Health eDecisions (HeD) All Hands Meeting July 11th, 2013.
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Health eDecisions (HeD)All Hands Meeting
July 11th, 2013
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).
From S&I Framework to Participants:Hi everyone: remember to keep your phone on mute
All Panelists
Agenda
Topic Time Allotted
Announcements 5 minutes
Work Stream 1 Update: HL7 Meeting Update
5 minutes
Work Stream 2 Update: Pilots 5 minutes
Work Stream 3: Use Case 2 IG discussion
65 minutes
Wrap up/Questions 10 minutes
Announcements• We submitted the NIB for our UC 2 HL7 Ballot
• We officially have 3.5 weeks until our HL7 Ballot for UC 2 is submitted
Weekly Meeting Schedule
• Stay tuned for additional working meetings to ensure we meet the HL7 Ballot deadline (3.5 weeks and counting….)
Weekday Meeting Time
Monday Pilots (UC 1) 1-2:30 ET
Monday Vocabulary and Terminology 12-1:00 ET
Tuesday CDS-HeD Working Meeting 3:00-4:00 ET
Tuesday Vocabulary and Terminology 4:00-5:00 ET
Wednesday Standards Sub work Group Call 1:00-2:00 ET
Thursday All Community Call 11:00-12:30 ET
HL7 Update • We have completed a working final Draft of the IG – it is being
circulated to the support team once we are finished we will put it out on the wiki for comment and review
• The Vocabulary and Terminology work for UC 1 will now be rolled into a “Master HeD” terminology spreadsheet that will include Data Elements and mappings for all of UC 1 and 2
HeD Pilots Update – WE ARE DONE!!!!!!!!!!!!!!!!• We met this week to review findings• Pilots Update
– CDC and AllScripts–ECA Rule --- DONE– NewMentor and AllScripts – ECA Rule DONE– Zynx and DesignClinicals - Order Set DONE– VA and Wolters Kluwer - Documentation Template DONE
• Please come to our open house to support to see what we have accomplished and the major milestone for the HeD initiative we have just crossed!!! (invite your friends)
HeD Pilots Open House
• We had the first ever S&I and HeD virtual Pilots Open House on Monday July 8th, 2013
• are having a pilots open house July 8th from 1:00-2:00• 165 Participants attended
• Materials and recording posted on HeD Wiki homepage: http://wiki.siframework.org/Health+eDecisions+Homepage
EHR Area of Interest MatchesDesign Clinicals Order Sets Zynx
AllScripts NQF – 068 Million Hearts ECA Rule
NewMentor
AllScripts San Diego Pertussis ECA Rule CDC
VA UTI Documentation Template
Wolters Kluwer
9
Timeline
10/11/2011
We are Here
Goal & Activities EST. Time
Dates Deliverables
Kickoff /Establish Goals & Partnerships: - Review HeD Initiative Goals - Review Piloting Process & Resources - Define Value Statement - Define HeD Pilot Goals & Success Metrics - Establish & Approve Pilots - Develop Pilot Briefs
4 wks.(reality 5 weeks)
1/07-2/25 (we missed 2 meetings in January pushing our Dates back)
-Wiki Capturing Pilot Deliverables-Established Partnerships-Documented Value Statements and Success Metrics-Documented Pilot Briefs
Pilot Configuration: - Establish Pilot Test Environment & Resources - Establish Pilot Implementation & Testing Process - Develop & Review Pilot Configuration
2 wks.(reality- 4
weeks)
2/25-3/25
-Use Case is Updated with HL7 Comments (3/4)-Approved Pilot Briefs -Committed Pilot Resources-Documented & Reviewed Pilot Configuration Guide-Weekly Feedback on Use-Cases & IG Alignment
Pilot Development : - Setup & Develop Pilot Prototypes - Review prototypes
