Joyce Sensmeier MS, RN, BC, CPHIMS, FHIMSS HIMSS Vice President Informatics August 25, 2006...
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Transcript of Joyce Sensmeier MS, RN, BC, CPHIMS, FHIMSS HIMSS Vice President Informatics August 25, 2006...
Joyce Sensmeier MS, RN, BC, CPHIMS, FHIMSSHIMSS Vice President Informatics
August 25, 2006
Healthcare Information Technology Standards Panel (HITSP) Overview
HIMSS Advocacy & Public Policy Steering Committee
2
The purpose of this presentation is to orient the Committee by providing. . .
Information about the formation of HITSP
An overview of the HITSP Harmonization Process
Schedule and next steps
3
In 2005, HHS awarded contracts to seed a public-private effort to build a national health information network
4
A public-private “Community” was then established to serve as the focal point for America’s health information concerns and drive opportunities for increasing interoperability
Healthcare Information Technology
Standards Panel (HITSP)
National Health Information
Network (NHIN) Architecture
Projects
The Health Information Security and
Privacy Collaboration
(HISPC)
The Certification Commission for
Health Information Technology
(CCHIT)
American Health
Information Community
The Community is a federally-chartered commission and will provide input and
recommendations to HHS on how to make health records digital and interoperable, and assure that
the privacy and security of those records are protected, in a smooth, market-led way.
The Community is a federally-chartered commission and will provide input and
recommendations to HHS on how to make health records digital and interoperable, and assure that
the privacy and security of those records are protected, in a smooth, market-led way.
HITSP includes 206 different member organizations and is administered by
a Board of Directors17 SDOs (8%)
161 Non-SDOs (79%) 18 Govt. bodies (8%)
10 Consumer groups (5%)
HITSP includes 206 different member organizations and is administered by
a Board of Directors17 SDOs (8%)
161 Non-SDOs (79%) 18 Govt. bodies (8%)
10 Consumer groups (5%)
5
The Community formed workgroups to focus on four breakthrough areas
Biosurveillance -- Transmit essential ambulatory care and emergency department visit, utilization, and lab result data from electronically enabled health care delivery and public health systems in standardized and anonymized format to authorized public health agencies with less than one day lag time.
Consumer Empowerment -- Deploy to targeted populations a pre-populated, consumer-directed and secure electronic registration summary. Deploy a widely available pre-populated medication history linked to the registration summary.
Electronic Health Record Exchange -- Deploy standardized, widely available, secure solutions for accessing laboratory results and interpretations in a patient-centric manner for clinical care by authorized parties.
Chronic Care – Ensure that widespread use of secure messaging, as appropriate, is fostered as a means of communication between clinicians and patients about care delivery
HITSP Focus
6
The HITSP team was charged with completing eleven different tasks, with current efforts focused on the harmonization process
The CommunityHHS Secretary
Mike Leavitt, Chair
Project Management TeamExecutive in Charge, F. Schrotter, ANSI
Program Manager, L. Jones GSIDeputy PM, J Corley, ATI
Project Manager, C Fantaskey, Booz Allen
Project Management TeamExecutive in Charge, F. Schrotter, ANSI
Program Manager, L. Jones GSIDeputy PM, J Corley, ATI
Project Manager, C Fantaskey, Booz Allen
Harmonization Process Delivery
Technical Manager
Joyce Sensmeier, HIMSS
Harmonization Process Delivery
Technical Manager
Joyce Sensmeier, HIMSS
Harmonization Process Definition
Technical Manager
Michelle Deane, ANSI
Harmonization Process Definition
Technical Manager
Michelle Deane, ANSI
HHS ONCHIT1 PO, Dr. John Loonsk
HHS ONCHIT1 PO, Dr. John Loonsk HITSP
Dr. John Halamka, ChairMember populated
Technical Committees
Eleven Tasks are included in this contract:
1. Comprehensive Work Plan
2. Conduct a Project Start Up Meeting
3. Deliver Recommended Use-Cases
4. Participate in related meetings and activities, including the AHIC Meetings
5. Develop a Gap Analysis
6. Standards Selection, Evaluations and Testing
7. Define a Harmonization Approach
8. Develop Interoperability Specifications
9. Develop and Evaluate a Business Plan for the self-sustaining processes
10. Submit Monthly Reports – ongoing efforts
11. Assist with communications – ongoing efforts
7
The HITSP process is an open, inclusive, and collaborative process
The Community selects breakthrough areas to be worked across ONC contracts
The HITSP then charters Technical Committees to address each break through
– Identify a pool of standards for a general breakthrough area
– Identify gaps and overlaps for a specific context,
– Make recommendations to the HITSP for resolution of gaps and overlaps
– Develop instructions for using the selected standard for a specific context
– Test the interoperability specifications for using the standard
A call for participation is announced to all HITSP members
8
HITSP Technical Committees Overview
•Biosurveillance
•63 members
Transmit essential ambulatory care and emergency department visit, utilization, and lab result data from electronically enabled health care delivery and public health systems in standardized and anonymized format to authorized Public Health Agencies with less than one day lag time.
