Putting the Patient Story at the Center of Standards Development

During the August 2016 HIMSS Health Story Project Roundtable, Lenel James, BlueCross BlueShield Association (BCBSA), Lisa Nelson, Life Over Time Solutions, shared a patient story that is making a difference in the development of health IT standards. 

The patient story

The presentation described how a patient’s story advances the HL7 standards for digital care plans. “Adam Everyman” was introduced as a patient living with multiple chronic conditions that require the input of stakeholders from across the care continuum to help coordinate the management of his various care needs.

His story helped reveal gaps in the Care Plan Document template included in Consolidated CDA R2.1. The CDA R2.1 is an information exchange standard that specifies the syntax, structure and semantics of "clinical documents" for the purpose of exchange between healthcare providers and patients.

Nelson and James explained how the story helped develop new constraints for the C-CDA document to make this standard more useful.

The implementation of containerized design represented multiple care plans within the C-CDA document.  

Highlighted linkages more easily displayed elements of the care plan in relation to interventions and observations.

The payer perspective

The patient story assisted in adding the payer perspective to the modeling work in the Care Plan Domain Analysis Model. (A care plan is a planning and coordination tool that helps a healthcare team deliver integrated/collaborative care with the patient at the center of the team.)

BCBSA examined HL7 Domain Analysis Model in conjunction with the C-CDA documents, which contains various story boards but does not consider the payer’s role in the transition of a member to different care locations.

Finally, after identifying gaps and opportunities, the patient story helped guide a project with multiple vendors that demonstrated the exchange of digital care plans for care coordination between health plans and payers. This patient story will be reused as efforts continue around improving the adoption of digital care plan exchanges.

With a lively Q&A discussion at the end of the session, some audience questions could not be answered due to time constraints. The responses to these questions can be found here.

A recording of this Roundtable event is available to view on the Health Story Project Roundtable Archives webpage.  Members of the HIMSS Health Story Project encourage dialogue on this topic and welcome your comments.

HIMSS; health IT; patient care