1. electronic Long-Term Services & Supports (eLTSS) Initiative All-Hands Workgroup Meeting March 19, 2015 1

2. Meeting Etiquette Remember: If you are not speaking, please keep your phone on mute Do not put your phone on hold. If you need to take a call, hang up and dial in again when finished with your other call o Hold = Elevator Music = frustrated speakers and participants This meeting is being recorded o Another reason to keep your phone on mute when not speaking Use the “Chat” feature for questions, comments and items you would like the moderator or other participants to know. o Send comments to All Panelists so they can be addressed publically in the chat, or discussed in the meeting (as appropriate). o Please DO NOT use the Q&A—only the presenter sees Q&A, not necessarily the person facilitating the discussion From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute All Panelists 2

3. 3 Agenda TopicPresenterTimeframe Welcome Announcements eLTSS Roadmap Lynette Elliott10 mins Use Case Working Session: Review User Story Comments Introduce Scope section Becky / Community 75 mins Homework / Next StepsBecky5 mins

4. Announcements ONC issued the Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Version 1.0Connecting Health and Care for the Nation: A Shared Nationwide Interoperability Roadmap Version 1.0 – The draft Roadmap is a proposal to deliver better care and result in healthier people through the safe and secure exchange and use of electronic health information. – Includes Person-Centered Planning and eLTSS initiative – ONC is accepting public comments until 5pm ET April 3, 2015: http://www.healthit.gov/policy-researchers- implementers/interoperability-roadmap-public-comments http://www.healthit.gov/policy-researchers- implementers/interoperability-roadmap-public-comments HIMSS Interoperability Showcase is being held April 12-15, 2015 in Chicago, IL – Live interactive demonstration where health IT solution providers collaborate to maximize the collective impact of their technologies – Highlight seamless health information exchange in multiple care settings 4

5. New Funding Announcement Advance Interoperable Health Information Technology Services to Support Health Information Exchange Funding Opportunity Announcement Advance Interoperable Health Information Technology Services to Support Health Information Exchange Funding Opportunity Announcement – Letters of Intent Due: March 2, 2015; Application Deadline: April 6, 2015 – Leverages investments and lessons learned from HITECH State HIE Program to accelerate widespread adoption and use of HIE infrastructure – Grantees MUST select at least one eligible care provider and at least two non-eligible care providers for their target populations: 5

6. Announcements A presentation was made to the HIT Standards Committee on March 18 th : – Background & Scope Recap – eLTSS Initiative Roadmap – Stakeholder Engagement – Use Case Development Approach & Progress – Next Steps – Questions for HITSC Presentation materials are posted on the wiki: – http://wiki.siframework.org/file/view/HITSC_eLTSS_Progress_U pdate_2015-03- 18_v3.ppt/544606348/HITSC_eLTSS_Progress_Update_2015- 03-18_v3.ppt http://wiki.siframework.org/file/view/HITSC_eLTSS_Progress_U pdate_2015-03- 18_v3.ppt/544606348/HITSC_eLTSS_Progress_Update_2015- 03-18_v3.ppt 6

7. Concert Series Presentations 7 Organizations are invited to present on an existing project or initiative that is related to the eLTSS scope of work and/or will help inform the eLTSS target outcomes and deliverables These projects do not have to be technically-focused Criteria for consideration: Has solution, whether it is technical or process driven, been implemented in a one or more of the eLTSS settings: home and community-based setting or clinical setting? Does solution incorporate existing or emerging standards and/or other relevant guidance?

