Documenting and Sharing Care Plans for a Single Clinical Context

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Type Standard / Implementation Specification Standards Process Maturity Implementation Maturity Adoption Level Federally required Cost Test Tool Availability
Implementation Specification
Balloted Draft
Pilot
Rating 3
Yes
Free
Yes
Emerging Standard
In Development
Pilot
Rating 1
No
Free
No
Emerging Implementation Specification
Balloted Draft
Pilot
Rating 1
No
Free
No
Limitations, Dependencies, and Preconditions for Consideration Applicable Value Set(s) and Starter Set(s)
  • The care plan as expressed in the C-CDA standard does not attempt to represent the longitudinal care plan; rather it represents a “snapshot” of a care plan at a single point in time for transmission to other providers and teams to ensure continuity of care.
  • The Care Plan Domain Analysis Model is used as a reference model for C-CDA care plan documents in the context of the longitudinal care plan.
  • FHIR Resources are in various stages of maturity. Please refer to the FHIR website for updates on specific profiles and their progress. The FHIR Maturity Model and each of the levels is described on the HL7 wiki.

  • See CDA and FHIR projects in the Interoperability Proving Ground.
  • Feedback requested

Comment

NCPDP - Comment

  • Add the following:

Type-Implementation Specification

Standard Implementation/Specification- NCPDP Pharmacist eCare Plan Version 1.0: Guidance on the Use of the HL7 CDA Consolidated Templates for Clinical Notes R2.1 Care Plan

Standards Process Maturity – Final

Implementation Maturity- Production

Adoption Level – 2

Federally Required – No

Cost – $

Test Tool Availability – Yes

  • Add the following:

Type-Implementation Specification

Standard Implementation/Specification- NCPDP HL7 CDA® R2 Implementation Guide: Pharmacist Care Plan Document, Release 1 - US Realm - US Realm

Standards Process Maturity – Final

Implementation Maturity- Production

Adoption Level – 2

Federally Required – No

Cost – $

Test Tool Availability – Yes

  • Add the following:

Type-Implementation Specification

Standard Implementation/Specification- NCPDP HL7 CDA® R2 FHIR Implementation Guide: Pharmacist Care Plan Document, Release 1 - US Realm - US Realm

Comment: FHIR is used to implement the Care Plan. See https://www.healthit.gov/techlab/ipg/node/4/submission/1376

Standards Process Maturity – Final

Implementation Maturity- Pilot

Adoption Level – 1

Federally Required – No

Cost – $

Test Tool Availability – Yes

Care Plan Document Type is not Required

HL7 Implementation Guide for CDA® Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Release 2.1. 

This should not be listed as required. MU2015 did not require the care plan document. MU2015 did require Concerns and Goals within transition of care documents but not specifically the Care Plan document. The snapshot or visit context of a care plan for transition of care is appropriate. A longitudinal care plan in the form of a CCDA is unwieldly and virtually useless from the perspective of a provider. The longitudinal care plan needs to be in the context of an application for optimal management and viewing.

Pharmacy HIT Collaborative's Comments on ONC's Proposed 2018 ISA

The Pharmacy HIT Collaborative supports the balloted drafts of HL7 Implementation Guide for CDA Release 2: Consolidated CDA Templates for Clinical Notes (US Realm), Draft Standard for Trial Use, Release 2.1 and HL7 Resource Care Plan (v3.0.1).  The Collaborative also supports HL7 Fast Healthcare Interoperability Resources (FHIR), STU3, which is in development.

NCPDP Comment

For NCPDP Pharmacist eCare Plan Version 1.0: Guidance on the Use of the HL7 CDA Consolidated Templates for Clinical Notes R2.1 Care Plan, change Adoption level to Pilot.