Care plans

 14 March 2017

 Upload of any additional documents or links by @Monica Harry

 16 March 2017

 14 March 2017

Open

Review proposed plan for the management of Care plan concepts and provide your countries feedback.

Note: Monica to provide a briefing note.

 @Monica Harry

Please post your final responses in the Country response table below. Discussion comments can be made as comments.

US

18MAR2017

This proposal seems beneficial to SNOMED, because 1) it derives from another standard; 2) it provides strong editorial guidance for content that has been inconsistently modeled across extensions. Moreover, it squarely anchors care plans into information artifacts. No drawbacks come to mind.

 UK

 27MAR2017

 Although generally this is what the UK expected I will need to consult on the recommendations formally with the change in the description. If we could extend the deadline for feedback to the 14th April this should enable me to do this.

DK

27MAR2017

Danish nurses tell me care plans are very relevant for them too, but presently the nurses do not have any comments to this proposal.

AU

28MAR2017

I not aware of any immenent requirement for this work within Australia, so no obvious impact, but it seems reasonable. Tidying up the qualifiers is always good. I assume it's only a specific subset of "regime/therapies" that are to be deprecated (it doesn't look like these are in the international release anyway? As for the "concept model" for these - seems reasonable, though I'm not sure about the need for "Type of clinical document" attribute... would an |IS A| be sufficient?

One thing to note though, is that the FHIR seems to have defined a value set based on the qualifier values (see https://www.hl7.org/fhir/valueset-care-plan-category.html ) (It's only a "maturity level 1". But Record Artifact seems like a more accurate class. (I've made a note for FHIR to "watch this space").

NL

29MAR2017

We agree with deprecating the suggested qualifier values and regime/therapies, because we do believe a care plan is a document. I would like to discuss the suggested modelling changes (like care location) internally with my team. It would be a good thing to share the record artifacts with other countries before more countries will do the same. We are not yet working on care plans related with Snomed CT, but we do have some record artifacts in our extension, may be modelled in a different way (other parents, not EHR related). We made those for XDS metadata purposes (what document is exchanged). I checked, but that does not count for the care plans. Summary: Agree.

SE

2017-03-30

There is a current Swedish national project looking at representation of care plans. No decisions have been made regarding terminology so Sweden would not be affected. The suggested changes would improve consistency.

NZ

3APR2017

General comments summarised: A useful initiative and the link to ISO 139040:2015 is noted. It may be too narrow to consider a care plan as simply a record artifact (i.e. the documentation of a care plan). This seems a reasonable way forward.

UK

13APR2017

Comment received from the UK are attached. Whilst the proposal seems reasonable for this smaller piece of work there are some bigger issues which need to be considered and it would be helpful if the questions raised in the attached document could be considered by SNOMED International and the Nursing SIG.

Open

Member countries without a CMAG rep