8. Concert Series Presentations: Logistics Presentations will be scheduled as part of the weekly eLTSS Community Meetings and will occur the last 30 mins of the call Duration: 15-20 mins webinar (or demo); 5-10 mins Q&A eLTSS Workgroup activities will always take precedence over concert series presentations If you have an interest in participating, please contact Evelyn Gallego (evelyn.gallego@siframework.org ) and Lynette Elliott (lynette.elliott@esacinc.com)evelyn.gallego@siframework.orglynette.elliott@esacinc.com A pre-planning meeting will be scheduled prior to any public demonstration 8

9. Upcoming Concert Series Presentations 9 March 26 th : NASDDDS National Core Indicators April 2 nd : Person-Centered Planning Tools April 9 th : PeerPlace April 16 th : MyDirectives.com / A|D Vault, Inc. April 23 rd : Care at Hand April 30 th : State of Colorado May 7 th : (available) May 14 th : State of Minnesota

10. Timelines for Consideration: Two Pilot Phases, SDO Ballot Cycles eLTSS Initiative Roadmap Q3 ‘14Q4 ‘14Q1 ‘15Q2 ‘15Q3 ‘15Q4 ‘15Q4 ‘17 Phase 4: Pilots & Testing Pilot site readiness Implementation of solution Test User Stories and Scenarios Monitor Progress & Outcomes Utilize Requirements Traceability Matrix Phase 5: Evaluation Evaluate outcomes against Success Metrics and Criteria Update Implementation Guidance Develop, review, and finalize the Use Case and Functional Requirements Pre-Planning Call for Participation Conduct Environmental Scan Success Criteria Stakeholder Engagement Finalize Candidate Standards Standards Gap Analysis Technical & Standards Design Develop Requirements Traceability Matrix Develop Implementation Guide Launch initiative Review and Finalize Charter Review initial Candidate Standards 10 Initiative Kick Off: 11/06/14 Phase 1: Pre-Discovery Phase 2: Use Case Development & Functional Requirements Phase 3: Standards & Harmonization

11. Goals for the eLTSS Initiative Identify key assessment domains and associated data elements to include in an electronic Long-term Services & Supports (eLTSS) plan Create a structured, longitudinal, person-centered eLTSS plan that can be exchanged electronically across and between community- based information systems, clinical care systems and personal health record systems. We will use Health IT to establish a person-centered electronic LTSS record, one that supports the person, makes him or her central to the process, and recognizes the person as the expert on goals and needs.* * Source: Guidance to HHS Agencies for Implementing Principles of Section 2402(a) of the Affordable Care Act: Standards for Person-Centered Planning and Self-Direction in Home and Community-Based Services Programs 11

12. Project Charter and eLTSS Glossary FINAL Published Project Charter located here: http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Charter http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Charter eLTSS Glossary posted here: http://wiki.siframework.org/eLTSS+Glossary http://wiki.siframework.org/eLTSS+Glossary – The eLTSS Glossary is a working document containing eLTSS-relevant terms, abbreviations and definitions as defined by stakeholders – We are looking for your feedback and comments Discussion Thread available Submit any change requests via the Change Request Form located on the wiki – Reminder: the Glossary is a living document and content may change as the initiative progresses 12

13. Week Target Date (2015) All Hands WG Meeting Tasks Review & Comments from Community via Wiki page due following Tuesday by 8 P.M. Eastern 1-51/22-2/19 Use Case Kick-Off & UC Process Overview Use Case Value Framing Discussions Review and Answer Value Framing Questions on wiki 62/26 Review: Consolidated UC Value Framing Introduce: Context Diagram & User Stories Review: Context Diagram & User Stories 73/12Finalize: Context Diagram & User StoriesReview: User Stories 83/19 Finalize: User Stories Introduce: In/Out of Scope Review: In/Out of Scope 93/26 Finalize: Assumptions & Pre/Post Conditions Introduce: Activity Diagram & Base Flow Review: Assumptions & Pre/Post Conditions, Activity Diagram & Base Flow 104/2 Finalize: Activity Diagram & Base Flow Introduce: Functional Requirements & Sequence Diagram Review: Functional Requirements & Sequence Diagram 114/9 Finalize: Functional Requirements & Sequence Diagram Introduce: Data Requirements Review: Data Requirements 124/16Review: Data Requirements 134/23 Finalize: Finalize Data Requirements Introduce: Risks & Issues Review: Risks & Issues 144/30 Finalize: Risks and Issues Begin End-to-End Review End-to-End Review by community 155/7End-to-End Comments Review & dispositionEnd-to-End Review ends 165/14Finalize End-to-End Review Comments & Begin ConsensusBegin casting consensus vote 175/21Consensus Vote*Conclude consensus voting Proposed Use Case & Functional Requirements Development Timeline 13