Floyd P. Eisenberg, MD MPH, SIEMENS Medical Solutions Health Services
Peter L. Elkin MD FACP, Mayo Clinic College of Medicine
Shaun Grannis, MD, The Regenstrief Institute, Indiana University School of Medicine
•Consumer Empowerment
•61 members
Allow consumers to establish and manage permissions access rights and informed consent for authorized and secure exchange, viewing, and querying of their linked patient registration summaries and medication histories between designated caregivers and other health professionals.
Elaine A. Blechman PhD, Professor, Univ. of Colorado-Boulder
Charles Parisot, EHR Vendor Association
•Electronic Health Record
•77 members
Allow ordering clinicians to electronically access laboratory results, and allow non-ordering authorized clinicians to electronically access historical and other laboratory results for clinical care.
Jamie Ferguson, Kaiser- Permanente
John Madden, MD, PhD, SNOMED Intl
Steve Wagner, Department of Veterans Affairs
9
The standards required to support each major Use Case event were organized within an agreed upon standards taxonomy.
The standards selected for inclusion in the pool were examined using ‘HITSP approved’ Tier 1 & Tier 2 Harmonization Readiness Criteria.
Tier 1 Readiness Criteria
10
Tier 2 Readiness Criteria•Suitability
- the standard is named at a proper level of specificity and meets technical and business criteria of use case
•Compatibility - the standard shares common context, information exchange structures, content or data elements, security and processes with other HITSP harmonized standards or adopted frameworks as appropriate
•Preferred Standards Characteristics- approved standards, widely used, readily available, technology neutral, supporting uniformity, demonstrating flexibility and international usage are preferred
•Standards Development Organization and Process- meet selected criteria including balance, transparency, developer due process, stewardship and others.
•Total Costs and Ease of Implementation
11
Current Work Technical Committees assigned to harmonize
standards that support the Community’s breakthroughs– Biosurveillance– Consumer Empowerment– Electronic Health Record exchange
Status of work productsUse Cases documented Gap and Overlap Analysis completed Standards Selection completed Interoperability Specifications – In Progress –
due Sept 29th
12
The purpose of this presentation is to orient the Committee by providing. . .
Information about the formation of HITSP
An overview of the HITSP Harmonization Process
Schedule and next steps
13
I
Harmonization Request
Harmonization Process Steps
II
RequirementsAnalysis
III
Identificationof Candidate
Standards
IV
Gaps,Duplications
and Overlaps
Resolution
V
Standards Selection
VI
Constructionof
InteroperabilitySpecification
VII
InspectionTest
VIII
InteroperabilitySpecification
Releaseand
Dissemination
IXProgram Management
BeginSupport
ReceiveRequest
The actual harmonization process is a series of steps taken by industry stakeholders within the context of HITSP
14
HITSP FrameworkBasis for Interoperability Specification Development
HITSP receives Use Cases and Harmonization Requests from external sources, such as AHIC and ONC.
The Use Case or Request defines scenarios, business actors, and business and functional/interoperability requirements.
HITSP decomposes the Use Case requirements into scenario(s) and then into transactions providing context: technical actors, actions and content. It may create or reuse a transaction or a grouping of transactions (transaction package) based on commonality at this level.
Transactions are logical groupings of actions that are decomposed into components, which are groupings of base standards that work together, such as message and terminology.
15
HITSP FrameworkBasis for Interoperability Specification Development
Each HITSP construct, i.e., transaction package, transaction or component, may constrain the construct or standard below it. Constraints follow a strict hierarchy and are only imposed by the next higher construct.
Transaction packages, transactions and components all are potential candidates for reuse if a new set of requirements and context are successful fulfilled by the existing construct.
While reuse is a HITSP goal, it is established in the context of a use case and its functional/interoperability requirements. The first objective for September is meeting Use Case functional/interoperability requirements.
HITSP constructs are version controlled and, if reused, will be uniquely identified.
