Health eDecisions (HeD) All Hands Meeting June 20th, 2013.

Health eDecisions (HeD)All Hands Meeting

June 20th, 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 minutesWork Stream 3: Use Case 2 IG discussion 65 minutes

Wrap up/Questions 10 minutes

Announcements• We are planning a pilots open house July 8th from 1-2:30

– Chance for the community and other federal partners, business community, vendors and FACA leads to virtually come see what we have accomplished

• HeD Meetings (By Day)

Weekday Meeting Time

Monday Pilots (UC 1) 1-2:30 ET

Monday Vocabulary and Terminolgy 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 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

• We are now meeting on Tuesdays from 3-4 pm to discuss HL7 topics for both UC 1 and UC 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

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 6. Submission of explicit feedback to sub workgroups such as vMR and Vocabulary

and Terminology work group to close gaps7. 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.

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

9. Ensure completeness and consumability of artifact

New

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(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

Vendor Partners

10/11/2011 9

EHR Area of Interest Matches

Design 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

Use Case 2

SDS & Harmonization HeD Agenda• Timeline Overview• HeD UC2 vMR Mapping Update• Functional Interaction Types• DSS Profile Update• vMR Profile Update

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SDS & Harmonization HeD Agenda• Timeline Overview• HeD UC2 vMR Mapping Update• Functional Interaction Types• DSS Profile Update• vMR Profile Update

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13

HeD Use Case 2 Timeline

vMR Extension & Alignment

DSS

HeD UC2 Guidance

Community Review & Ballot Preparations

DSS Update & Profile Development6/4-6/25

Jun ‘13 Jul ‘13 Aug ‘13

Update Mapping with vMR data elements, cardinality,

data types6/10-6/21

Update Mapping with C-CDA/QRDA data elements, cardinality, data type,

value restrictions6/17-7/1

Update vMR XML IG

7/12-7/19

Develop vMR Container/Payload Profiles

6/19-6/28

Update vMR DAM with Semantics 7/1-7/18

Include vMR templates and

mapping in DSS IG 7/12-7/22

Determine Functional

Interaction Type Examples

6/17-6/19

DSS Update & Profile Review & Packaging

6/25-7/9

vMR XML HeD UC1 IG Review &

Packaging7/22-8/2

New DSS IG Review & Packaging

7/22-8/2

vMR DAM Review & Packaging

7/12-7/25

vMR XML IG Review & Packaging

7/22-8/2

Extend vMR for HeD UC27/1-7/18

Update HeD UC1 IG

7/12-7/19

Update Mapping with vMR/HeD

Value restrictions 6/18-6/26Develop Mapping

Template6/4-6/13

Harmonize vMR with CCDA/QRDA

6/26-7/10

Update Mapping with HeD UC2 data elements,

cardinality6/17-6/25

Today (6/20)

Key Milestone Dates for September BallotAdministrative Deadlines:• HL7 Notification of Intent to Ballot: July 7• HL7 Initial Content Deadline: July 14

Content Deadlines:• End-to-End Review Period:

– Initial DSS Update & Profile Review & Packaging : 6/25 – 7/9– Initial vMR DAM Review & Packaging: 7/12 – 7/25– Initial vMR XML IG Review & Packaging : 7/22 – 8/2– Initial vMR XML HeD UC1 IG Review & Packaging: 7/22 – 8/2– New DSS IG Review & Packaging: 7/22 – 8/2

• There will be end to end reviews of each section as they are completed at earlier dates

• HL7 Final Content Deadline: August 4• HL7 Examples Deadline: August 19• HL7 Final Content Deadline: August 4• 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 14

SDS & Harmonization HeD Agenda• Timeline Overview• HeD UC2 vMR Mapping Update• Functional Interaction Types• DSS Profile Update• vMR Profile Update

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HeD UC2 vMR Mapping

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Workstream Owner & Resources Current Status Update

vMR Mapping HeD Internal Team and Vocab and Terminology Work Group

• Data Elements, Cardinality, and Data Types have been populated and need to be reviewed

• HeD/vMR Value restrictions are being reviewed for quality and accuracy

• Victor Lee is populating the “HeD/vMR Value Restriction” columns

CCDA Mapping HeD Internal Team • CCDA mapping has begun.• Problems, Demographics, and Encounters tab are near completion• Looking to have complete early next week

QRDA Mapping Mark Roche • QRDA mapping has begun• Wil receive update next week

HeD UC2 Mapping Bryn Rhodes and HeD Internal Team

• Bryn Rhodes has done an initial mapping of vMR data elements to HeD UC2 clinical data elements.

