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Attendance

Administrative topics

Action items

The 360X-SD IHE profile has been published for public comment at https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_360XSD_Rev1-0_PC_2024-04-10.pdf. Please review and send comments (including "I approve") using the form at https://www.ihe.net/PCC_Public_Comments/

The comments will be discussed at the next IHE face-to-face meeting. The tentative time slots for 360X topics are:

• 360X-HH (Home Health) 11 am - 1 pm Eastern time on Wednesday, May 8,
• 360X-SD (SDOH comment review + Referral Status Query) 10 am - 11 am  Eastern Time on Thursday, May 9.

Reminders

Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 
There is an archive of all messages sent to the mailing list, including the the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

SDOH referrals

The 360X-SD IHE specification has a "named option" for enabling updates of the status of an SDOH referral to make it to the Referral initiator. One of the mechanisms for the retrieving the status is a FHIR query. The implementation guide for the FHIR query is being developed at https://build.fhir.org/ig/IHE/PCC.SDOH.RSQ/ and it will be discussed at the next SDOH call.

Industry news

We got a brief update on TEFCA with a new update coming up, which will introduce FHIR access.

Attendance

Administrative topics

Action items

The 360X-SD IHE profile has been published for public comment at https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_360XSD_Rev1-0_PC_2024-04-10.pdf. Please review and send comments (including "I approve") using the form at https://www.ihe.net/PCC_Public_Comments/

Reminders

Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 
There is an archive of all messages sent to the mailing list, including the the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

Home Health referrals

Work continues on the IHE profile document for 360X-HH. The goal is to get it complete for the IHE face-to-face meeting in May, the specific 360X sessions will likely be May 8-10. The details for the meeting will become available at https://wiki.ihe.net/index.php/ITI,_PCC_%26_QRPH_Meetings#May_2024_Meeting.

Attendance

Administrative topics

Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 
There is an archive of all messages sent to the mailing list, including the the meeting requests, at https://360x-referral.com/archives/list/360x-contrib@360x-referral.com/

SDOH referrals

We took a high-level look of the document as submitted to IHE to be published for public comment. The expected timeline is for public comment to start early next week, and to be done by the end of the next IHE face-to-face meeting (May 6-10). Due to availability, the discussions for 360X will be on May 8-10.

Everyone is encouraged to review the document and prepare their comments.

Attendance

Administrative topics

Mailing list is up and running. Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 

Home Health

Work is continuing on the Home Health specification. Next IHE meeting is during the week of May 6-10, the 360X activities will be most likely focused during May 8-10.

The timeline for the HH specification is to have it available for initial review before the next call on April 12, and the second round of review before the following call on April 26.

The links for review will be sent to mailing list in advance to the calls.

Attendance

Administrative topics

Mailing list is up and running. Signing up for the mailing list can be done at https://360x-referral.com/mailman3/lists/360x-contrib.360x-referral.com/ 

The meeting request for the HH calls will come out early next week.

SDOH

There was SDOH buzz at HIMSS, and even though there was no 360X-specific demo there were some discussions about it.

SDOH supplement is being prepared for public comment, which is expected to start early April. Responses to any comments can be done and approved at the next IHE face-to face meetings during the week of May 6-10, after which the supplement is expected published in time to be considered for the IHE connectathon 2025, and subsequently for the HIMSS Interop showcase in Las Vegas.

The candidate document for public comment will be sent to the mailing list for reference.

Next call will have the details on how to send public comment.

The recording from the HIMSS 2021 Interoperability Showcase is now available, and has been added to the 360X homepage.

Happy New Year!

We are continuing our work on the two main areas from last year: LTPAC transfer to ED, and Social Determinants of Health (SDoH) interactions with extra-clinical providers.

LTPAC transfers to ED:

• Review list of data items from Partners
• Next steps to be taken: start documentation in Confluence for

  • transition flows

  • data elements (see document)

  • any HL7 message contents

We reviewed the testing schedule for the week of 1/18

Discussion on plans for Connectathon, and HIMSS Interoperability Showcase.

For next week - look at the Gravity Project HL7 ballot: 

http://hl7.org/fhir/us/sdoh-clinicalcare/2021JAN/index.html

Timeline for 360XL - to be approved for publication at the IHE meeting next week.

