Laboratory Orders Interface (LOI) Initiative Kickoff 3/30/2012.

Laboratory Orders Interface (LOI)

Initiative Kickoff3/30/2012

Agenda for Pre-Discovery Prep

• Introductions• S&I Framework Overview• LOI Introduction

• Initiative Summary• Background• Target Goals & Outcomes• Scope• Timeline

• F2F Overview• Next Steps

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Standards & Interoperability (S&I) Framework

The Standards and Interoperability (S&I) Framework is an open and transparent forum sponsored by the Office of Standards & Interoperability (OSI) to fulfill its charge of enabling harmonized specifications in support of national healthcare priorities. These efforts are carried out in the form of targeted Initiatives based on the healthcare priorities set forth by OSI to achieve lasting results and delivery improvements.

LOI Initiative Summary

• The Laboratory Orders Interface (LOI) Initiative is focused on the creation of an Implementation Guide (IG) that builds on the architecture and design of the California HealthCare Foundation’s (CHCF) ELINCS Laboratory Orders and the Health Level Seven (HL7) Version 2.5.1 Implementation Guide: Laboratory Results Interface for US Realm, Release 1 (LRI IG).

• The goal of the initiative is an IG for electronic ordering of laboratory tests in an ambulatory setting that can serve as a foundation for eventual use in in-patient and public health settings. Further, the design will incorporate vocabulary consistent with the above mentioned guides as well as support for use of the Electronic Directory of Service (eDOS) IG.

Background & Tiger Team

• The LOI Initiative will leverage existing California HealthCare Foundation (CHCF) work to develop an ambulatory laboratory order Implementation Guide (IG)

• CHCF and the Office of the National Coordinator for Health IT (ONC) have discussed how to align the CHCF ELINCS Orders effort with the Standards & Interoperability (S&I) Framework goal of producing a Health Level Seven (HL7) balloted IG that would complement the Laboratory Results Interface (LRI) IG

• Through the formation of a Tiger Team, key stakeholders have taken several initial steps to queue up this Initiative – The Tiger Team consists of Corey Spears, Glen Moy, Walter

Sujansky, Bob Dieterle, Ken McCaslin, Bob Yencha, Hans Buitendijk, Austin Kreisler and Sam Faus

Background & Tiger Team• The Tiger Team met on January 25 – January 26 to discuss the overall

approach, key activities, requirements & supported needed for an HL7 DSTU process, workgroup structure/leadership and timelines to develop the LOI work products within the S&I Framework.– Several follow up meetings have occurred to prepare for the launch of the

Initiative

• The Tiger Team will continue to meet over the next several weeks to help prepare the work products for the larger community’s review and approval

• As part of these efforts, the Tiger Team will conduct an initial analysis and produce the following initial work products: – Use Case Translation/Validation– Draft LOI IG Aligning ELINCs Orders and the LRI IG– Vocabulary Review

• Once the initial analysis is complete the Tiger Team will no longer meet on a regular basis

LOI Target Goals & Outcome

• Goal: To develop an IG that, when broadly adopted by clinical laboratories and ambulatory EHR systems, will obviate the requirement to define a new specification each time an EHR system-LIS orders interface is implemented.

• Stretch Goal/Consideration: To pursue an approach that enables expansion to consistently support laboratory orders for the acute care and Public Health settings. Note that in the future multiple message structures may be required to support this. This guide does not intend to define the complete framework in the first phase.

• Outcome: A laboratory orders interface IG designed to serve as a companion document to the LRI IG.

LOI Scope

• Develop an IG to support electronic laboratory ordering between an EHR System and a LIS in an ambulatory care setting.