• Bryn will complete mapping for rest of the HeD UC2 data elements• Once this is complete, we can start identifying how the vMR needs

to be extended to meet requirements for UC2• Internal team has begun mapping each tab and master tab based

on Bryn’s spreadsheet

Proposed Templates

Dave Shields • Dave Shields has begun populating the proposed template tab with potential templates for each category

• Each tab will then be populated with these templates• This is where the actual harmonization effort will take place• This effort could begin on individual tabs as the mapping those

categories are completed

SDS & Harmonization HeD Agenda• Timeline Overview• HeD UC2 vMR Mapping Update• Functional Interaction Types• DSS Profile Update• vMR Profile Update

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Potential Functional Interaction Types1. Disease Management 2. Drug Dosing Calculation3. Immunization Forecasting4. Quality Measure Evaluation5. Transition of Care Support6. Prediction Rule Evaluation – APACHE score, AHRQ Pneumonia Severity Index, etc.7. Severity of Illness Assessment – Charlson index, etc.

Talking points from Pilots discussion on functional interaction types:• Questions Asked:

– Which functional interaction types best align with current pilot efforts? – Which types would be the most straight forward to test? – Which types would best validate the HeD UC2 solution, or be the most widely used in the industry?

• Feedback:– The top three are “safe” examples – they are aligned with UC2 scope, could leverage UC1 pilots and

would be easy to test/validate, but they aren’t innovative– Quality Measure Evaluation and Transition of Care Support would be more innovative – they aren’t

currently physician-driven activities, but could be by leveraging a CDS-like system

• How do we want to include Quality Measure Evaluation and Transition of Care Support given that they don’t align directly with UC2 scope?

SDS & Harmonization HeD Agenda• Timeline Overview• HeD UC2 vMR Mapping Update• Functional Interaction Types• DSS Profile Update• vMR Profile Update

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DSS Profile Update

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Task Owner & Resources Update

Develop DSS Profile for Request with REST Bryn Rhodes

Develop DSS Profile for Response with REST Bryn Rhodes

Develop DSS Profile for Request with SOAP Dave Shields

Develop DSS Profile for Response with SOAP

Dave Shields

Update DSS Standard with REST guidance, including modifications to the standard itself (as necessary) and guidance on use of REST for general use cases (not HeD UC2-specific)

Bryn Rhodes/Dave Shields (as needed)

SDS & Harmonization HeD Agenda• Timeline Overview• HeD UC2 vMR Mapping Update• Functional Interaction Types• DSS Profile Update• vMR Profile Update

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vMR Profile Update

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Task Owner & Resources Update

Develop vMR Container Profile for Request Aziz Boxwala/Dave Shields

Develop vMR Container Profile for Response Aziz Boxwala/Dave Shields

Develop vMR Request Payload Profile for specific functional profile interaction types

Dave Shields/Claude Nanjo/ Victor Lee/Bryn Rhodes

Develop HeD S/vMR Response Payload Profile for specific functional profile interaction types

Dave Shields/Claude Nanjo/ Victor Lee/Bryn Rhodes

Next StepsWeekday Meeting Time Topics DetailsJune 24th Pilots (UC 1) 1-2:30 ET Review additional

Pilot findingsReview IG

http://wiki.siframework.org/Health+eDecisions+Homepag

June 24th Vocabulary and Terminology

12-1:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage

June 25th CDS-HeD Working Meeting

3:00-4:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage

June 25th Vocabulary and Terminology

4:00-5:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage

June 26th Standards Sub work Group Call

1:00-2:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage

June 27th 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