Health eDecisions Initiative – Closing Ceremony March 27, 2014
Health eDecisions (HeD) All Hands Meeting June 27th, 2013.
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Transcript of Health eDecisions (HeD) All Hands Meeting June 27th, 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• July 4th All Hands meeting is canceled
• We are having a pilots open house July 8th from 1:00-2:00
– Chance for the community and other federal partners, business community, vendors and FACA leads to virtually come see what we have accomplished
• Date and Time: July 8, 2013 1:00 pmDial In: +1-650-479-3208Access code: 664 366 291URL:https://siframework1.webex.com/siframework1/onstage/g.php?t=a&d=664366291
• Announcement also on our HeD Wiki homepage: http://wiki.siframework.org/Health+eDecisions+Homepage
Weekly Meeting Schedule
• Stay tuned for additional working meetings to ensure we meet the HL7 Ballot deadline (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 Goal
GoalThe 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
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
Vendor Partners
10/11/2011 10
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
SDS & Harmonization HeD
• Timeline Overview• HeD UC2 vMR Mapping Template Update• DSS Profile Update• vMR Profile Update• Ballot Work Products Update
12
SDS & Harmonization HeD
• Timeline Overview• HeD UC2 vMR Mapping Template Update• DSS Profile Update• vMR Profile Update• Ballot Work Products Update
13
14
HeD Use Case 2 Timeline
vMR Extension & Alignment
DSS
HeD UC2 Guidance
Community Review & Ballot Preparations
DSS Update & Profile Development6/4-6/28
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
6/19-6/28
Update vMR DAM with Harmonized
Semantics 7/11-7/18
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
6/25-7/9vMR XML & HeD UC1 IG Review &
Packaging7/22-8/2
New DSS IG Review & Packaging
7/22-8/2
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
7/1-7/10
Update Mapping with HeD UC2 data elements,
cardinality6/17-6/28
Today (6/27)
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 IG along with place holders for vMR mapping and vMR profiles
6/26-7/11Finalize context and
section introductions within IG7/12-7/21
vMR DAM Review & Packaging
7/12-7/25HL7 NIB Prep & Submission
6/25-7/7HL7 Initial
Content Prep & Submission
7/5-7/14
HL7 Final Submission Deadline (Aug 4)
HL7 Notification of Intent to Ballot (July 7)
HL7 Initial Content Deadline (July 14)
Incorporate vMR DAM changes
6/28-7/10
Update vMR XML IG 7/12-7/19
Update HeD UC1 IG 7/12-7/19
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 15
SDS & Harmonization HeD
• Timeline Overview• HeD UC2 vMR Mapping Template Update• DSS Profile Update• vMR Profile Update• Ballot Work Products Update
16
HeD UC2 vMR Mapping
17
Workstream Owner & Resources
Current Status Update
vMR Mapping HeD Internal Team and Vocab and Terminology Work Group
• Initial mapping complete• Updates to the vMR DAM to be completed on June 27• These changes will be updated in the vMR Mapping Google doc on
June 28
CCDA Mapping
HeD Internal Team
• CCDA mapping is in process• Completed tabs: Problems, Demographics, Observations,
Encounters, Medications and Adverse Events• Looking to have rest complete by June 28th
QRDA Mapping
Mark Roche • QRDA mapping is in process• Looking to have done by 7/1
HeD UC2 vMR Mapping (continued)
18
Workstream Owner & Resources
Current Status Update
HeD UC2 Mapping
Bryn Rhodes and HeD Internal Team
• Initial mapping of clinical data elements complete• Updates to the vMR DAM to be completed on June 27• Bryn to complete mapping of other data elements and changes from
vMR DAM by June 28
Proposed Templates
Dave Shields • Dave Shields has begun populating the proposed template tab with potential templates for each category, and will have complete by June 28th
• Templates for vMR will have one general version that is very broad• Will try to create templates that match CCDA and QRDA.