Review of current document about Food Needs and SDOH in general  - several outstanding tasks remain for Vassil Peytchev  to follow up on.

Discussion on possible alternatives to current 360X conventions as the basis for SDOH interactions, or mixed model where 360X initiates, and other types of exchange continue as a result.

In a spooky Halloween fashion, this call was cancelled...

• Report out from discussion with ONC SDOH lead and Gravity project: overall well-received, groups to stay connected. Potential for HIMSS21 interoperability showcase alongside a FHIR-based Gravity/SDOH referral demonstration.
  • Use case / user story in development. Dan P/OHIP to distribute user story from their work for reference. Dr. Miller to share user story for input.
• Walkthrough of 360X SDOH Needs Referral Management document in development
  • Discussion on patient consent – largely handled by providers at time referral is made, but to non-clinical providers may be slight differences. OHIP getting legal opinion for sending of PHI from CE to non-CE w/ no BA. Some precedent for social services referrals. Dan P. to bring back legal opinion once they have it.
  • Discussion of statuses – potential need for “pending” status given potential lag
    • Should be addressed by vendor behavior (e.g., eCW referrals go into pending queue in system until next status is received)
    • Still a need for systems to configure or somehow flag if a referral has not been accepted to ensure patients do not fall through cracks.
  • C-CDA template for use: Unstructured Document template – no clinical info, just patient header/demographics. Could include unstructured attachment (e.g. benefits application pdf or image)
    • Could be heavy lift for vendors – conformance validation, etc. XDM metadata could allow PDF sent alongside C-CDA instead of within C-CDA. Unstructured C-CDA as optional.
    • Possibility for two options – one very light information, one with more information as needed for referral. Need to ensure not too onerous for vendor implementation
    • Alan to help make updates to C-CDA section of document based on discussion
  • Direct address provision for non-CEs may be a bit more complicated, but should be possible.
    • If non-provider, non-CE gets a direct address, there’s nothing in the directory to indicate someone is or is not a covered entity.
    • Dan P to look into how DT may be including/flagging non-clinical providers in directory.

Review SNF Discharge Summary contents, provided by Amy

• Good starting point
• Data is present in SNF systems
• Most of the information will be of use for the case where a patient is admitted to the hospital after they were in the ED

Reminder about the IHE public comment on 360XL

• The actual document is at https://www.ihe.net/uploadedFiles/Documents/PCC/IHE_PCC_Suppl_360XL_Rev1-0_PC_2020-08-26.pdf
• Submit comments at https://www.ihe.net/PCC_Public_Comments/

Vassil to send out call for volunteers

Review of discussion with Ohio HIE (OHIP Online)

• Initial focusing on 360X clinical referrals, eCW and Netsmart are on board
• Continue investigating food-related SDoH

Discussions on how we can move forward in this area

• A lot of interest, and very timely considering COVID-19 impact
• At the same time, there are a lot of disparate threads involved
  • Social services Initiation can occur in acute and ambulatory settings
    • Acute settings probably don't need any type of follow-up, unless part of larger organizations that provide primary care. 
    • Ambulatory settings, especially in the cases of PCPs who are members of ACOs or patient centered medical home (PCMH) organizations, will likely have care coordinators who need to know if the patient has followed up on the social services referrals
  • Social services, especially those related to food deficiency, often work together with government programs, and some of the followup includes enrollment in such programs. Current paper forms include enrollment information, some even include voter registration. While we cannot affect electronic communications with government programs, we need to describe the interaction points when possible
• Continue working to analysis, and publish findings on 360X wiki, although it is unlikely that a 360X-based solution can emerge in the short term. A thorough analysis will help guide future efforts.
• Contact major SDoH vendors and invite them to meetings, including the Gravity project

We reviewed a couple of paper forms for SNF to ED transfers. They are a good match to the list from Partners Healthcare, and we will use that as the baseline for content description.

We discussed the OHIP needs for possibly using 360X for SDOH purposes, and specifically food needs for patients, which is an increased concern during the COVID-19 pandemic. We will invite more participants in these calls to continue gathering information on how to best approach this. Basic 360X is not necessarily a good fit for this area.