6 wks. or less
depending on Pilot activity
3/25 – 5/6
-Use Case is Updated with HL7 Comments (3/4)-Weekly Pilot Development Status Updates-Weekly Feedback on Use-Cases & IG Alignment-Updates to Pilot Configuration Guides
Pilot Testing & Showcase : - Complete Testing - Prepare Solution Showcase
2wks(In Reality this was closer to 10 weeks
5/6 -5/20 -Weekly Pilot Testing Updates & KPIs-Showcase-Prepare for HL7
Pilot Wrap-up : - Develop Lessons Learned an ONC Feedback - Review Initiative Goal Alignment - Establish Next-Steps
2 wks. 6/10– 6/24 -Documented ONC Feedback- Next Steps Action Plan
Use Case 2
SDS & Harmonization HeD
• Timeline Overview• HeD UC2 vMR Mapping Template Update• Ballot Work Products Update• DSS IG Review
11
12
vMR Extension & Alignment
DSS
HeD UC2 Guidance
Community Review & Ballot Preparations
DSS Update & Profile Development6/4-7/12
Jun ‘13 Jul ‘13 Aug ‘13
Update Mapping with C-CDA/QRDA data elements, cardinality, data type, value
restrictions6/17-7/1
Develop vMR Container/ Payload Profiles 6/19-7/3
Update vMR DAM with Harmonized
Semantics 7/11-7/18
Include vMR templates and mapping in IG
7/26-7/31
Determine Functional
Interaction Type Examples
6/17-6/19
New DSS IG and vMR Template IG
Review & Packaging7/22-8/2
vMR XML IG Review & Packaging 7/22-8/2
Extend vMR for HeD UC27/1-7/18
Develop Mapping Template6/4-6/13
Harmonize vMR with CCDA/QRDA
7/1-7/17
Update Mapping with HeD UC2 data elements,
cardinality6/17-6/28
Today (7/11)
Update Mapping with vMR data elements, cardinality,
data types6/10-6/21 Update Mapping with
vMR/HeD Value restrictions 6/18-6/28
Add DSS profiles to IGalong with place
holders for vMR mapping and vMR profiles
6/26-7/9
Finalize context and section introductions
within IG7/12-7/21
HL7 NIB Prep & Submission
6/25-7/7
HL7 Final Submission Deadline (Aug 4)
HL7 Notification of Intent to Ballot (July 7)
HL7 Initial Content Deadline (July 14)
Incorporate vMR DAM changes
6/28-7/11
Update vMR XML IG 7/12-7/17
Update HeD UC1 IG 7/12-7/17
DSS Update & Profile Review & Packaging 6/25-7/18
vMR XML & HeD UC1 IG Review & Packaging
7/22-8/2vMR DAM & Profile Review & Packaging
7/10-7/25HL7 Initial Content Prep &
Submission7/5-7/14
HeD Use Case 2 Timeline
Key Milestone Dates for September Ballot
Administrative Deadlines:• HL7 Notification of Intent to Ballot (NIB): July 7 – COMPLETE
– 6 NIBs submitted• HL7 Initial Content Deadline: July 14
Content Deadlines:
• HL7 Final Content Deadline: August 4• HL7 Examples Deadline: August 19• HeD Consensus Review Period: August 19 – September 2
– Comments will be received during balloting from August 19 – August 26
– Comments will be vetted by the community
• Submit Comments to HL7 on September 3 13
SDS & Harmonization HeD
• Timeline Overview• HeD UC2 vMR Mapping Template Update• Ballot Work Products Update• DSS IG Review
14
HeD UC2 vMR Mapping
15
Workstream Owner & Resources
Current Status Update & Next Steps
CCDA Mapping
HeD Internal Team
• CCDA mapping is complete n/a
QRDA Mapping
Mark Roche • QRDA mapping is complete n/a
vMR Mapping HeD Internal Team and Vocab and Terminology Work Group
• Business Friendly names populated by support team with some gaps identified
• Update
• Next Steps:• Validate business friendly name population and
confirm gaps with David Shields
HeD UC2 Mapping
Bryn Rhodes and HeD Internal Team
