Health eDecisions (HeD) All Hands Meeting July 11th, 2013.

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: [email protected]

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

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

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

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

– Harmonization: • Lynette Elliot: [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