• In Scope– Development of an Orders IG that aligns with the LRI IG and

ELINCS Laboratory Orders IG– Incorporation of support for the adoption and use of the Test

Compendium Framework, i.e., eDOS• Out of Scope

– Non-US laboratory ordering use cases– Referral orders placed between laboratories– Laboratory orders in the acute setting (EHR System to LIS all

within the hospital)

S&I Framework Phases & LOI Activities

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Phase Planned Activities Pre-Discovery Development of Initiative Synopsis

Development of Initiative Charter Definition of Goals & Initiative Outcomes

Discovery Creation/Validation of Use Cases, User Stories & Functional Requirements Identification of interoperability gaps, barriers, obstacles and costs Review of Vocabulary

Implementation Creation of aligned specification Documentation of relevant specifications and reference implementations such as

guides, design documents, etc. Validation of Vocabulary Development of testing tools and reference implementation tools

Pilot Validation of aligned specifications, testing tools, and reference implementation tools Revision of documentation and tools

Evaluation Measurement of initiative success against goals and outcomes Identification of best practices and lessons learned from pilots for wider scale

deployment Identification of hard and soft policy tools that could be considered for wider scale

deployments

LOI Timeline

Key

Kick-off (3/30)

Discovery

F2F (4/11 – 4/13)

Today (3/30)

Implementation

Vocabulary Review

Pilot Testing

Reference Implementation & Validation

Assessment of RI and Pilot Outcomes

Mar Apr May Jun Jul Aug Sep Oct

IG Ready for Ballot 8/31

Creation/Validation Use Case & FR

Initial LOI – LRI Alignment/ Development of DRAFT LOI IG

Vocabulary Validation

LOI Validation

Tiger Team/Support ActivitiesCommunity ActivitiesHL7 ActivitiesCHCF/ELINCS Orders Pilot ParticipantseDOS Sub Workgroup

HL7 Ballot Cycle

Pilot & Evaluation

Documentation & Incorporation ELINCS Orders Lessons Learned/Key Findings from Pilot Participants

eDOS Alignment

Aligned Specification

Testing & RI Tool Development

Pre Discovery

LOI Timeline

LOI Upcoming Activities

April 2012

• Achieve consensus on Initiative Charter (Community)

• F2F Meeting (Community & Tiger Team)• Validate preliminary Use Case and Vocabulary

work products (Tiger Team)• Achieve consensus on the Use Case and

Vocabulary work products (Community)

• Develop initial LOI IG draft based on the ELINCS Orders v 1.0 (Tiger Team)

F2F Basic Information• Dates: Wednesday, April 11– Friday, April 13• Alexandria Westin:

– Address: 400 Courthouse Square, Alexandria, VA, 22314– Phone: 703-253-8600     – Website: www.westin.com/alexandria– Public Transportation:

• King Street Metro (Blue/Yellow Lines) – 3 Blocks• Ronald Reagan Airport (DCA) – 6 miles

• Booking Accommodations:– See F2F Logistics page on wiki for details– Phone: 1-866-837-4210– Rate: $169/night (excluding tax)

• This rate is only available through 5pm ET on April 2• Group rate includes free wireless in all guest rooms

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F2F LOI Meeting Agenda

F2F Next Steps for Community Members

• Reserve guest rooms at Westin and make travel plans– On Wednesday, April 11 Workgroup Leads Meeting starts at 9:00am, All-

Hands Kickoff Session starts at 1:00pm– Event concludes at 3:00pm on Friday, April 13– Information on booking the hotel is available on the Logistics page

• F2F Registration is now open– Use the Registration page to indicate whether you are attending or not– Registration form allows you to select which specific workgroup sessions you

will attend

• F2F is entirely in person – no phones or WebExs will be provided. Notes will be taken during breakout sessions and posted to the wiki as soon as possible after sessions are over.

• You must register for the meeting sessions and book your room at the Westin by 5pm ET on Monday, April 2

14For more information, visit the F2F Wiki or email the F2F planning committee at [email protected].

Next Steps

• Review Initiative Charter prior to 4/6 Work Group meeting (link)• Sign up for the S& Framework F2F by 4/2 (link)• The next LOI Work Group meeting will be held on April 6 from 1:00

– 2:00 PM EST

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