HL7 Clinical Guidelines Special Interest Group
Minutes: Unified Guideline Model Planning Group -- June 13, 2005
Attendees: Bob Greenes, Robert Jenders, Samson Tu,
Rick Shiffman, Guy Mansfield (scribe)
First Agenda Item: How to pick the stakeholder community.
A. Discussion:
§ How do we pick this knowledgeable community?
§ RJ: A suggested simplification would be to not look beyond HL7. (This would be typical of other HL7 efforts).
§ BG: This is somewhat similar to the EHR functional model. Thought this did not work well. Guidelines vary a lot in the view of what they are for, this would dictate the model functionality, so we need external input.
B. What are the constituencies (and suggested representatives):
§ Professional specialty groups
o ACP (Thom Kuhn),
o AAP (guidelines branch or someone from informatics backround?
o How about someone actually involved in building guidelines. Asbru group is collaborating with Dutch primary care guideline organization, if we want to go international.
o Also consider New Zealand guidelines international network.
o What about WHO? ,
§ Clinical trial community? (for clinical trial protocols)
o Trial DB database at Yale? Not much guideline work.
o HL7 RCRIM committee? Doug Frisma (sp?)
§ Payors (insurers)
o eRX business (Ross Martin, prior authorization).
o CMS? (CHI effort?
o Eduardo Cortez (VA?)
o Pay for Performance ?
o Blue Cross?
§ Health Care provider organizations (e.g., Partners, Kaiser)
o Partners prior authorization for radiology? Harvard program health plan seeking to incorporate DSS into order entry process.
o David Bates
o Blackford Middleton
o Andy Wiesenthal at Kaiser?
o Mary Goldstein VA
§ Quality improvement organizations. (e.g., NCQA)
o Charlie Homer (sp?)
o Check with Don Berwick
o NQSA?
§ Clinical information system vendors
o IDX
o Epic?
o NexGen (small office EMR) John Dolcey
o Martin Entwhistle (Enigma)
§ Knowledge resource vendors
o Robert Dunlop (Proforma)
o Jerry Osherhoff
§ Disseminators (of guideline content)
o (e.g. Jean Slutsky National Guideline Clearinghouse)
o Kathrine Marshall’s group.
§ Modelers
o The usual suspects . . .
§ Academics (those interested in how guidelines effect care).
o Health service researchers (Mary Goldstein, Ida Sims? )
o COGS meeting attendees – Steve Wolf? Liv Solberg
o Bill Tierny?
o Someone from Cochrane?
§ End-user clinicians (e.g., clinicians, care evaluators).
o
Discussion:
§ How can we find knowledgeable people for the above constituencies?
§ If we signed up 2-4 from each group + modelers that would be 40-50 people – seems like a large group for a working session. BG: Shoot for 20-25 stakeholders + equal number of modelers.
§ Our conference would attempt to come up with requirements in the first day or two. Stakeholders can leave after first two days. Total conference would be 3-4 days.
§ Suggestion: Maybe have list of functional requirements that stakeholders to react to.
§ Note: OpenClinical recently published a list of competing guideline formalisms.
B. Next Steps
§ Bob: Assuming we could get funded, when would we want to have this conference? Coming Fall or next Spring.
§ When will we know about funding? BG: Will need final draft of proposal to submit to Ed Hammond. Maybe about a 3-month process to get funding. Maybe know by end of September. Can’t organize until we get funded, so maybe earliest would be a meeting in Spring 2006.
§ Will this require more than a conference grant from AHRQ?
§ We are seeking money for project manager and maybe .20 FTE for each modeling group. All agreed Mor Peleg would work for the project manager position if she were available. Suggestion that we would want to augment the project manager with clinical people to provide clinical perspective. Maybe ask for a higher percentage time for the modelers from each group. Total budget maybe about 200-300K.
§ Next teleconference: Same time (11PT, 12MT, 1CT, 2ET) two weeks from now - Monday June 27th. Have revised draft proposal ready for final review. Include categories of stakeholders.
C. Before Next Meetng:
§ Guy and Bob will review and revise notes and distribute.
§ Bob will update the proposal based on this discussion.
§ Draft proposal will be circulated for comments. (to Clinical Guidelines SIG and to those who have expressed interest in the Unified Guideline Model Project).
§ All – send comments on draft proposal to Bob Greenes prior to (how about Wednesday, June 22.)
§ Bob will forward revised draft and suggested invitees to Ed Hammond.