eLTSS Plan Content Sub-Work GroupKickoff Meeting

May 5, 2015

11:00am–12:00pm

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Meeting Etiquette

• Remember: If you are not speaking, please keep your phone on mute

• Do not put your phone on hold. If you need to take a call, hang up and dial in again when finished with your other call– Hold = Elevator Music = frustrated speakers and

participants• This meeting is being recorded

– Another reason to keep your phone on mute when not speaking

• Use the “Chat” feature for questions, comments,and items you would like the moderator or other participants to know.– Send comments to All Panelists so they can be

addressed publically in the chat, or discussed in the meeting (as appropriate).

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From S&I Framework to Participants:Hi everyone: remember to keep your phone on mute

All Panelists

Agenda

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Topic Time Allotted

Welcome and Announcements 5 minutes

Overview of the eLTSS Initiative Goals and Use Case 5 minutes

eLTSS Plan Content SWG OverviewObjectivesMethods/Approach

10 minutes

Project Timeline 5 minutes

Introduction to Domains and Data Elements 20 minutes

Discussion/Reactions 10 minutes

Homework and Next Steps 5 minutes

Meeting Reminders

• eLTSS Plan Content SWG Meetings are held Tuesdays @ 11:00am – 12:00pm Eastern– Next meeting: May 12, 2015 from 11:00am–12:00pm Eastern– Meeting information can be found on the Wiki:

• http://wiki.siframework.org/eLTSS+Plan+Content+SWG– Duration: May 5–July 21 (11 Weeks)

• eLTSS All-Hands Meetings are held Thursdays @ 12:30pm Eastern– Next meeting: May 7, 2015 from 12:30–2:00pm Eastern– Meeting information can be found on the Wiki:

• http://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29

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REMINDER - Please check the Wiki for the latest meeting schedule –meeting link and call in numbers may change.

Recap: eLTSS Initiative Goal

Identify and harmonize electronic standards that can enable the creation, exchange and re-use of interoperable service plans for use by health care and community-based long-term services and supports providers, payers and the individuals they serve.

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eLTSS Use Case Context for SWG (1 of 3)

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Beneficiary SystemState-defined Case

Management System

State-defined LTSS/Service

Provide SystemEHR System Accountable Entity

System

1. Access the eLTSS plan

3. Send notification identifying the modifications

5. Access and view relevant eLTSS plan components

6. Add proposed modifications to the beneficiary’s clinical documentation7. Send proposed modifications to the eLTSS plan

8. Receive and integrate proposed modifications

12a. ALT: Send notification if the plan is not approved by all parties

12b. ALT: Send revised proposed modifications (go to 8)

12. Finalize and send plan if approved by all parties

13. Receive, review, and execute the modified eLTSS plan

15. Access the eLTSS plan and provide services

2. Modify ‘non-regulated’ section of eLTSS plan

4. Access the eLTSS plan and provide services

9a. Send modified plan for approval

9b. Send modified plan for approval

9c. Send modified plan for approval

10a. Provide approval or disapproval

10b. Provide approval or disapproval

10c. Provide approval or disapproval

11. Receive and review approval/disapproval

14a. Send notification of updated plan

14b. Send notification of updated plan

14c. Send notification of updated plan

14d. Send notification of updated plan

eLTSS Use Case Context for SWG (2 of 3)

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eLTSS Use Case Context for SWG (3 of 3)

• This initiative will identify key domains that will inform the creation of a structured, longitudinal, person-centered electronic LTSS plan for CB-LTSS beneficiaries.

• The eLTSS plan will be designed in such a way that it can be shared electronically across multiple CB-LTSS settings (e.g., adult day services, beneficiary homes, group homes, foster homes, assisted living, supportive housing, home health and hospice), institutional settings (e.g. hospitals, nursing facilities, primary care, post-acute care) and with beneficiaries and payers.

• eLTSS Initiative Project Charter– http://wiki.siframework.org/electronic+Long-Term+Services+and+Su

pports+%28eLTSS%29+Charter

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eLTSS Plan Content SWG Objectives

Identify and harmonize a core set of domains that will inform the creation of a structured, longitudinal, person-centered electronic LTSS plan for CB-LTSS beneficiaries:• clinical and non-clinical domains with terminology consistent

across the seven TEFT states and• example set of discrete data elements for the purpose of

clarifying the type of information that will be collected per domain area.

