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LCC -Proposal for Next Steps. August 28, 2012. Discussion Points. Recap of Whitepaper Recommendations Critical milestones and activities driving LCC activities IMPACT Project deadlines and their impact on LCC activities Scope for Potential LCC Use Case 2.0

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discussion points
Discussion Points
  • Recap of Whitepaper Recommendations
  • Critical milestones and activities driving LCC activities
  • IMPACT Project deadlines and their impact on LCC activities
  • Scope for Potential LCC Use Case 2.0
  • Scope for developing Stage 3 MU Comments
  • Proposed key activities and timelines for LTPAC and LCP SWGs
external drivers
External Drivers

Standards Analysis & Recommendation (1-2months)

Implementation Guidance Development (1- 2 months)



HITPC Pre-RFC Meeting

Draft stage 3 Recs due

Stage 3 RFC Distributed

RFC Deadline (Dec 21)

Final stage 3 Recs due to HHS

HITPC Stage 3 MU

ONC Synthesis of RFC Comments (1- 2 months)

WGs reconcile RFC comments (1 month)

HL7 Fall Ballot Closes

HL7 Spring Ballot Open

HL7 Ballots

HL7 January Ballot Open

key questions for lcc wgs
Key Questions for LCC WGs
  • Is there value in developing the IG for LCC Use Case 1.0 given the IMPACT Project Scope of Work?
  • If yes, how do we reconcile use case 1.0 with the IMPACT project data sets?
  • If no, let’s consider…
how to leverage impact work for lcc wg activities
…How to leverage IMPACT work for LCC WG activities
  • Build from IMPACT standards analysis work and IG to create LCC Use Case 2.0 (contains all ~450 data elements)
    • LCC Use Case 1.0 may no longer be relevant for S&I harmonization given additional data elements identified since LCC Use Case 1.0 consensus (June 2012)
  • LCC Use Case 2.0 will be handed off to S&I Harmonization Team (Deloitte). Deloitte team will then create ‘Care Plan IG’ which will be submitted for HL7 balloting
  • Monitor and review IMPACT contract work (standards analysis) as part of weekly LTPAC SWG call
scope for lcc use case 2 0
Scope for LCC Use Case 2.0
  • LCC Use Case 2.0 and IG may not contain all data elements for the exchange of Collaborative Care Plans
  • LCC WG should revisit ‘baseline transaction and build’ presented during June LTPAC Collaborative Summit
    • Versions 2.0 to Version X.0 of LCC Use Case are built incrementally to add requirements of other trading partners (i.e. IRF, Behavioral Health, CBO)
  • Care Plan is built out from most simple to most complex (i.e. treatment plan, care plan…to collaborative care plan)
from ltpac summit baseline transaction and build
From LTPAC Summit: Baseline Transaction and Build

Master Longitudinal Care Use Case


Full LCP Support

Version …: Other trading partners

Round out full longitudinal picture

Version 3: (IRF, Behavioral Health, CBO, ???)

White Paper Roadmap lays out priority order to incrementally add requirements of other trading partners

Building Incrementally

Version 2: Include ~450 elements identified by the IMPACT Project (potential Use Case 2.)

Version 1: Baseline Developed HH-POC

Creates base Use Case Structure and focuses on HHA/ SNF as the starting point that gives the best overall coverage of data elements.



June 2012, Baltimore, MD

building a common terminology for the care plan
Building a Common Terminology for the Care Plan

Most resembles HHPoC



The WP acknowledges there are at least 10 recognized nursing care plan models and vocabularies. The concepts, vocabularies and value sets are not standardized.

scope for stage 3 mu comments
Scope for Stage 3 MU comments
  • Map whitepaper recommendations against Stage 3 Preliminary Recommendations for ‘Improve Care Coordination’
  • Leverage gap analysis to develop LCC Use Case 2.0

Out of Scope

  • Mapping WP to Stage 2 MU Final Rule
    • Part of Deloitte Scope of Work for ‘ToCCompanion Guide’
  • Mapping WP to S&I Framework CEDD
    • Use Case 2.0 will need to be mapped to ToCCEDD
summary of proposed key activities for lcc swgs
Summary of Proposed Key Activities for LCC SWGs
  • Finalize and get consensus on ~450 Data Elements List - LTPAC
  • Monitor and review progress of IMPACT Project Standards Analysis and IG Development work - LTPAC
  • Update LCC Use Case to develop LCC Use Case 2.0 based on ~450 Data Elements List - LCP
  • Map Whitepaper recommendations against Stage 3 MU Preliminary recommendations – LCC and LCP

Discussion Point: Which activities will be led by LTPAC SWG and which will be led by LCP SWG?


LCC WG Timeline: Sept 2012 – May 2013

Finalize: Use Case Data Elements List (07SEP2012)

Monitor: IMPACT Project Standards Analysis & IG Development (3-4 months)


Monitor IMPACT Project Pilot (1-2 months)

Mapping: Whitepaper to Stage 3 Preliminary Recommendations

Use Case 2.0 Standards Analysis & Development

Development: Use Case v2.0 (2 to 3 months)

Development: Use Case 2.0 Implementation Guide


Development: Stage 3 MU Recommendations

Ballot Reconciliation

Fall BallotPrep


Implementation Guidance

IMPACT Contract Awarded

HL7 January

Ballot Opens

IMPACT Project Go-Live

S&I Framework

Contracts Expire


HL7 Spring

Ballot Opens

HL7 Fall

Ballot Closes

Stage 3 MU RFC Deadline

other discussion points
Other Discussion Points
  • Timeline for reconciling Use Case 1.0 or developing Use Case 2.0 and submitting to S&I Harmonization team
  • Timeline for S&I Harmonization Team to develop IG and put through HL7 balloting cycle
    • What version of Use Case will be developed to ensure submission of IG for January cycle? For May cycle?
  • Contract end dates for S&I Framework Support Contracts (end of Feb 2013)