• Initial mapping of clinical data elements complete• Updates to the vMR DAM were completed• Bryn to complete mapping of non-clinical data elements and
changes from vMR DAM• Container and response changes were needed
• Update• In progress
• Next Steps:
Proposed Templates
Dave Shields and HeD Community
• Contains 94 templates• Harmonization began 7/1 and two working sessions were held last
week • Templates were assigned to smaller groups to complete work
offline and working sessions on 7/9 and 7/10
• Update
• Next Steps:• Continue review of Templates• Validate business friendly name population and
confirm gaps with David Shields
HeD UC2 vMR Templates Harmonization
16
Proposed Templates Status Total
0. Not Started 31
1. Drafted 36
2. Initial Review In Process 5
3. Ready for Standards SWG Review 3
4. Complete 21
Grand Total 94
Definition of “Status” Types:0. Not Started – Template has been created, but is blank 1. Drafted – populated with content and ready for assigned team to begin work2. Initial Review in Process – work is being done by the assigned team3. Ready for Standards SWG Review – assigned team has completed work and requests entire SWG review for any feedback4. Complete – ready for incorporation into the vMR IG
Priority:Represents the suggested order for harmonizing the vMR Templates
Priority Total
High 24
Low 48
Complete 21
Deleted 5
Deferred 1
Grand Total 99
Open Discussion
17
• Issue: For the HeD UC2 vMR Mapping Template Mappings Google doc, we need to make sure that the 9 Category tabs (e.g., for Problems, Substance Administration, etc.) have the latest vMR data elements, cardinality, and data types
– Proposed action: Bryn is working on this?
• Issue: We need to decide whether we are going to attempt to provide normative guidance on EVERY data element in the vMR with respect to value restriction, etc. (the notion of creating the “Mega Tab”). Good to have, but we probably need to prioritize given the time pressures
– Proposed action: Focus on those data elements to be included in published Templates first. Work on other data elements later with a goal of complete coverage. This MAY occur before ballot materials are due or it MAY occur after that date (e.g., submitted through ballot comments and reconciliation)
Open Discussion cont.
18
• Issue: We need to decide on the location of the source of truth. (3 potential locations – separate V&T SWG document, the Proposed Templates tab , or the 9 Category tabs
– Proposed action: • All relevant terminology SWG content are moved into the Templates Google Doc in the 9
Category tabs• The primary value set restrictions will be done in the 9 Category tabs (e.g., observation
focus is LOINC code)– This means that the Template development work MUST be synchronized with what
is in the 9 Category tabs. For example, if a template needs to use LOINC, but the Category tab only allows SNOMED CT at the moment, update the Category tab to allow both LOINC and SNOMED CT. This should either be done by one of the V&T SWG members (e.g., Rob, Mark, and David Tao) or it should be discussed with them prior to making the change
– Any initial content provided by Dave S. in the Template’s value restrictions are strictly strawman and intended to be reviewed/edited
• All terminology restrictions in the Proposed Templates must be compatible with the terminology restrictions in the 9 Category tabs (e.g., observation focus is LOINC code, LOINC code for systolic BP, etc.)
