1. Kaiser Permanente Standards Summit September 7-8, 2011 Stanley M. Huff, MD Huff # 1 We Are on the Right Path! SHARPn Face-to-Face June 11, 2012 Stanley M Huff, MD Chief Medical Informatics Officer

2. patientslikeme Institute of Medicine meeting –James Heywood –Brother Stephen with ALS "It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” Marcia Angell, MD Huff # 2

3. A Learning Health System (LHS) “ … one in which progress in science, informatics, and care culture align to generate new knowledge as an ongoing, natural by-product of the care experience, and seamlessly refine and deliver best practices for continuous improvement in health and health care. ” (Institute of Medicine)

4. Assertion If we capture accurate data at the point of care, and make it comparable (as Chris has described), we can learn something from the $4 trillion + of health care provided every year in the US. Even more if we can share world wide. Huff # 4

5. What Is Needed to Create a New Paradigm? Standard set of detailed clinical data models coupled with… Standard coded terminology Standard API’s (Application Programmer Interfaces) for healthcare related services Open sharing of models, coded terms, and API’s Sharing of tools for data abstraction and normalization Sharing of data, decision support modules and knowledge

6. # 6 A diagram of a simple clinical model data 138 mmHg quals SystolicBP SystolicBPObs data Right Arm BodyLocation data Sitting PatientPosition Clinical Element Model for Systolic Blood Pressure

7. Clinical modeling activities Netherlands/ISO Standard CEN 13606 United Kingdom – NHS Singapore Sweden Australia openEHR Foundation Canada US Veterans Administration US Department of Defense Intermountain Healthcare Mayo Clinic HL7 –Version 3 RIM, message templates –TermInfo –CDA plus Templates –Detailed Clinical Models –greenCDA Tolven NIH/NCI – Common Data Elements, CaBIG CDISC SHARE Korea # 7

8. Clinical Information Modeling Initiative Mission Improve the interoperability of healthcare systems through shared implementable clinical information models. Huff # 8

9. Clinical Information Modeling Initiative Goals Shared repository of detailed clinical information models Using a single formalism Based on a common set of base data types With formal bindings of the models to standard coded terminologies Repository is open and models are free for use at no cost Huff # 9

10. Get Involved in CIMI Clinical Information Model Initiative (CIMI) http://informatics.mayo.edu/CIMI/ Stan Huff –stan.huff@imail.org CEM Session Jun 11: 8:30AM, RM 414

11. Huff # 11 Questions?