2015-10-27/28 Montevideo Day 2

Welcome and Introductions (permission to record)

Care Management and Care Regime - see attached file

NOTE - Slide 4 – refers to the Vice Chair of Nursing SIG, who was Zac at that time.

DISCUSSION

Judith Warren - SNOMED should be about the patient receiving care, not who gives the care.  Otherwise we would need to have nursing care/regime,therapist care/regime, etc

Jane Millar The solution supports ALL care – nursing, allied health and medical.

Ismat Mohd Sulaiman – I will include that in the paper.  

Ismat Mohd Sulaiman Should ‘care’ be a part of FSN of all (regime/therapy) concepts?  Should all concepts under the (regime/therapy) hierarchy have the term ‘care’ to make it understood?           

Judith Warren  support. (regime/therapy) – Is support a synonym for care? 

Ismat Mohd Sulaiman  No – it is a sibling

Judith Warren What is management?  This needs to be defined.

Barbara Kripps Do we need a concept to represent that a patient needs a certain type of care plan, e.g. diabetic care plan? 

Zac Whitewood-Moores – no, that is more for chronic illness.

Roberta Severin How does surveillance fit?

Zac Whitewood-Moores Surveillance of chronic disease or public health surveillance

Nick Hardiker – ICNP definition for regime/therapy – consider it a pathway, e.g. bowel care and bowel care management - difficult to say where bowel care starts and management starts.  In the equivalency work, management concepts were redundant.

Judith Warren slide 16 – another example, epistaxis care and epistaxis care management

Nick Hardiker and  Zac Whitewood-Moores agree there are multiple inconsistencies and clarification would be beneficial.     

Judith Warren – clinical management is different from administrative/managerial

Zac Whitewood-Moores  Care planning – multi-disciplinary – includes clinical and non-clinical aspects (insurance/financial).  It is not a nursing document.  It is a patient document.

Zac Whitewood-Moores, Judith Warren and Jane Millar agree.

Jane Millar Care of an individual – could include charities, etc. not just healthcare professionals

ACTION for Ismat Mohd Sulaiman and Cathy Richardson

1. Review care/regime hierarchy
2. Proposition to consider the addition of ‘care’ to FSN if not present
    Zac Whitewood-Moores and Jane Millar agree that this is broader than nursing.  Semantic meaning is more important than textual matching.
3. Proposition that some concepts were not subsumed appropriately.
4. Find candidates that are not in the hierarchy that need to be

• Ismat Mohd Sulaiman and Cathy Richardson Review care/regime hierarchy
• Ismat Mohd Sulaiman and Cathy Richardson Proposition to consider the addition of ‘care’ to FSN if not present
• Ismat Mohd Sulaiman and Cathy Richardson Proposition that some concepts were not subsumed appropriately.
• Ismat Mohd Sulaiman and Cathy Richardson Find candidates that are not in the hierarchy that need to be

Care Plan Representation - see attached file

Mind map – Personalised care plans – All agree that these are complex and not just nursing

ISO definition of a care plan – ISO 13940        

18 artefacts in Content Tracker now for ‘care plan’

GOALS are a challenge in SNOMED – currently only findings.   This is not sufficient. 

               UK – made them situations so that they encompass negation

               HL7 – has mood model – yet needs to be in the terminology as well

Range of movement – observables – another issue;

Jane Millar This is being picked up in the functioning project

Activity bundle – need, activity and goal

Creation of the 3 point slide for the closing plenary

Nursing Special Interest Group -Grupo de Interes Especial Enfermeria

1)      Identification of items on the content tracker that the Nursing SIG should engage with

2)      Pragmatic definitions for care management and care regimes

3)      What is a ‘care plan?

1. 1. Record artefact
   2. Regime/therapy
   3. Qualifier value

Discussion about all presentations

Judith Warren – When we submitted SNOMED nursing subset to the ANA for recognition, it was focused on diagnoses alone.  We need to include the hierarchy of observables and findings.  Currently, none of the terminologies contain that except some content in LOINC

Nick Hardiker – Continue ICNP analysis from SNOMED to ICNP to define scope of nursing in both terminologies

Zac Whitewood-Moores – Is arranging a physiotherapist a nursing activity or physiotherapist activity?  If you are going to create a subset, is it everything that you do as a nurse, or just core nursing activity?

Next meetings

November 2015 – cancelled due to AMIA-HIMSS conference - ANI directors meeting occurs on Saturday before the conference

15 December 2015 – 1700 UTC