Collaborative Care Messages

For people who care

Max Walker

Co-Chair CBHS SIG

DHS (Vic) Australia

Who Care?

• General Practitioners

• Hospitals

• Primary Care Providers

• Allied Health Providers

• State Health Authorities

• Federal Health Authorities

Who Collaborates?

• General Practitioners

• Hospitals

• Primary Care Providers

• Allied Health Providers

• State Health Authorities

• Federal Health Authorities

• Others?

CCM - Collaborative Care Message

• When sharing isn’t transferring care

• Population Information?

We’ve got some patient data

We’ve got a complete clinical history

We’ve got some patient visits

We’ve got a complete drug chart

We’ve got problems

And Goals

And Pathways

And of course, we’ve got REL

We’ve got the lot

CCR – Collaborative Care Referral

• CCM with extra bits

• Bits of REF_I12

• Reason for referral and providers

• A Clinical Order

• And multiple patients

The bits from REF_I12

The Clinical Order

And multiple patients

But if you care, you really care

• And you want to know what’s happening

• You want to know if the referral has been accepted or rejected

• You want to know how the patients are going

• You want to know when treatment is complete

CCU – Collaborative Care Unsolicited Update

• Notification from the receiver, to the sender, that something has happened.

• Includes a Clinical History of treatment related to the referral

• CCR without Clinical Order

CCQ – Collaborative Care QueryCQU – Collaborative Query Update

• Demand an update on your referral

• And if thing’s aren’t going well, then there’s CCR Modify and CCR Cancel

Uses for CCR

• Collaborative Care Referral differs from Collaborative Care Message because it implies workflow.

• CCR lets you order stuff in an informed way

The CCM Suite

• Trigger Event I21 – Collaborative Care Message – Information from one Health Care Provider to another e.g. Discharge Summary, Registry Notification

• I16, I17 & I18 – Collaborative Care Referral – Implies a Transfer of Care – I16 is the Referral for a single or group of patients(?). Expect a Collaborative Care Update (CCU) back – I17 Modify CCR (expect CCU back) – I18 – Cancel CCR

The CCR Suite cont.

• I20 – CCU – Asynchronous Collaborative Care Update (ACK)

• I19 – Collaborative Care Query/Update – A trigger that sends sufficient information to find a previously sent Referral & hence generate a CCU

• I22 - Collaborative Care Fetch – Sends query to provider, repository, registry etc, on patient and returns Collaborative Care Information which is equivalent to a Collaborative Care Message