Positioning Aging Services in the Standards Agenda

1
Positioning Aging Services in the Standards Agenda

• LTC HIT Summit, Baltimore
• Content Interoperability Standards
• Peter Kress
• June 9, 2006

2
Recapping the Session

• Terminology Strategies Omaha
• Person-centered resident assessments InterRAI
• A New approach to dealing with legacy or
  propietary data sets
• Loincification of legacy components
• good enough mapping strategies

3
Consumerist Social Model Profile Preferences

• Life History
• Expanded
• Family Social History
• Structured Narrative
• Preferences
• Sleep
• Bathing
• Activities
• Socialization

4
Consumerist Social Model Abilities Goals

• Document what person can do (not cant)
• can walk fifty feet in ten minutes
• Document what person wants to be able to do
• gardening
• Document on the wellness dimensions
• Health Fitness
• Intellectual
• Spiritual
• Vocational
• Emotional
• Social
• Consumer directed service care plan
• Reflect goals preferences
• Identifies and plans around risks and obstacles

5
The Consumerist Reversal
Who contributes the most important information to
the EHR?
6
EHR Enabled Care Delivery
Care Giver
EHR/PHR System
Who participates in these activities? The whole
care team individually and collaboratively Encoun
ter Level Provide Consumer with a electronic
Summary of Care
7
EHR Data Set

• Header
• Personal Information
• Financial Information
• Provider Information
• Context Document Type
• Functional Status
• Problems
• Family History
• Social History
• Allergies

• Medications
• Immunizations
• Vital Signs
• Results
• Procedures
• Encounters
• Plan of Care
• Advanced Directives

8
Person-centered Documentation

• Person-Centered Documentation
• Orient by the persons unique story, preferences
  and goals
• Leverage unique relationship
• Documentation is for the person ltfirst
  principlegt
• Caregiver Context, Role Relationship
• Support richness of unique caregiver perspectives
• Roles, skills, specialties, contexts, purpose
• Unique modes of observations, access to tools,
  etc.
• Interface Terminologies
• Enhance comparability usability
• Loincification of best practice content
• Leverage usefully related mapping to enhance
  exchange reuse (i.e. decision support)
• Not real-time mapping/coding, concepts are mapped
  as part of implementation guides.
• Maintain human readability
• Representation of original capture and context
• Translate as appropriate for use
• For Persons and their Caregivers
  Internal/External

9
CAST Content Project

• Implementation guide for an aging services
  Continuity of Care Document with Structured
  Functional Status Wellness Content
• Requirements, Gap Analysis, Development
• CAST sponsored and funded activity
• Partnership with AHIMA
• Stakeholder collaboration
• Standardization through HL7 process
• Interoperability Testing Industry Level
• Interoperability Testing -- IHE

10
CAST Project

• Required/Recommeded Data Set?
• Privileged Data Sets, Assessments, Instruments
• Balances
• Need for caregiver, setting, context
  appropriate observation
• With need for semantic comparability and reuse
• Process
• Identify (registry)
• Map
• To standards strategies
• For readability
• Structure for inclusion in CDD
• Clinical Statement Implementation

11
Questions

• kress_at_actslife.org
• Cast Website
• www.agingtech.org