Collaborative Care Messages

For people who care

Max WalkerCo-Chair CBHS SIGDHS (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