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Primary Focus Secondary Focus

TEFT State Requirements Non-TEFT State Initiative Requirements

Common Clinical Data Set RequirementsUse Case Requirements

eLTSS Plan Content SWG Method & Approach

The eLTSS Plan Content SWG will:• Identify a core set of domains

– Pinpoint concrete definitions and key attributes for the domains

• Define criteria for evaluating each domain– Relate to state, Common Clinical Data Set, and Use Case

requirements– Look for synergies within other initiatives (i.e. IMPACT Act, National

Core Indicators Domains, NQF Domains, etc.)

• Perform domain validation– Internal validation tools (e.g. matrix)– Gap mitigation

• Finalize and present consensus list of domains• Outline example data elements based on approved domains

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eLTSS Initiative Timeline

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Phase 1 Pilots &Testing …

Standards & HarmonizationUse Case &Functional

RequirementsPre-Discovery

DEC 14 JUNJAN FEB MAY JUL AUG SEP OCT NOV

Kick Off11/06/14

Evaluation...

ContentWork Stream

eLTSS All-Hands Work Group

Use Case WG1. eLTSS Use Case

eLTSS Plan Content SWG1. eLTSS Plan Domains &

Data Elements

Standards & Harmonization WG1. Candidate Standards2. Solution Plan3. Implementation Guide (Phase 1)

MAR APR DEC 15 JAN 16

eLTSS Plan Content SWG Timeline (1 of 3)

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Week TargetDate eLTSS Plan Content SWG Meeting Tasks Homework

due Fridays 12pm Eastern

1 5/5 Kickoff• Introduction to Domains and Data Elements

• States begin to identify current relevant domains

2 5/12• Introduce/Review Domain Harmonization Matrix• Validate Domain Mappings

• Review domain mappings• Continue to identify relevant

domains

3 5/19• Finalize Validation of Domain Mappings• Validate/Populate Additional State Domains within

Matrix

• Review domain mappings• Continue to identify relevant

domains

4 5/26• Finalize List of Additional State Domains• Identify Baseline for Domain Standards Evaluation• Validate Criteria for Domain Standards Evaluation

• Review criteria for domain standards evaluation

5 6/2 • Identify Baseline for Domain Standards Evaluation• Validate Criteria for Domain Standards Evaluation

• Review criteria for domain standards evaluation

6 6/9• Finalize Validation Criteria for Domain Standards

Evaluation• Begin Evaluation of Domains per Validated Criteria

• Perform domain evaluation per assigned section

7 6/16 • Continue Evaluation of Domains per Validated Criteria

• Perform domain evaluation per assigned section

eLTSS Plan Content SWG Timeline (2 of 3)

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Week TargetDate eLTSS Plan Content SWG Meeting Tasks Homework

due Fridays 12pm Eastern

8 6/23• Continue Evaluation of Domains per Validated

Criteria• Begin Listing Example Set of Data Elements per Each

Domain

• Perform domain evaluation per assigned section

• States begin to identify data elements per each domain

9 6/30• Begin Review of Consensus List of Domains• Review Gap Mitigation Plan• Continue Listing/Mapping Example Set of Data

Elements per Each Domain

• Vote on consensus list of domains

• Continue to identify data elements per each domain

107/7

• Finalize Consensus List of Domains to Present to eLTSS All-Hands

• Continue Listing/Mapping Example Set of Data Elements per Each Domain

• Continue to identify data elements per each domain

7/9 • Present Consensus List of Domains to eLTSS All-Hands • eLTSS Community provides feedback

eLTSS Plan Content SWG Timeline (3 of 3)

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Week TargetDate eLTSS Plan Content SWG Meeting Tasks Homework

due Fridays 12pm Eastern

117/14

• Review Community Feedback on Consensus List of Domains

• Continue Listing/Mapping Example Set of Data Elements per Each Domain

• Finalize Consensus List of Domains with eLTSS Community Feedback

• Finalize data elements per each domain

7/16 • Present Final Consensus List of Domains to eLTSS All-Hands

• None

12 7/21Final Meeting• Finalize Listing/Mapping Example Set of Data

Elements per Each Domain

• None

Introduction to Domains and Data Elements (1 of 2)