16
Use Case/Modification Request
Interoperability Specification
Transaction1… n components or composite standards
Component1... n base standards or composite standard
Base Standard
#1
Base Standard
#2
Base Standard
#3
Transaction Package1…n transactions or composite
standards
Package (Composite)
Standard
Component (Composite)
Standard
Transaction(Composite)
Standard
Pot
entia
l for
Reu
se in
Oth
er C
onte
xt
Defines and N
arrow
s Context
Policy Makers and Industry
Base Standard
#4
HITSP
Base Standard
#6
Base Standard
#7
Base Standard
#8
Base Standard
#9
Base Standard
#5
HITSP Framework
17
Level Definition Example Rules
Use Case or Harmonization Request
Defines business/functional requirements
Sets Context
ONC Harmonized EHR Use Case
Interoperability Specification
Models business/ functional/ interoperability requirements
Identifies technical/system requirements to meet use-case
Identifies how to use one or more HITSP constructs to meet use-case requirements
HITSP EHR Interoperability Specification
Based on UML diagram to identify technical actors and actions
Sets context Testable functional requirements Ids transactions or transaction packages
Transaction Package
Defines how two or more transactions are used to support a stand-alone information interchange within a defined context between two or more systems
Record Locator Service
Entity Identification Service
Thin context and interoperability requirements
Testable Based on analysis of like technical actors,
context and content harmonized across transactions
May be fulfilled by one or more transactions or composite standard
Expresses constraints on the transactions or composite standard
Transaction Logical grouping of actions, including necessary content and context, that must all succeed or fail as a group.
Query lab result Send lab result
Fulfills all actions between two or more systems needed to meet one or more interoperability requirements
Testable May be fulfilled by components or
composite standard Expresses constraints on components or
composite standard
HITSP Framework Definitions and Rules
18
HITSP Framework Definitions and Rules (cont.)
Level Definition Example Rules
Component An atomic construct used to support an information interchange or to meet an infrastructure requirement (e.g., security, logging/audit)
Lab result message
Lab result context
Typically will use one “primary” standard and may have other “secondary” standards
Expresses constraints on base or composite standards
Base Standard A standard capable of fulfilling a discrete function within a single category produced and maintained by a single standards organization.
Messaging standard
Security standard Code set.
Per HITSP definition the term “standard” refers, but is not limited to,:
– Specifications
– Implementation Guides
– Code Sets
– Terminologies
– Integration Profiles
Composite Standard
Grouping of coordinated base standards, often from multiple standards organizations, maintained by a single organization. In HITSP, it can serve as a component, transaction or transaction package functional requirements..
Integration profiles
Implementation guides
Health transaction services
Per Definition above
19
Current HITSP Document InventoryHITSP
document number
Construct Name Type TC
02 Interoperability Specification BIO IS BIO03 Interoperability Specification CE IS CE01 Interoperability Specification EHR. IS EHR
13 Manage Sharing of Docs TP BIO, CE, EHR14 Send Lab Result Message to Ordering Clinician and Providers of Care TP BIO, EHR
18 View lab results from a web application TP EHR
24 Pseudonymize Tx BIO25 Anonymize Tx BIO
22 Patient ID Cross Referencing (IHE PIX) Tx BIO, CE, EHR23 Patient Demographics Query (IHE PDQ) Tx BIO, CE, EHR29 Notification of lab report availability Tx BIO, EHR19 Patient Registration Information Update Tx CE
41 Radiology Results Message C BIO
47 Resource Utilization Message C BIO39 Encounter Message - HL7 ADT C BIO, CE
45 Acknowledgements C BIO, CE, EHR36 Lab Report Message - HL7 2.5 (as constrained by ELINCS, etc.) C BIO, EHR37 Lab Report Document Structure C BIO, EHR32 Registration and Med History Document(s) Content C CE33 Map x12 Registration to Reg/Med Document C CE34 Map NCPDP 8.1 to Reg/Med Doc C CE35 EHR Lab Terminology C EHR44 Secure Web Connection C EHR
20
The Harmonization Process – Inspection Testing
I
Harmonization Request
Harmonization Process Steps
II
RequirementsAnalysis
III
Identificationof Candidate
Standards
IV
Gaps,Duplications
and Overlaps
Resolution
V
Standards Selection
VI
Constructionof
InteroperabilitySpecification
VII
InspectionTest
VIII
InteroperabilitySpecification
Releaseand
Dissemination
IXProgram Management
BeginSupport
ReceiveRequest
We are here
21
The Inspection Test is just one in a series of tests that will be performed to validate the utility of the specification
The HITSP harmonization process results in an interoperability specification that will be widely disseminated
A series of tests is required to validate the quality and usability of the specification
The first test in the series of tests is the Inspection Test
The objective of the Inspection Test is to ensure that the IS meets the requirements of the Use Case and can be used to implement the requirements
Title Due to HHS Stakeholders
Inspection Test Sept 29, 06 HITSP, EHRVA, IHE, Gov’t, others
Plan for interoperability testing
Sept 29, 06 HITSP, NIST, NLM, others
Third party testing 2007 HITSP, NIST, CCHIT
Orchestration and implementation test
2007 HITSP, IHE, FHA, EHRVA, NHIN
22
The purpose of the inspection test is to ensure the Interoperability Specifications meet the following objectives
Conforms to Style and Editorial Guidelines
(Note that this will primarily be the responsibility of the HITSP project team and not the testers)
Ensure the integrity of document pieces – that all the cascading documents are present
Validate grammar, spelling, and consistency of terminologyValidate that it follows the style guide for text and graphics
Contains Accurate References and Data
Validate the references to other documents and data sources are valid and that data in tables is accurate.
