Health eDecisions (HeD) All Hands Meeting

Health eDecisions (HeD)All Hands Meeting

April 18th, 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 minutesWork Stream 1 Update: HL7 Meeting Update 5 minutes

Work Stream 2 Update: Pilots 5 minutes

Work Stream 3: Use Case 2 65 minutes

Next Steps 5 minutes

Wrap up/Questions 5 minutes

Announcements• Vocabulary and Terminologies sub work will be meeting this

week – Friday 12:30-1:30 EDT– http://wiki.siframework.org/Health+eDecisions+Homepage

• We will be presenting the work of HeD at an AMIA webinar– June 6th from 1-2 pm EST (please watch the “Announcements”

section of our wiki homepage for details on how to participate• May HL7 Meeting May 5-10th

– http://www.hl7.org/events/wgm052013/ – HeD will have no formal meetings– There will be discussion on the vMR

HL7 Update • We have completed a rough draft of the Implementation Guide

– http://wiki.siframework.org/HeD+Pilot+Tools • The Vocabulary and Terminology IG is also complete and will be

incorporated into our IG.– To view and comment on the work of the Vocab and Terminology

team please see the pilots tool page: http://wiki.siframework.org/HeD+Pilot+Tools

• Plans: – We are postponing our HeD/CDS meetings but will resume as

needed during Pilots http://wiki.siframework.org/Health+eDecisions+Homepage )

HeD Pilots Update• We met this week

– CDC gave a brief description of their pilot• San Diego Pertussis pilot (ECA rule written in HQMF being

transformed into the HeD schema)– Bryn gave some additional training on the HeD Schema

Framework tool• NewMentor, AllScripts and Bryn are working on getting an NQF

rule translated• Zynx is working with DesignClinicals on an Order Set• CDC and Aziz are working to translate the HQMF rule into HeD

schema• VA is now agreed to pilot a Documentation Template

HeD Pilots Goal Goal

The goal of this initiative is to produce, consume and where feasible, execute implementable CDS interventions.1. Event Condition Action Rules (ECA Rules)2. Order Sets3. Documentation Templates

Pilot Scope4. Health eDecisions will apply defined aspects of the Implementation Guide in a real-

world setting.5. Modify the Implementation Guide to ensure it is usable

a. Provide explicit feedback to other sub-working groups (i.e. the vMR and the Terminology and Value Sets SWGs).

6. The real-world pilots evaluate not only the technology, standards and model (VMR), but also provide a test bed to evaluate the interaction of technology, implementation support, and operational infrastructure required to meet Health eDecisions use case 1 objectives at the stakeholder or organization levels.

7. Demonstrate intent of artifact (specifically structures and semantics) are communicated either by direct execution or by translation to native format

8. Ensure completeness and consumability of artifact

8

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 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. 5/20 – 6/3 -Documented ONC Feedback- Next Steps Action Plan

Vendor Partners

10/11/2011 9

EHR Area of Interest Potential or Actual Match

Design Clinicals Order Sets Zynx

AllScripts ECA Rules –NQMF Rule (for Ambulatory Setting)

NewMentor (have catalog for rules in ambulatory setting)

Practice Fusion Anything MU centered

CDC (also may need Artifact supplier to help) Wolters Kluwer NewMentor (MU rule as example)

Success EHS

Next Gen Considering other rules that are a better fit

CDC

HeD Use Case 2

FUTU

RE T

OPI

CSIN

SCO

PECDS Guidance Requestor

CDS Response (guidance and/or other response elements)

CDS Guidance Supplier

CDS Request (patient data and potentially context)

Query for Available Guidance

List of Available Guidance

Query for Metadata for Specific Clinical Guidance

Metadata for Clinical Guidance, e.g. Data Requirements

• Interface Definitions for Sending Patient Data & CDS Guidance• Patient Data Input and Clinical Context to Service• Format of the CDS Guidance (output from CDS service) • Requirements to Support Service Transactions, Transport &