• I.e., the value restrictions in the 9 Category tabs MUST be the union/superset of the value restrictions in the Templates tab
SDS & Harmonization HeD
• Timeline Overview• HeD UC2 vMR Mapping Template Update• Ballot Work Products Update• DSS IG Review
19
Ballot Work Products UpdateWork Product
Product Readiness
Owner Current Status Update & Next Steps
Decision Support Service (DSS) IG
Development: Atanu SenPackaging for HL7: Saunya Williams
• Template for IG has been drafted• Support team have included Bryn’s initial content and are
updating introductory sections • Sections remaining:
• SOAP Example – Dave Shields• REST Example – Bryn• Exception Example - Bryn• Semantic Signifier – Bryn • Request & Response Containers – Aziz & Dave Shields • Warning Container – Bryn• Clinical Data Representation – Copy of vMR Templates• Supported Functional Interaction Types – Bryn
• Update
• Next Steps:
vMR Templates IG
Development: Atanu Sen, Ken KawamotoPackaging for HL7: Saunya Williams
• IG outline drafted• Ken drafting write-ups for each section this week (due 7/12)• Templates being drafted now will be copied and pasted into a
designated section of this IG
• Update
• Next Steps:• Receive updated draft
from Ken• Incorporate finalized
templates
Updated DSS Standard
Development: Dave Shields & Bryn RhodesPackaging for HL7: Dave Shields & Ken Kawamoto
• David Shields & Bryn Rhodes conducted initial analysis to identify updates and specified the 7 artifacts/documents that will be submitted as part of this ballot
• This work has been paused while both David & Bryn focus on vMR Templates development
• Update• Next Steps:
• Resume updates after Harmonization is complete
Legend: Not Started; In progress; Ready
Work Product
Product Readiness
Owner Current Status Update & Next Steps
Updated vMR DAM
Development: Aziz Boxwala, Claude Nanjo, & Dave ShieldsPackaging for HL7: Claude Nanjo
• Updates to vMR DAM finalized last week based on UC1 ballot & pilot feedback
• No additional changes to the vMR DAM are planned
• Update• In progress
• Next Steps:
Updated vMR XML IG
Development: Aziz Boxwala, Claude Nanjo, & Dave ShieldsPackaging for HL7: Claude Nanjo
• vMR DAM has been updated based on UC1 updates/feedback• vMR XML files will be automatically regenerated from vMR DAM
• Update• In progress
• Next Steps:
Updated HeD UC1 IG
Development: Aziz Boxwala, Claude Nanjo, & Bryn RhodesPackaging for HL7: Aziz Boxwala &Bryn Rhodes
• vMR DAM has been updated based on UC1 updates/feedback• vMR XML files will be automatically regenerated from vMR DAM
• Update• In progress
• Next Steps:
Ballot Work Products Update
Legend: Not Started; In progress; Ready
SDS & Harmonization HeD
• Timeline Overview• HeD UC2 vMR Mapping Template Update• Ballot Work Products Update• DSS IG Review
22
DSS IG Review
• Review the “Implementation Approach” section of the DSS IG
23
Microsoft Word Document
Next Steps
Weekday Meeting Time Topics Details
July 15th Pilots (UC 1) 1-2:30 ET Review additional Pilot findingsReview IG
http://wiki.siframework.org/Health+eDecisions+Homepag
July 15th Vocabulary and Terminology
12-1:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage
July 16th CDS-HeD Working Meeting
3:00-4:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage
July 16th Vocabulary and Terminology
4:00-5:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage
July 17th Standards Sub work Group Call
1:00-2:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage
July 18th All Community Call
11:00-12:30 ET
http://wiki.siframework.org/Health+eDecisions+Homepage
Questions?
Contact Information
• For questions, please contact your support leads– Coordinator:
• Ken Kawamoto: kensaku.kawamoto@utah.edu
– Co-Coordinators:• Aziz Boxwala: aziz.boxwala@meliorix.com• Bryn Rhodes: bryn@veracitysolutions.com
– ONC Leadership: • Alicia Morton: alicia.morton@hhs.gov
– Project Management:• Jamie Parker: jamie.parker@esacinc.com
– Use Case 2:• Dave Shevlin: d.s.shevlin@accenturefederal.com • Virginia Rhiel: virginia.riehl@verizon.net
– Harmonization: • Lynette Elliot: lynette.elliott@esacinc.com • Anna Langhans: anna.langhans@accenture.com
Useful Links
• Wiki– http://wiki.siframework.org/Health+eDecisions+Homepage
• Use Case 1& 2– http://wiki.siframework.org/Health+eDecisions+Use+Case – UC 2: Use Case 2:
http://wiki.siframework.org/UC+2+-+CDS+Guidance+Service • Pilots
– http://wiki.siframework.org/Health+eDecisions+Pilots • HL7 Ballot Submission:
– http://wiki.siframework.org/Health+eDecisions+Reference+Materials#Ballot • UC 1 Harmonization and IG:
– http://wiki.siframework.org/Health+eDecisions+Harmonization+and+Standards+%28Implementation%29
• HeD Glossary – http://wiki.siframework.org/HeD+Glossary
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