Presentation is loading. Please wait.

Presentation is loading. Please wait.

EHR Systems Functional Model and Standard Triplets (what + why + criteria) Hierarchies/Decompositions Timelines Open Process Screens Ballot Reconciliation.

Similar presentations


Presentation on theme: "EHR Systems Functional Model and Standard Triplets (what + why + criteria) Hierarchies/Decompositions Timelines Open Process Screens Ballot Reconciliation."— Presentation transcript:

1 EHR Systems Functional Model and Standard Triplets (what + why + criteria) Hierarchies/Decompositions Timelines Open Process Screens Ballot Reconciliation 2 July 2003

2 Functional Decomposition Functional decomposition –Based on a functional hierarchy –Abstract to specific EHR Function Specification Triplet –At arbitrary level of decomposition: 3+ (?) –Deemed useful for applicability across functional profiles or conformance measure

3 EHR Function Specification Triplet WHAT Statement of Function, Functionality WHY Rationale, with references Conformance Criteria HOW Out of Scope

4 Statement of Function - WHAT Statement of EHR System function(ality) Final Proposed Form [EHR Systems] “must/should/may” [verb-first function statement] Considered per care setting –must/shall :: essential –should :: desirable –may :: optional

5 Core v. profile specific Core –Deemed essential in all care settings –Deemed desirable in all care settings Functional Profile Specific –Deemed essential in one care setting and not in another –Deemed desirable in one care setting and not in another

6 Statement of Function - WHAT Example: Care delivery Example hierarchy, decomposition –L1: Prescribing –L2: Prescription validation –L3: Drug-Disease interaction warnings

7 Statement of Function - WHAT Example: Care delivery(cont.) Short statement, verb-first –“Warn of drug-disease interactions” Full statement –“EHRS provide a synchronous warning if a clinician is about to order a medication when the patient has an entry in their problem list which is a contraindication to this medication”

8 Rationale - WHY Rationale for inclusion of function(ality) –Utility based – efficiency, workflow –Safety based – prevent medical errors –Outcome based – improved patient outcomes –Empowerment based – patient in a better position to manage their own care References

9 Rationale - WHY Example: Care delivery Prescription validation Safety –Proven reduction in medication errors Reference… Utility –Proven reduced requirement for medication review by other staff (including pharmacist. Reference…

10 Statement of Function - WHAT Example: Infrastructure Example hierarchy, decomposition –L1: Security –L2: Entity authentication –L3: User authentication

11 Statement of Function - WHAT Example: Infrastructure (cont.) Short statement, verb-first –“Ensure user authentication” Full statement –“EHRS must/should/may ensure user authentication: at signon, at start of user session; and throughout user session.”

12 Rationale - WHY Example: Infrastructure (cont.) User Authentication example “To ensure… –“User identity is verified at signon; –“User identity is established for duration of user session; –“Accountable actions can be attributed (traced) to authenticated users, including acts of EHR authorship and amendment.”

13 Rationale - WHY Example: Infrastructure(cont.) User authentication references –HIPAA –JCAHO –IOM –ISO 18308, 18307, 21089, –ASTM E1462, E1467 –…

14 Conformance Criteria Method or basis for measuring conformance –Of EHR systems

15 Conformance Criteria Example: Infrastructure User Authentication example EHRS conforms if user identity –Is actively verified at each signon or session start –(and thus) is actively verified before EHR function(s) or content is accessed –Is maintained for duration of user session

16 Contribution Propose functional triplets Process documents and derive functional triplets Review functional triplets in an agreed manner and with agreed criteria Review functional triplets from limited set from the perspective of a care setting

17 Contribution (cont.) Join the lists Join the Groove collaboration Lead the Groove collaboration Others…(Ken)

18 Proposal for Initial Ballot Functional Hierarchy and Decomposition (v1.0) –Infrastructure: 3-5 levels –Care delivery: 3 levels Triplet –What, Why: v1.0 –Conformance Criteria: v1.1, v2…

19 EHR Ballot Schedule 21 July Draft published: Co-Chairs and Staff July EHR SIG Open Meeting Rockville, MD - AHRQ Conference Center Attendees must register, no meeting fee Draft reviewed and vetted

20 EHR Ballot Schedule, con’t 1 Aug v1.0 ballot opens 1 September v1.0 ballot closes

21 EHR Ballot Schedule, con’t 9-11 September Memphis, Tennessee Ballot reconciliation HL7 Fall Plenary and Working Group Open meeting Attendees must register w/HL7 and pay meeting fees Sept/Oct Next ballot draft and ballot round…

22 EHR Roadmap Now –v1.0 –Draft Standard for Trial Use –60% consensus needed Future –v1.1,, v2… –Progressive iterations, each with greater specificity

23 EHR Roadmap (cont.) Functional Hierarchy and Decomposition v1.0 General v1.1, v2… More Specific Infrastructure Functions 1-5 levels1-n levels Care Delivery Functions 1-3 levels1-n levels TripletWHAT, WHY+ Conformance Criteria

24 EHR Ballot, Part 1 (proposed) EHR Functional Model Framework Horizontal Axis - EHR Function –EHR Infrastructure Functions –EHR Care Delivery Functions Vertical Axis - EHR Use –EHR Care Setting Profiles –EHR Use Profiles Informative

