1. S&I Public Health * We will start the meeting 3 min after the hour October 7 th, 2014

2. Housekeeping This meeting is being recorded and un-paused and will be available via the wiki *Please mute your phone when not speaking to assist with background noise.

3. Today’s Agenda –Announcements –Updates –Provenance – Next steps

4. Announcements New Listserv –Lab Results Interface (LRI) Initiative –wiki.siframework.org/LRI+Implementation+Guides+Analysis+WG –LRI - Purpose and Goals –Meaningful Use Alignment: Incorporate lab results into EHR as structured data. Supports objectives for Decision Support, Quality Reporting, Transitions in Care, and Electronic copies of Clinical Summaries and Discharge Instructions.

5. Updates Nationwide Interoperability Roadmap Community Home (comments closed but viewable) –http://confluence.siframework.org/display/NIRCH/Nationwide+Interoperability+Roadmap+Co mmunity+Homehttp://confluence.siframework.org/display/NIRCH/Nationwide+Interoperability+Roadmap+Co mmunity+Home –http://www.healthit.gov/sites/default/files/ONC10yearInteroperabilityConceptPaper.pdfhttp://www.healthit.gov/sites/default/files/ONC10yearInteroperabilityConceptPaper.pdf

6. Provenance – PHTT Next Steps The term “provenance” in the context of Health IT refers to evidence and attributes describing the origin of health information as it is captured in a health system. Use cases and comments are published here: –http://wiki.siframework.org/Data+Provenance+Use+Case+Consensushttp://wiki.siframework.org/Data+Provenance+Use+Case+Consensus –Source for content in this presentation

7. Provenance – Questions addressed When healthcare data is first created, what is the provenance information that should be captured (previously created provenance information or newly created provenance information), retained, and conveyed? Can a receiving system understand and trust that provenance information? Do we need to know who touched it along the way? If so, how do we know? When the receiving system combines this information with data received from third parties, how do we persist the provenance from multiple sources? When multi-sourced data is assembled and sent to another system, how do we convey the provenance of the multiple data sources as well as for the system doing the assembly? –Is this considered new data? –What if the assembling system “cherry picks” from multiple sources, or adds some new health information of its own?

8. Provenance – In scope To identify and define guidance on use of standards to facilitate provenance capabilities by specifying the following: *** –Standards for the provenance (e.g. origin, source, custodian(s), FHIR resources, CDA, etc.) –Supportive standards (e.g. integrity, non-repudiation, and privacy & security with respect to provenance ) –Vocabulary standard metadata tags for data provenance Variance in granularity of data to which provenance is applied, the way provenance is encoded, and how data and its provenance are conveyed to consuming systems and users To define system requirements that describe how applications capture, retain and convey data provenance and maintain association with the data To ensure sufficient granularity to support chain of custody

9. Provenance – Out of scope Patient identity matching*** Third party mechanisms for checking patient consent and the relative merits of existing policies or regulations (such as privacy policies or jurisdictional considerations)*** Policy-based decisions (such as records management based policies on record retention) Non-clinical data (such as environmental data) Mechanisms to verify the validity of the original source data

10. Provenance – The Actors ActorSystemRole *Start Point (e.g., patient, provider/provider organizations, labs) Data Capture System (e.g., EHR, PHR) Create Data Send Data Transmitter (e.g., State HIEs) Intermediary System (e.g., HIE, HISP) Receive Data Send Data Assembler (e.g., provider/provider organizations, State HIEs) Data Integration System (e.g., EHR, HIE, PHR) Receive Data Consolidate Data Send Data End Point Data Storage System (e.g., EHR, HIE, PHR) Receive Data ComposerData Integration Composer System Receive Data Consolidate Selected Data Send Data

11. Provenance – The Use Cases

12. Questions for PHTT Does PH use data provenance today and if so, how and to what end?

13. Questions for PHTT Are there other scenarios where PH could use health data provenance? To start the discussion: –When getting the data from a primary source, e.g. directly from a hospital ED? –When getting data from a secondary source, e.g. using clinical data from an HIE, or then combining that with claims data?

14. Questions for PHTT Does PH use data provenance today and if so, how and to what end?

15. S&I Public Health Contact Information ONC Public Health Lead: Daniel Chaput (daniel.chaput@hhs.gov)daniel.chaput@hhs.gov CDC Public Health Lead: John M. Saindon (uzn0@cdc.gov)uzn0@cdc.gov PHTT Wiki Page PHTT Wiki Page: http://wiki.siframework.org/Public+Health+Tiger+Teamhttp://wiki.siframework.org/Public+Health+Tiger+Team SDC Wiki Page: http://wiki.siframework.org/Structured+Data+Capture+Initiativehttp://wiki.siframework.org/Structured+Data+Capture+Initiative DAF Wiki Page: http://wiki.siframework.org/Data+Access+Framework+Homepagehttp://wiki.siframework.org/Data+Access+Framework+Homepage CQF Wiki http://wiki.siframework.org/Clinical+Quality+Framework+Initiativehttp://wiki.siframework.org/Clinical+Quality+Framework+Initiative PHRi Archived Wiki http://wiki.siframework.org/Public+Health+Reporting+Initiativehttp://wiki.siframework.org/Public+Health+Reporting+Initiative Weekly PHTT Meeting Info (Tuesdays): Time: 2:00pm - 3:00pm Eastern URL: https://siframework1.webex.com/https://siframework1.webex.com/ Dial-In Number: 1-650-479-3208 Access Code: 665 131 907