For eLTSS Initiative, want to list domains and example data elements present within the eLTSS Plan

– Requires input from data sharing experts = YOU

Top-down approach to classifying eLTSS plan elements:• Domain = High-level description that specifies a sub-domain• Sub-Domain = More granular groupings which define

categories for individual data elements• Data Element = Even more specific term that serves a

specific function– Attributes are based on a domain and sub-domain– Function is described by field labels and definition

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Introduction to Domains and Data Elements (2 of 2)

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Domain

Sub-Domain

Data Element

Vitals ProblemsLab

Results

Medications

Blood Pressure (BP)

Heart Rate

Systolic BP Diastolic BP

Allergies

Unit of data for which the definition, identification, representation, and permissible values are specified by means of sets of attributes

Logical, high-level groupings that categorize many sub-domains

More granular groupings of criteria specified within the domain that is used to define categories for individual data elements

Common Clinical

Data Set

Normal

Tachy.Brady.

The Grocery Store Concept

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• The beneficiary leads, owns and approves the content in the eLTSS plan

• User Story 1: think of the eLTSS Plan content as a “store”– Plan components/domains are aisles– Component/domain details are items

The Cart

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• Beneficiary chooses what to include in the plan• Items can be put in or taken out like a shopping cart

The Aisles – Typical Grocery Store

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• Method of organizing content so that beneficiary can easily locate and use items

• Like items are organized together by “domain”

Activities of Daily Living Aisle (Domain)

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• Aisle 5: Produce (Activities of Daily Living)

Activities of Daily Living Aisle Shelf (Sub-Domains)

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• Aisles contain shelves (Sub-Domains) that contain items (Data Elements) which the beneficiary selects, modifies and shares

GROOMING

BATHING

DRESSING

EATING

TOILETING

Activities of Daily Living Eating Shelf Items(Data Elements)

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Difficulty with eating?

Cuing and Supervision Type

Physical Assistance Type

Item Organization – Data Segmentation

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• Items (data elements) the beneficiary selects and modifies are segmented appropriately (“grocery bags”)

BATHING

DRESSING

GROOMING

EATING

TOILETING

Checkpoint

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Domains Sub-Domains Data Elements

Activities of Daily Living

Transportation Bus, Train, Car

Employment Employed, Unemployed

Vital SignsBlood Pressure Systolic BP, Diastolic BP

Heart Rate Bradycardia, Normal, Tachycardia

• Domain = High-level description that specifies a sub-domain• Sub-Domain = More granular groupings which define

categories for individual data elements• Data Element = Even more specific term that serves a specific

function

Discussion

Discussion/Reactions

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eLTSS Plan Content SWG Next Steps

• Sign up for the eLTSS Plan Content SWG on the Wiki– http://wiki.siframework.org/eLTSS+Plan+Content+SWG– Joining the eLTSS Plan Content SWG ensures that you are included on

workgroup communications and announcements.

• Homework– Each state to begin identifying current relevant domains.– Due Friday, May 8 by 12:00pm Eastern.

• Next eLTSS Plan Content SWG Meeting– Will focus on introducing and reviewing the Domain Harmonization

Matrix and validating domain mappings.– Tuesday, May 12 from 11:00am – 12:00pm Eastern

• http://wiki.siframework.org/eLTSS+Plan+Content+SWG

• Thank you! Your commitment and participation are critical to our success.

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eLTSS Plan Content SWG Contact Information

• For questions, please contact your support leads:– eLTSS Plan Content SWG Lead: Grant Kovich,

grant.kovich@accenture.com– eLTSS Plan Content SWG Co-Lead (Arizona): Name, Email– eLTSS Plan Content SWG Co-Lead (Colorado): Name, Email– eLTSS Plan Content SWG Co-Lead (Connecticut): Name, Email– eLTSS Plan Content SWG Co-Lead (Georgia): Name, Email– eLTSS Plan Content SWG Co-Lead (Kentucky): Name, Email– eLTSS Plan Content SWG Co-Lead (Maryland): Name, Email– eLTSS Plan Content SWG Co-Lead (Minnesota): Name, Email– Initiative Coordinator: Evelyn Gallego,

evelyn.gallego@siframework.org– Project Manager: Lynette Elliott, lynette.elliott@esacinc.org

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