25 EHR Ballot, Part 2 (proposed) Functional Hierarchy/Decomposition Framework Hierarchical framework –Establishes functional groupings and relationships –Identifies functional inter-dependencies and redundancies –Supports Functional Decomposition Informative Does not dictate implementation

26 EHR Ballot, Part 3 (proposed) EHR Function Specification Triplets One per EHR function(ality) proposed for inclusion Placed at parent or leaf nodes in Functional Hierarchy Where applicability/conformance metric is deemed useful

27 EHR Ballot, Part 3 (proposed, con’t) EHR Function Specification Triplets Now –v1.0 –Informative (as DTSU) –What + Why Next –v1.1, v2… –Normative –What + Why + Conformance Criteria

28 Function Specification Triplet Basis for Inclusion, 1st Screen SIG Co-Chairs and Staff Applicability: Within EHR scope? –Does function(ality) apply to at least one EHR system in one EHR use setting? –Identify applicable use settings Now or Next Iteration: Within EHR v1.0 scope? –Is function(ality) within decomposition scope for v1.0?

29 Function Specification Triplet Basis for Inclusion, 1st Screen, con’t Position triplet within Functional Hierarchy and Decomposition First pre-ballot draft - target 21 July 2003

30 Function Specification Triplet Basis for Inclusion, 2nd Screen Review in open session –EHR SIG Open Meeting, July –HL7 membership not required Consensus of attendees Per triplet: –Applicability? –Now or next iteration? –Typical Use Setting(s)

31 Function Specification Triplet Basis for Inclusion, 2nd Screen, con’t Post meeting revisions Final ballot draft Target: End July 2003

32 Function Specification Triplet Basis for Inclusion, 3rd Screen Ballot Opens/Closes: 1 Aug to 1 Sep Ballot options –Add new function(ality), including proposed: Function Specification Triplet Placement within Functional Hierarchy and Decomposition Urgency: now or future iteration –Exclude proposed function(ality) Reason for exclusion OK in future iteration?

33 Function Specification Triplet Basis for Inclusion, 3rd Screen, con’t Ballot options, con’t –Add/delete proposed EHR use setting –Revise Statement of Function(ality) - WHAT –Revise Rationale - WHY

34 Function Specification Triplet Basis for Inclusion, 4th Screen Review in open session –EHR SIG Meeting, 9-11 September –In conjunction with HL7 Annual Plenary, Memphis –HL7 membership not required but meeting fee is Consensus of attendees Ballot submitters are encouraged to attend while their comments are discussed and resolution sought!!

35 Function Specification Triplet Basis for Inclusion, 4th Screen, con’t Ballot Resolution Options Accept vote to add function(ality) –Establish Statement of Function(ality) - WHAT –Establish Rationale - WHY –Within v1.0 scope? Place in Functional Hierarchy and Decomposition –Beyond v1.0 scope? Log for future consideration, inclusion –Establish related EHR Use Setting(s) –Revise ballot draft –Request submitter to withdraw negative (if any)

36 Function Specification Triplet Basis for Inclusion, 4th Screen, con’t Ballot Resolution Options, con’t Decline vote to add function(ality) –State reason: e.g., out of scope –Offer compromise to submitter: e.g., future consideration –Notify submitter, request withdrawal of negative (if any) Votes to include or exclude care settings –Consensus of committee –No committee response to individual submitter

37 Function Specification Triplet Basis for Inclusion, 4th Screen, con’t Ballot Resolution Options, con’t Accept vote to exclude function(ality) –State reason: e.g., out of scope –Offer compromise to submitter: e.g., future consideration –Revise ballot draft –Notify submitter, request withdrawal of negative (if any) Decline vote to exclude function(ality) –State reason –Notify submitter, request withdrawal of negative (if any)

38 Function Specification Triplet Basis for Inclusion, 4th Screen, con’t Ballot Resolution Options, con’t Accept revision to Statement of Function(ality) or Rationale –Revise draft –Notify submitter, request withdrawal of negative (if any) Decline revision to Statement of Function(ality) or Rationale –State reason or suggest compromise –Notify submitter, request withdrawal of negative (if any)

39 Function Specification Triplet Basis for Inclusion, 5th+ Screens Sep/Oct Next ballot round Repeat Screens 3&4 until consensus is achieved…

40 Accepted Submissions EHR Functional Hierarchies Proposed EHR functional hierarchies and decompositions, as scoped for v1.0: –EHR Infrastructure Functions Decomposition - target 5 levels –EHR Care Delivery Functions Decomposition - target 3 levels

41 Accepted Submissions EHR Specification Triplets Proposed EHR Specification Triplets –1) What 2) Why 3) Conformance Criteria Proposed in context of: –Applicable use setting(s) –Placement within Functional Hierarchy and Decomposition

42 Contacts Linda Fischetti, RN Veterans Health Administration Gary Dickinson Per-Sé Technologies, Inc. Sam Heard, MD OpenEHR, Australia


Download ppt "EHR Systems Functional Model and Standard Triplets (what + why + criteria) Hierarchies/Decompositions Timelines Open Process Screens Ballot Reconciliation."

Similar presentations


Ads by Google