Security• Stateless Transactions• Format of the request

IN S

COPE

• Workflow Integration• User Presentation• Direct Interaction with the

User• How the Guidance

Integrator will utilize the information

• Deciding what guidance is subscribed to

OUT OF SCOPE • Authoring, Creation and Maintenance of Clinical Decision Support Knowledge

• Internal workings of the CDS services supplier

OUT OF SCOPE

Initiating System

(describes action)

Information Interchange

Requirement Name

Transportation and Security Standards

Service and Payloads Standards

Vocabulary and Code Sets Standards

(describes action) Ending System

CDS Guidance Requestor’s System (e.g., Clinical Workflow System)

Sends CDS Request (Patient Data and Potentially Contextual Information)

SAMLSOAPTLSREST

Context Aware Retrieval Application (Infobutton)HL7 v2.xDecision Support Service (DSS)Virtual Medical Record (vMR)C32 - Summary Documents Using HL7 Continuity of Care Document (CCD) ComponentContinuity of Care Document (CCD)CDA R2Arden Syntax for Medical Logic SystemsCDS Knowledge Artifact Implementation Guide (HeD UC1 IG)HL7 v3Arden Markup LanguageConsolidated CDAFederal Health Information Model (FHIM)HL7 Version 3 Standard: Order Set Publication, Release 1

LOINCSNOMED CTCVXManufacturers of Vaccines (MVX)OIDRxNormICD-9-CM and ICD-10-CMHCPCSC80 - Clinical Document and Message Terminology Component NQF Value SetsICD-10-PCSUCUMCPTC154NDCFDA Route AdministrationHL7 Vocabulary

Receives CDS Service

CDS Service Sends CDS Response (Clinical Guidance and/or Other Response Elements)

SAMLSOAPTLSREST

Context Aware Retrieval Application (Infobutton)HL7 v2.xDecision Support Service (DSS)Virtual Medical Record (vMR)C32 - Summary Documents Using HL7 Continuity of Care Document (CCD) ComponentContinuity of Care Document (CCD)CDA R2Arden Syntax for Medical Logic SystemsCDS Knowledge Artifact Implementation Guide (HeD UC1 IG)HL7 v3Arden Markup LanguageConsolidated CDAFederal Health Information Model (FHIM)HL7 Version 3 Standard: Order Set Publication, Release 1

LOINCSNOMED CTCVXManufacturers of Vaccines (MVX)OIDRxNormICD-9-CM and ICD-10-CMHCPCSC80 - Clinical Document and Message Terminology Component NQF Value SetsICD-10-PCSUCUMCPTC154NDCFDA Route AdministrationHL7 Vocabulary

Receives CDS Guidance Requestor’s System (e.g., Clinical Workflow System)

• Work Stream 1 – HL7:– Next HL7 meeting TBD– (see HeD Homepage wiki for meeting details: http://wiki.siframework.org/Health+eDecisions+Homepage

• Work Stream 2 – Pilots:– We are beginning the work of pilots– Next Pilots meeting: April 22nd, 1-2:30 pm EDT see HeD home page wiki

for meeting details: http://wiki.siframework.org/Health+eDecisions+Homepage – Updates on Pilot Activities, Review of Timelines

• Work Stream 3 – Use Case 2:– Data Elements and Standards Sub Work Group

• Next Meeting: April 24th, 20132• Homepage wiki for meetings:

http://wiki.siframework.org/Health+eDecisions+Homepage • All Hands Community Meeting

– We will reviewing candidate standards – Next meeting April 25th, 11-12:30 EDT (see the HeD Homepage wiki

for meeting details: http://wiki.siframework.org/Health+eDecisions+Homepage

Next Steps

Questions?

Contact Information• For questions, please contact your support leads

– Coordinator: • Ken Kawamoto: [email protected]

– Co-Coordinators:• Aziz Boxwala: [email protected]• Bryn Rhodes: [email protected]

– ONC Leadership: • Alicia Morton: [email protected]

– Project Management:• Jamie Parker: [email protected] • Christina Arenas: [email protected]

– Use Case 2:• Dave Shevlin: [email protected] • Virginia Riehl: [email protected]

– Harmonization: • Lynette Elliott: [email protected] • Anna Langhans: [email protected]

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