Electronic Long-Term Services and Supports (eLTSS) Service Plan (Jira PSS-2235)

Description

Brief Overview: The eLTSS FHIR Implementation guide was previously published as STU1 in 2019. There are deferred JIRA issues, a new, additional, Pilot implementation and an ONC sponsored IG development effort. This PSS covers updating the eLTSS FHIR IG as an ONC funded project.

This next phase of the project is to:

Update the eLTSS FHIR IG based on the learnings and feedback from the Missouri DMH pilot implementation and stakeholders in the HL7 standards development community.

The electronic Long-Term Services and Supports (eLTSS) FHIR Implementation Guide (IG) was developed to support exchange of data generated during the planning and provision of long-term services and supports. HL7 published an STU version 1.0.0 in 2019.

In 2020, the Office of the National Coordinator for Health IT (ONC) awarded a cooperative agreement to the Missouri Department of Mental Health (DMH), Division of Developmental Disabilities as part of the Leading Edge Acceleration Project (LEAP) program. Under the cooperative agreement, the Missouri DMH supported testing and implementation of the eLTSS IG for exchange of Missouri Individual Service Plan information across provider IT systems.

Tasks include, but are not limited to, the following:

Evaluate lessons learned and feedback from stakeholders to inform content updates to the IG:

- Sources of feedback should include, The Office of the National Coordinator for Health Information Technology (ONC), Missouri DMH, HL7 Community-based

Care & Privacy (CBCP) Workgroup, and Human and HL7 Social Services (HSS) Workgroup.

Work with the Gravity Project to align with the Gravity SDOH Clinical Care IG. § Review the SDOH Clinical Care IG for profiles intended for similar use case and align where appropriate

- Review Gravity value sets and how they are used in US Core profiles (in version 5.0.1 or later) for SDOH content to determine if these profiles and/or the model of value set usage can be incorporated into the eLTSS approach.

- Address any known issues with the IG, including those documented in HL7’s Jira: o Propose resolutions to any outstanding Jira trackers and apply changes to the IG as appropriate. Consider replacing the use of CarePlan.activity.detail (which is intended for inline simple summary of a planned activity suitable for a general care plan system (e.g. form driven) that doesn't know about specific resources and, instead, using referencing resources (e.g. procedure orders) already existing in the health systemEvaluate any Jira trackers marked “consider for future use” and develop/update IG content as appropriate.

- Update the content of the eLTSS FHIR IG for a subsequent version update. o Update content to align with US Core v3.1.1 or a more recent version, if it becomes appropriate during the projectDetermine publication pathway for an IG version update, e.g. un-balloted STU update or STU ballot

(see: https://confluence.hl7.org/pages/viewpage.action?pageId=107217093)

- Facilitate testing of updated content as prerequisite to version update:Coordinate with Missouri DMH to determine appropriate testing venue, i.e. HL7 FHIR Connectathon or other standalone testing event (as approved by the HL7 FHIR Management Group).Provide administrative support for testing event, including: define objectives, develop presentations and other documentation to support participants, facilitate HL7 processes for testing event (e.g. obtain necessary approvals, submit content according to HL7 deadlines, etc.), participate in testing event to ensure participants achieve goals and objects, prepare summary of results, etc.Update the eLTSS FHIR IG as appropriate based on findings from testing event. · Facilitate balloting and ballot reconciliation (if needed)

- Facilitate publication of updated eLTSS FHIR IG

The original scope of this project was the following:

The electronic Long-Term Services and Supports (eLTSS) Initiative, a joint project between the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator (ONC), initiated in late 2014 as one of the four components of the Medicaid testing Experience and Functional Tools (TEFT) demonstration grant program.

The project’s aim is to advance data-level interoperability for the Home and Community-Based Services (HCBS community) and to facilitate the identification and validation of a data standard for capturing and exchanging person-centered LTSS service plan data.

The primary objectives of the eLTSS Initiative are:

1) To identify components or data elements needed for the electronic creation and interoperable exchange of person-centered service plans by health care and HCBS providers, payers and the individuals they serve; and

2) To field test these data elements within and across participating organizations’ electronic systems.

The Primary Products of the eLTSS Initiative to-date are:

1. eLTSS Dataset Published - September 2017

Collaborative requirements gathering and harmonization efforts have culminated into the publication of the eLTSS dataset and supporting documentation (e.g. use cases, etc.). The eLTSS dataset contains data items commonly found on LTSS Service Plans and serves as the groundwork for developing electronic means for exchanging LTSS data.

2. Initial implementer guidance (eLTSS Informative Document) - balloted by HL7 in September 2018, submitted for publication

The eLTSS Informative document serves as the initial technical guidance for leveraging FHIR and C-CDA Health IT Standards for exchanging eLTSS Dataset data items. It served to introduce LTSS perspectives to the HL7 community and may be used to support electronic piloting efforts by LTSS solution implementers.

The next phase of the project is to develop:

3. eLTSS FHIR Implementation Guide - planned to be balloted in May 2019

The eLTSS FHIR Implementation Guide is under development and is projected to be included in t

Misc Notes
2024 May: TSC approved STU Publication Request for Electronic Long-Term Services and Supports (eLTSS) Release 1 - US Realm for 2 years 2023 June: PSS Updated for STU2 FHIR IG. 2022 May: TSC approved STU Extension Request for Electronic Long-Term Services & Supports (eLTSS), Release 1 - US Realm for 5 years 2022 Jan: TSC approved STU extension request for Electronic Long-Term Services & Supports (eLTSS), Release 1 - US Realm 2019 Jan: TSC approved Informative Publication Request for HL7 Cross-Paradigm Information Sharing for Electronic Long-Term Services and Supports (eLTSS), Release 1. PMO archiving. 2018 October: Updated PSS as follows: Mature the eLTSS Whitepaper into a draft Implementation Guide - Target: By Jan 2019