saturday, June 5th, we are having a demo for the VA, and the call is cancelled.

Review of IHE profile proposal for long term care (SNF) transfers - 360XL

A discussion to consider transforming 360X as a "base standard" with different higher layers to include PCP to specialist referrals, acute to SNF referrals, etc. This may be done in a different way, for example in the "XDM and XDR for Direct" specification to be balloted and published by Direct Trust Standards, where fundamental requirements for XDM are specified to be used by other implementation guides like 360X.

Note: the IHE Profile proposal was approved for public comment on the subsequent IHE PCC call. When the public comment period is open, the participants will be notified to provide more feedback.

Short call, work continues on preparing the 360XL (long term to SNF referrals) IHE proposal for public comment.

• Fill out the Doodle poll for possible rehearsal dates and times for the DirectTrust Summit demo.
• The VA/DoD demo will be re-scheduled soon. It will likely be May 22 or June 5
• Review the IHE profile for transfers to SNF (currently at https://drive.google.com/file/d/1eJ1YYoPYNUpXDkBZ1etLNa_so1r-oEp3/view?usp=sharing)

Rehearsal for the May 5th demo. 

• Review of upcoming demos, next week's call will be used for a rehearsal.
• IHE Profile work updates, several participants offered help

Discussion on the uses of LOINC codes as the content type code in the Submission Set.

85187-3 Long term care facility Transfer summary note - for the case where it is an actual transfer from the hospital the SNF

85199-8 Long term care facility Referral note - for the case where it is a referral from an ambulatory setting to the SNF

We will try to get some feedback from CMS.

On the other hand, there are two transactions pushing documents from the hospital - one for the request, another when the actual transfer takes place. In that case the codes could be used like this:

• Hospital to SNF request: 85199-8
• Hospital to selected SNF at time of transfer: 85187-3
• Ambulatory setting to SNF request: 85199-8

Is the common code for request helpful or harmful?

Rehearsal for the demo

Update on demo opportunities:

• DirectTrust Clinicians Steering Workgroup - Noon Eastern April 14 meeting. They plan to also invite the Physician EHR Coalition (PEHRC). DirectTrust can also provide the EMDI questionnaire to attendants.
• LeadingAge State Technology Initiatives - May 5th is a possible date. Epic to confirm participation.
• The Annual DirectTrust Summit in June - there is a 360X demo already planned, not the same as the HIMSS demo.
• HIMSS LTPAC committee - very interested, they will get back to us with possible dates.
• The VA - They are looking at May dates, they will invite Cerner, and they want to invite the DoD.
• The CMS EMDI Initiative (which is sponsoring the first production 360X pilot) are working on a June date.
• NCQA is interested in a presentation (not demo).

Assuming that the April 14 demo will go ahead, we plan to use next week's call on Friday, April 10 (10:30 - 12:30 Eastern) and Monday, April 13 (3-4 pm Eastern) for rehearsal.

Vassil to send e-mail when this is reflected in the minutes.

The outreach for venues for the HIMSS demo has produced several opportunities:

• LeadingAge State Technology Initiatives - they were looking for a demo on April 1, which was a too short of a notice. Looking to re-schedule.

• DirectTrust Clinicians Steering Workgroup - Noon Eastern April 14 meeting. They plan to also invite the Physician EHR Coalition (PEHRC). They can also provide the EMDI questionnaire to attendants.

• The Annual DirectTrust Summit in June - there is a 360X demo already planned, not the same as the HIMSS demo.
• HIMSS LTPAC committee - Dr, Miller has a call with them next week.
• The VA - They are interested to see the demo, and they want to invite the DoD. Dr. Miller has a call with them on April 2.
• The DoD - separately or with VA, no suggested timeframe
• The CMS EMDI Initiative (which is sponsoring the first production 360X pilot) would like to see the demo. They are working on a June date.
• NCQA is interested in a presentation (not demo).

The work on the 360 XL IHE profile will continue with volume 2. Volunteers for editors are welcome. Mid-April Vassil can provide guidance on the process and available tasks.

Short call. Still no communications from HIMSS regarding online demo opportunities. Several volunteers will look at various opportunities to demo to interested groups (starting with VIP tour list).

Work on IHE profile for 360XL (L is for Long-term care). One thing we hadn't noted before is the LOINC code to use for submission set content type (and in the HL7 v2 message, and in Document Entry document class). Appropriate codes seem to be LOINC 85199-8 and LOINC 85187-3. An older code, 34140-4, seems to be discontinued.