• Next Step: Each tab will then be populated with these templates and will be used for the actual harmonization beginning 7/1
HeD UC2 vMR Mapping
• Due to dependencies between our vMR mapping and the vMR DAM, a freeze on updates to the vMR DAM will occur on Friday, June 28th
o If updates to the vMR and vocab and terminology are a moving target, the google doc will never be up to date
o With a freeze date, we can ensure that no further updates will be made in the short term, and that the google doc can be synched up with the most recent updates
o These updates will need to be vetted with the CDS WG next week, and Aziz will update harmonization group on any changes
• There is also a dependency between the vMR Mapping document and the Vocab and Terminology documento There are current discussions on which document will be the source or truth
19
vMR Harmonization (continued…)
Below is the suggested strategy for harmonization, which will begin Monday:
• Kick off harmonization meetingso Hold 3 live working sessions a week
o First meeting will be Monday 7/1 at 11:00o Utilize Monday/Tuesday Vocab and Terminology WGo Wednesday SWG, o Complete work offline as needed
o Resource familiar with each standard/work stream should be present at all meetings» vMR – Bryn Rhodes/Dave Shields/Aziz Boxwala/Claude Nanjo» CCDA – David Tao/Elvino Saldanha» QRDA – Mark Roche» Value Restrictions – Victor Lee/Rob McClure/Mark Roche
• Begin harmonization efforts on the Problems tab on Monday 7/1o Option 1: Review tab line by line for updates and then complete harmonization
simultaneouslyo Option 2: Complete all updates first, then begin harmonization
20
SDS & Harmonization HeD
• Timeline Overview• HeD UC2 vMR Mapping Template Update• DSS Profile Update• vMR Profile Update• Ballot Work Products Update
21
DSS Profile Update
22
Task Owner & Resources
Current Status Update
Develop DSS Profile for Request with REST
Bryn Rhodes
• Created WSDL for REST• Working through validation errors• Section defining the RESTful profile for
inclusion in the IG complete
Develop DSS Profile for Response with REST
Bryn Rhodes
• Created WSDL for REST• Working through validation errors• Section defining the RESTful profile for
inclusion in the IG complete
Develop DSS Profile for Request with SOAP
Dave Shields
• Has done initial analysis, should not be big changes
• Tentatively complete by EOW for DSS Profile
Develop DSS Profile for Response with SOAP
Dave Shields
• Has done initial analysis, should not be big changes
• Tentatively complete by EOW for DSS Profile
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)
• Dave Shields has pu t a list together of DSS standard sections and artifacts that need to be updated
• No changes for DSS standards on request transactions
• Updates to DSS standard will be complete by EOW
SDS & Harmonization HeD
• Timeline Overview• HeD UC2 vMR Mapping Template Update• DSS Profile Update• vMR Profile Update• Ballot Work Products Update
23
vMR Profile Update
24
Task Owner & Resources
Current Status Update
Develop vMR Container Profile for Request
Aziz Boxwala/Dave Shields
• Will use UC1 as a reference• There are a number of new data elements needed in
the cdsInput container for the Request
Develop vMR Container Profile for Response
Aziz Boxwala/Dave Shields
• Will use schema for UC1• Significantly constraining this schema• Wrote set of constraints in plan English that can
translate into schematron • Has shared google doc with this information
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
SDS & Harmonization HeD
• Timeline Overview• HeD UC2 vMR Mapping Template Update• DSS Profile Update• vMR Profile Update• Ballot Work Products Update
25
Ballot Work Products Update
26
Work Product Owner Current Status Update
Decision Support Service (DSS) IG
Development: Atanu SenPackaging for HL7: Saunya Williams
• Template for IG has been drafted• DSS Profile for REST has been drafted• DSS Profile for SOAP is in process
Updated DSS Standard
Development: Dave Shields & Bryn RhodesPackaging for HL7: TBD (Ken Kawamoto?)
• David Shields & Bryn Rhodes conducted initial analysis to identify updates
Updated vMR DAM
Development: Aziz Boxwala & Claude NanjoPackaging for HL7: TBD (Ken Kawamoto?)
• Finalizing updates to vMR DAM that were previously identified
• Harmonization may result in further updates to vMR DAM
Updated vMR XML IG
Development: Aziz Boxwala & Claude NanjoPackaging for HL7: TBD (Ken Kawamoto?)
• Once vMR DAM updates finalized the updates to vMR XML schemas can begin
Updated HeD UC1 IG
Development: Aziz Boxwala & Claude NanjoPackaging for HL7: TBD (Ken Kawamoto?)
• Once vMR DAM updates finalized the updates to HeD UC1 IG can begin
• Next step to determine if updates to HeD UC1 IG are necessary based on Pilots
Next Steps
Weekday Meeting Time Topics Details
July 1st Pilots (UC 1) 1-2:30 ET Review additional Pilot findingsReview IG
http://wiki.siframework.org/Health+eDecisions+Homepag
July 1st Vocabulary and Terminology
12-1:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage
July 2nd CDS-HeD Working Meeting
3:00-4:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage
July 2nd Vocabulary and Terminology
4:00-5:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage
July 3rd Standards Sub work Group Call
1:00-2:00 ET http://wiki.siframework.org/Health+eDecisions+Homepage
July 4th All Community Call
11:00-12:30 ET
http://wiki.siframework.org/Health+eDecisions+HomepageCanceled!!
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