Meets Use Case Requirements
Validate that the IS when implemented will meet the specific requirements as defined in the use case
Is Technically Valid Check the specification to determine the existence of the following:• Ambiguities/ lack of specificity• Inconsistencies• Gaps and overlaps• Testability• Completeness• Internal consistency• Ability to implement
23
There are 8 major steps to complete the Interoperability Specification (IS) inspection test process
1. Identify and engage key volunteer test resources
2. Develop the tools and procedures for gathering and responding to test findings
3. Assign testers to IS documents
4. Distribute Interoperability Specifications to the assigned testers
5. Conduct the test and hold test monitoring sessions– including a test kickoff, mid-point test monitoring session, IS specific walkthrough sessions, and final test debrief
6. Consolidate and document test results
7. Writers analyze and disposition test defects, updating IS documents as appropriate
8. Wrap up testing and prepare for posting to HITSP.org for public comment
24
The purpose of this presentation is to orient the Committee by providing. . .
Information about the formation of HITSP
An overview of the HITSP Harmonization Process
The schedule and next steps
25
Meeting Schedule
Activity Description of Activity Responsible Dates
Meetings
TC Face to Face I TC’s meet to draft Interoperability Specifications
Four Points Sheraton - Baltimore
TCs and Performance Team
TC Leadership: July 17TC: July 18 - 20
TC Face to Face II TC’s meet to finalize Interoperability Specifications
Chicago Hilton Garden Inn
TCs and Performance Team
TC Leadership: August 14TC: August 15 – 17Project team only August 18
TC Face to Face III TC’s meet to update Interoperability Specifications post Test and Comment
Crystal City Marriott at Reagan National Airport
TCs and Performance Team
TC: September 6-8
Board Meeting Board meets to review HITSP progress
Design Team Lead September 8
Panel Meeting Panel meets to approve Interoperability Specifications
Design Team Lead September 20
26
Other Deliverables
Activity Description of Activity Responsible Dates
Draft Interoperability Specifications
Technical Committees meet to finalize the draft IS for inspection testing
TCs & Performance Team
July 5 – August 17 COBAugust 18 – Project team
Panel Review I: Comment and/or Inspection Test of IS
Interoperability Specification is reviewed and inspection tested by the HITSP Panel and public
Design Team Lead Posts, Performance Team manages comments
August 18 - 30
Update I: Address Comments from Review / Inspection Test
Technical Committees update Interoperability Specifications
TCs & Performance Team
August 31 – September 12
Panel Review II: Review and comment of IS updates
Posted to www.HITSP.org and review and comment thru the 19th – comment review period closes the 20th
Design Team Lead Posts, Performance Team manages comments
September 13 – 19
Panel Approval: Approval IS HITSP Panel Approves IS Panel September 20
Update II: TCs Finalize Interoperability Specifications
TC’s finalize IS for delivery to ONC TCs & Performance Team
September 20 – 25 COB
Finalize Interoperability Specifications
TCs update based on panel comments
Project Management Team
September 26 – 28 COB
Deliver Interoperability Specifications
SOW Ref # 9 Project Management Team
Friday, September 29, 2006
27
Lab
Emergency
Surgical
Pharmacy
Copyright © 2002 College of American Pathologists
Building a Nationwide Health Information Network
28
Contact Information
Joyce Sensmeier MS, RN, BC, CPHIMS, FHIMSS
Vice President, Informatics
Healthcare Information and Management Systems Society (HIMSS)
230 East Ohio, Suite 500
Chicago, IL 60611
312-915-9281