---------- Forwarded message ----------
From: Darrell O'Donnell <darrell.odonnell@continuumloop.com>
Date: Tue, Sep 11, 2012 at 11:21 AM
Subject: [emergency-have] HAVE meeting today
To: "emergency-have@lists.oasis-open.org" <emergency-have@lists.oasis-open.org>
From: Darrell O'Donnell <darrell.odonnell@continuumloop.com>
Date: Tue, Sep 11, 2012 at 11:21 AM
Subject: [emergency-have] HAVE meeting today
To: "emergency-have@lists.oasis-open.org" <emergency-have@lists.oasis-open.org>
Folks - I wasn't able to make it to last week's meeting. Due to the end of summer things just blew up.
As we haven't had many successful meetings over the summer I would like to propose a plan of attack for getting the ball rolling.
To me there are two high-level items that we really need to decide upon before we can get down into the nitty-gritty details. I say this only because I need to understand if the direction that I have taken the XML Schema makes sense and these two items
are fundamental to the schema (detailed discussion follows):
- Services - the HAVE 1.0 schema didn't allow for extension of the services that a Hospital (now Facility) would be able to list and supply information about.
- Bed Counting - I am frankly a bit confused by the way bed counts were done in HAVE 1.0 and how they have been carried forward. I could use some input here and I'll add another piece based on Tim's email from 29AUG - do we want/need to track bed counts?
The Bed Counting item is likely contentious so let me clarify what I mean here. Basically the early HaVBED (and HAVE 1.0) standards were very centred on bed counts. This is a key metric for hospital administration and only relevant to the Emergency Management/Public
Safety (EMPS) side at times (e.g. major crisis, epidemic). We are being pushed to align with HL7 and I would propose that the HL7 folks would be the best ones for managing bed counts and we can focus on the key bed counts that matter outside of the hospital
administration space. I'll throw out an example here.
In theory we can track the number of beds available for any medical service - ICU, CCU, Neurosurgery, Infant Neurosurgery, etc. What does the EMPS space really need though - typically we are more concerned about the "exceptions" (e.g. this hospital has
exceeded its capacity to handle neurosurgery") not the number of beds. Even seeing details stats makes it tempting for an emergency manager to micromanage something that they are not really capable of doing - if there is a city-wide/regional incident (e.g.
epidemic) the health departments/administration will likely be the group managing bed counts and where to send patients. So - focusing on bed counts may be distracting us from the key information that the EMPS community really needs:
- What facilities are OK and which are having capacity issues (near/at/beyond capacity)? I would place Emergency Room capacity here (with extra information for offload times).
- What facilities provide particular services? e.g. STEMI (particular heart attack type) service availability is key for EMS/ambulance response - bringing a STEMI patient to a non-STEMI facility is bad. Similarly, in an emergency there are key services that the at-risk population will need and EMPS members need to know (e.g. Dialysis availability).
The Services discussion is a bit easier from a high-level but I need some input on the data schema that I created for the ServicesType. My intent has been to create a list of values that one can use (e.g. we can have a HAVE1.0 compatible services list)
that any organization can use with extensibility and named Taxonomy support. I have included a screenshot of the data model below for reference - you can get a PDF of the whole model here: https://www.oasis-open.org/apps/org/workgroup/emergency-have/download.php/46684/edxl-have2.1DRAFT_v0.6.pdf
We just indicate what Taxonomy we use (e.g. HAVE1.0 or OntarioLHIN1.0 for the Ontario Local Health Integrated Network system in Ontario, Canada) at the ServiceList level (attributes ServiceList TaxonomyName and TaxonomyURI - could make these elements).
Each ServiceListItem is then based on that Taxonomy (NOTE: We can have multiple ServiceList elements to support multiple taxonomies.)
Now, under each ServiceListItem we have the concepts of:
- What Service are we talking about (ServiceValueType per the Taxonomy - and the ServiceName as a human-readable text item)
- Is the service available? (true/false)
- What is the Status of the service. This gets into a further discussion (future time) for later on StatusType but for purposes of this discussion this is about what state the service is in (e.g. normal/near capacity/at capacity/beyond capacity)
- What is the Capacity? For those services where Capacity is relevant (germane?) for the EMPS community we would share what the Capacity levels are.
I look forward to discussing this at 4pm today.
cheers,
Darrell