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  1. Project Scope Statements/Proposals
  2. PSS-1712

PACIO FHIR Profile - Re-assessment Timepoint

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    • Icon: Project Scope Statement Project Scope Statement
    • Resolution: Done
    • Icon: Medium Medium
    • None
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      Post-Acute Admissions extend over much longer periods of time than the encounters in the Acute and Ambulatory Care Settings, often going for several months or even years. Over the course of these time periods the patient condition and therefore the care being provided is changing - for example in Home Health the goal is rehabilitation so Care Plans, Medications, and Orders are all likely changing throughout an admission that could last several months. Already in existence within post-acute care settings are periods of time structured by a variety of stakeholders, some more rigid than others - regulatory and conditions of participation, payer and revenue cycle requirements, and provider specific processes and protocols. In settings like Home Health and SNF, there are defined Medicare assessment instruments that must be completed every X number of days (varies by care setting); the results of said assessment drive the Care Plan for the next X number of days; if a patient has a pain management Care Plan, and their pain scores are down then they may have their Opioid drug dosages reduced or eliminated. If the patient's ambulation is improving, then we may see interventions focused on more complex exercises. These periods of time, defined by many different drivers, have direct impact on how data is made available outside of an EMR; without a structure in place to hold this information a connecting application or patient would have no choice but to sift through months worth of information rather than focusing on a given period or periods most relevant to the need of the application, patient, or other entity.

      Fields in the Encounter resource under consideration for existing or new code systems (differing from the standard Encounter IG);

      • Reason Code - proposed use: new recommended code list to define the entity that constructs the timepoint. Ex. if the timepoint is driven by a Medicare revenue cycle requirement, the reason code could be "Payer"
      • Service Type - in discussion: define the the care setting. 
      • Type - in discussion: define the disciplines or key treatments that are involved during the given period of time.  

      This project has been defined and in the process of being refined by the Post Acute Care Interoperability working group (PACIO) http://pacioproject.org/ 

      Show
      Post-Acute Admissions extend over much longer periods of time than the encounters in the Acute and Ambulatory Care Settings, often going for several months or even years. Over the course of these time periods the patient condition and therefore the care being provided is changing - for example in Home Health the goal is rehabilitation so Care Plans, Medications, and Orders are all likely changing throughout an admission that could last several months. Already in existence within post-acute care settings are periods of time structured by a variety of stakeholders, some more rigid than others - regulatory and conditions of participation, payer and revenue cycle requirements, and provider specific processes and protocols. In settings like Home Health and SNF, there are defined Medicare assessment instruments that must be completed every X number of days (varies by care setting); the results of said assessment drive the Care Plan for the next X number of days; if a patient has a pain management Care Plan, and their pain scores are down then they may have their Opioid drug dosages reduced or eliminated. If the patient's ambulation is improving, then we may see interventions focused on more complex exercises. These periods of time, defined by many different drivers, have direct impact on how data is made available outside of an EMR; without a structure in place to hold this information a connecting application or patient would have no choice but to sift through months worth of information rather than focusing on a given period or periods most relevant to the need of the application, patient, or other entity. Fields in the Encounter resource under consideration for existing or new code systems (differing from the standard Encounter IG); Reason Code -  proposed use : new recommended code list to define the entity that constructs the timepoint. Ex. if the timepoint is driven by a Medicare revenue cycle requirement, the reason code could be "Payer" Service Type - in discussion : define the the care setting.   Type -  in discussion : define the disciplines or key treatments that are involved during the given period of time.    This project has been defined and in the process of being refined by the Post Acute Care Interoperability working group (PACIO) http://pacioproject.org/  
    • Community-Based Care and Privacy
    • Patient Care
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      Patient Administration
      Pharmacy
      External Terminology

      PACIO Leads
      - Chris Pugliese (MatrixCare)
      - Dave Hill <dwhill@mitre.org>
      - Siama Rizvi <rizvi@mitre.org>
      - Robert Samples <robert.samples@esacinc.com>
      Show
      Patient Administration Pharmacy External Terminology PACIO Leads - Chris Pugliese (MatrixCare) - Dave Hill < dwhill@mitre.org > - Siama Rizvi < rizvi@mitre.org > - Robert Samples < robert.samples@esacinc.com >
    • Hide
      MatrixCare Home Health
      MatrixCare SNF
      PACIO Project
      Show
      MatrixCare Home Health MatrixCare SNF PACIO Project
    • PACIO Project Workgroup
    • Product Family Product Project Intent Lineage Ballot Type Target Cycle Actions
      1
      FHIR
      Profile
      Create New Release (specify Lineage)
       
      STU
      September 2021
    • Re-assessment Timepoint
    • FHIR Encounter Resource, FHIR Episode of Care Resource, US Core, FHIR Care Plan Resource
    • No
    • Yes
    • PACIO Project
    • No
    • US

    Description

      This project goal is to profile the encounter and/or the episode of care resource to create definition for sub-periods of time within an extended post-acute admission. Since Post-Acute admissions can extend weeks, months, and years the "Re-assessment Timepoint" profile provides a way to break this information up into consumable blocks that can reflect the evolution of care over time in a Post Acute Admission. As the Encounter the primary method for reflecting the entirety of a Post Acute admission, it is the logical choice to profile for these smaller chunks of a longer admission. 

      This FHIR implementation guide will use the US Core profiles. If this FHIR implementation guide is unable to use a US Core profile, we will follow the Cross Group Projects WG's variance request process, and provide the US Realm Steering Committee an approved rationale for deviation in the implementation guide where applicable.

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            chris_pugliese Chris Pugliese (Inactive)
            chris_pugliese Chris Pugliese (Inactive)
            Chris Pugliese Chris Pugliese (Inactive)
            Chris Pugliese Chris Pugliese (Inactive)
            Chris Pugliese Chris Pugliese (Inactive)
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            Dates

              Created:
              Updated:
              Resolved: