S&I Framework Update HIT Standards Committee

July 16, 2014

Steve PosnackOffice Standards & TechnologyOffice of the National Coordinator for Health IT

S&I Initiative Portfolio Snapshot:

In production

* Community led initiatives leverage the S&I framework platform with minimal or no ONC funded contractor support.

Pre-Discovery Use Case Harmonization RI, Test & Pilot Evaluation

Active Initiatives

Structured Data Capture

Blue Button Plus

Data Provenance

EU/US eHealth Cooperation

2

Data Access Framework

Clinical Quality Framework

Community-Led* or Other Agency-Led

Inactive or Closed Initiatives

Longitudinal Coordination of Care

Laboratory Results Interface

Electronic Submission of Medical Documentation

Health eDecisions

Query Health

Data Segmentation for Privacy

PDMP & HIT Integration

Public Health

Laboratory Orders Interface

Direct Project (S&I Archetype)

Transitions of Care

Summary of Current & Upcoming SDO Engagement:S&I Active Initiatives [as of 7/1/2014]

3

Initiative SDO WG/ Domain Ballot/ Work Product Timing

Structured Data Capture

HL7 Orders & Observations (O&O)• Structured Data Capture (SDC) FHIR Profile • Comment only Sept 2014

• DSTU Jan 2015

IHE Quality, Research & Public Health

(QRPH)• Structured Data Capture (SDC) (TF Supplement) • Publish Aug 2014

Data Access Framework

IHE Patient Care Coordination (PCC)• A Data Access Framework Using IHE Profiles

(White Paper)• Publish Aug 2014

IHE PCC /

IT Infrastructure (ITI)/ QRPH• DAF White Paper Gap (1-11) Matrix • Proposals FY15 Cycle?

• Change proposals?

HL7Infrastructure and Messaging

(INM) / Implementable Technology Specifications (ITS)

• Data Elements-based Query using FHIR (Implementation Guide, IG)

• Project Scope Statement Sept 2014 ?

• Ballot TBD (Jan 2015?)

Data Provenance HL7Community Based Collaborative

Care (CBCC)1. Data Provenance Use Case2. Provenance for Clinical Document Architecture (

CDA R2) Implementation Guide

1. N/A2. DSTU Sept 2014

Blue Button Plus HL7 Attachments • HL7 Implementation Guide based on CDA R2 - Blue Button Plus Document

• DSTU Sept 2014

EU-US eHealth Cooperation

HL7 Structured Documents (SD)1. EU-US White Paper2. International Patient Summary Template

1. N/A2. DSTU Jan 2015 [TBD]

Clinical Quality Framework

HL7

Clinical Quality Information (CQI) / Clinical Decision Support (CDS) /

Implementable Technology Specifications (ITS)

1.Quality Information and Clinical Knowledge (QUICK) model (derived from QIDAM)

2.Clinical Quality Expression Language3.Clinical Quality Common Metadata4.Decision Support Service Implementation Guide, D

STU Updates

1.DSTU Sept 2014

2.DSTU Sept 20143.Spec Changes Dec 20144.Normative Sept 2015

PDMP-HIT Integration

n/a –working with NCPDP, ASAP and HL7 but no balloting timeline or specific workgroups for engagement have been identified

• IG for translation between NCPDP SCRIPT, HL7 V2, and ASAP Web Services against PMIX-NIEM payload

n/a

3

Summary of Current & Upcoming SDO Engagement:S&I Community Led/Other Agency Led [as of 7/1/2014]

4

Initiative SDO WG/ Domain Ballot/ Work Product Timing

Cancer Registry HL7Public Health &

Emergency Response (PHER)

• CDA Implementation Guide for Ambulatory Healthcare Provider Reporting to Central Cancer Registries

• DSTU Sept 2014

Laboratory Orders Interface

HL7Orders &

Observations (O&O)• Laboratory Order Interface Implementation Guide (L

OI IG) DSTU• 3rd DSTU ballot Sept 2014

Laboratory Results Interface

HL7 O&O • Ambulatory Laboratory Results Reporting IG for LRI,

Release 1• 2nd DSTU ballot Sept 2014

Electronic Submission of

Medical Documentation

HL7 Attachments

• HL7 Complete Documentation Templates IG • 2nd DSTU ballot Sept 2014

Longitudinal Coordination of Care

HL7 Patient Care /

Structured Documents (SD)

n/a – LCC is engaged in ongoing ballots/efforts being led by HL7 Patient Care WG

n/a

Public Health Tiger Team

n/a n/an/a – no currently planned ballots n/a

For Your ReferenceFOR YOUR REFERENCECURRENT S&I INITIATIVE

TIMELINES

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SDC Initiative Timeline

Jan-Mar’13 Apr-Jun ’13 Jul-Sep ’13 Oct-Dec ’13 Jan-Mar ’14 Apr-Jun ‘14 Jul-Sep ’14 Oct-Dec ’14 Jan-Mar ’15

(Today)

IHE Profile

FHIR Profile

SOAP/SAML IG

Patient Safety Event/Adverse Event Pilot

Public Health Tiger Team Pilot

Standards Analysis & Gap Mitigation

Project Charter

SDC Use Case

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DAF Initiative Timeline

Jun-Aug ‘13 Sep-Nov ‘13 Dec-Feb ’14 Mar-May ‘14 Jun-Aug ‘14 Sep-Nov ‘14 Dec-Feb ‘15 Mar-May

‘15 Jun-Aug ‘15

Local and Targeted Access Use Cases

Project Charter

(Today)

Pilots

Evaluation (~Spring/Summer 2015)

IHE DAF White Paper Development

Document Metadata Candidate Standards Evaluation

Federated DAF Use Case

Document Metadata IG Development

Data Elements Candidate Standards Evaluation

Data Elements IG Development

DAF White Paper published August 2014

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EU-US initiative Timeline

Jun-Aug ‘13 Sep-Nov ‘13 Dec-Feb ’14 Mar-May ‘14 Jun-Aug ‘14

Sep-Nov ‘14 Dec-Feb ‘15 Mar-May

‘15Jun-Aug

‘15

EU-US Interoperability Use Case

International Patient Summary template development

(Today)

Interoperability Pilots

Evaluation

Comparative Analysis Between HL7 C-CDA R1.1 CCD and epSoS PS v1.4 (Interoperability Standards Mapping)

Workforce Competency Mapping

Workforce White Paper Development and Proof of Concept Tooling

Charter Development

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Blue Button Plus Initiative Timeline

April 2014 May 2014 June 2014 July 2014 August 2014

Use Cases(Completed Fall 2012)

Standards Evaluation(Completed Spring 2013)

IG Development(Completed Summer 2013)

(Today)

Reference Implementation and Pilots

Evaluation

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PDMP & HITI Initiative Timeline

Dec ‘13 Jan ‘14 Feb ‘14 Mar ‘14 Apr ‘14 May ‘14 Jun ‘14 Jul ‘14 Aug ‘14 Sept

‘14 Oct ‘14 Nov ‘14 Dec ‘14

Use Case

Candidate Standards Evaluation

IG Development

(Today)

Pilots

Evaluation

Charter

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Data Provenance Timeline

April – May ‘14 June-July ‘14 Aug –Sep ‘14 Oct- Nov ‘14 Dec ’14-Jan’15 Feb -Mar ‘15

Use Case

(Today)

Charter

Tiger Team September Ballot Development

Pilots

IG Development

Evaluation

Candidate Standards Evaluation

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Clinical Quality Framework (CQF) Timeline

Jan-Mar ‘14 Apr-Jun ‘14 Jul-Sep ’14 Oct-Dec ‘14 Jan-Mar ‘15 Apr-Jun ‘15 Jul-Sep ‘15 Oct-Dec ‘15 Jan-Mar ‘16

CQF Use Case

Harmonization of Health Quality Information Models (HL7 DSTU)

(Today)

CQF Evaluation

Clinical Quality Expression Language (HL7 DSTU)

Clinical Quality Common Metadata (Spec Changes)

CQF Pilots

CQF Charter

Quality Information Domain Analysis Model (HL7 Ballot Reconciliation Complete)

FHIR as a Potential Common Logical Model paper (HL7 Comment Period Complete)

FHIR Profile

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Oct ‘11-Jul ’12 Jul-Dec ’13 Jan-Mar ‘14 Apr-Jun ‘14 Apr-Jun ’14 Jul-Sep ’14

Laboratory Results Interface (LRI)

Use Case1(Completed Spring 2011)

HL7 DSTU Ballot(Completed Fall 2011 and Spring 2012)

Implementation Guide(Completed Summer/Fall 2012)

(Today)

Pilots(Summer 2012-Summer 2013)

Evaluation

LRI DSTU R2 Update(Fall/Winter 2014)

EHR Functional Requirements (Jan 2015)

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Oct ‘12-Jul ‘13 Jul-Sep ’13 Oct-Dec ‘13 Jan-Mar ‘14 Apr-Jun ’14 Jul-Sep ‘14

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Laboratory Orders Interface (LOI)

Use Case(Completed Summer 2012)

HL7 LOI Implementation Guide(Completed Fall 2012)

HL7 eDOS Implementation Guide(Completed Fall/Winter 2013)

(Today)

Evaluation

HL7 LOI and eDOS Implementation Guides(Summer/Fall 2014)

LOI and eDOS Integrated Deployments(Summer/Fall 2014)

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esMD – Electronic Submission of Medical Documentation

Oct – Dec ‘11 Jan – Jun ‘12 Jul – Dec ‘12 Jan – Jun ‘13 Jul – Dec ‘13 Jan – Jun ‘14 Jul - Dec ‘14

Charter

Pilots

Evaluation

UC 1 IG

UC 2 IG

Provider Directories Guidance for esMD IG

AoR L1 IG

HL7 Digital Signatures Ballot/Recon

AoR L2 IG

eDoC Companion/Implementation Guide Development

HL7 eDoC Additional C-CDA R2 Templates Ballot/Recon

eDoC User Story Development

(Today)

eDoC Coded Data Mapping

AoR L3 Use Case

AoR L1 Use Case

AoR L2 Use Case

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Oct ‘11-Jul ‘13 Jul-Sep ’13 Oct-Dec ‘13 Jan-Mar ‘14 Apr-Jun ’14 Jul-Sep ‘14

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Longitudinal Coordination of Care Timeline

Use Case1 (Transfer Summary)(Completed Summer 2012)

HL7 LTPAC Summary Document(Completed Fall 2012)

HL7 CCDA R2.0 Implementation Guide (Care Plan)(Completed Summer/Fall 2013)

(Today)

Transfer Summary Pilots(Completed 2012)

Evaluation

Use Case2 (Care Plan / Home Health Plan of Care)(Completed Summer 2013)

CCDA R2.0 Care Plan Implementations(Completed Fall 2013 / Spring 2014)

CCDA R2.0 Transfer Summary Go-Live(Summer/Fall 2014)

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