14. We Need YOU! In order to stick to our timeline and to ensure that the artifacts we develop fit the need of our stakeholders (you), we need your feedback, comments and participation Each week, please review the use case content and provide comments via the wiki at: http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case Thank you for providing input for our eLTSS Use Case Framing Questions (via the wiki, live discussions or email). – We have consolidated the responses and posted the document on the eLTSS wiki at: http://wiki.siframework.org/electronic+Long+Term+Services+and+Supports+Use+Case+Value+Framing+Questions http://wiki.siframework.org/electronic+Long+Term+Services+and+Supports+Use+Case+Value+Framing+Questions – This document and YOUR responses will be used as input for various sections of the eLTSS Use Case Artifact 14

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16. User Story Description: – User Stories summarize the interaction between the actors of the Use Case – Specify what information is exchanged from a contextual perspective – Describe the real world application as an example of the Scenario – Provide clinical context User Stories will be displayed on screen as a working draft Word document to capture updates and comments during the working session. – These will be posted on the wiki Use Case page: http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case Thank you to those Community Members who have provided comments and feedback via the wiki comment form and email. We will discuss those comments now. 16

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18. Scope Further defines the scope of the Use Case itself and NOT the scope of the Initiative If there are multiple Use Cases within the same Initiative, this section can be used to explain how the scope of this Use Case relates to the others. Diagrams and other supplemental data / examples help provide context and clarify the basis for the Use Case 18

19. Scope subsections Background – describes the relevance of the Use Case in relation to what gaps currently exist within the healthcare industry. Includes all policy and/or regulatory issues/dependencies that may impact the Use Case In Scope – indicates what is in scope for the Use Case. For example, the type of transactions, the information/data to be exchanged, and specific aspects that need to be in place to enable the information to be sent, received and understood the same at both ends of the transmission. Out of Scope – indicates what is out of scope for the Use Case. These points may highlight dependencies on the feasibility, implementability, and usability that result in limitations of the Use Case. At a high level, whatever is not declared “In Scope” is by definition, “Out of Scope”. – Note: Items that are out of scope for the Use Case, Functional Requirements and Standards Harmonization activities can be still be part of a Pilot. Communities of Interest 19

20. Scope DRAFT Today we will look at the draft scope section content (via a word document) Document and text is provided on the Use Case Wiki: http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case Please review and comment on the Scope section for homework – Use the Comment Form provided on the wiki or email comments to becky.angeles@esacinc.com 20

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22. Next Steps HOMEWORK – Due by COB Tuesday, March 24th: –Review Use Case Scope section –Utilize Comment Form at http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Casehttp://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case –Email feedback / comments to becky.angeles@esacinc.com or evelyn.gallego@siframework.orgbecky.angeles@esacinc.com NEXT WEEK: –Assumptions –Pre Conditions –Post Conditions –Concert Series Presentation: NASDDDS National Core Indicators Join the eLTSS Initiative: http://wiki.siframework.org/eLTSS+Join+the+Initiative http://wiki.siframework.org/eLTSS+Join+the+Initiative –Only Committed Members can vote on artifacts 22

23. eLTSS Initiative: Project Team Leads ONC Leads – Elizabeth Palena-Hall (elizabeth.palenahall@hhs.gov)elizabeth.palenahall@hhs.gov – Patricia Greim (Patricia.Greim@hhs.gov)Patricia.Greim@hhs.gov CMS Lead – Kerry Lida (Kerry.Lida@cms.hhs.gov)Kerry.Lida@cms.hhs.gov Federal Lead – Jennie Harvell (jennie.harvell@hhs.gov)jennie.harvell@hhs.gov Initiative Coordinator – Evelyn Gallego-Haag (evelyn.gallego@siframework.org)evelyn.gallego@siframework.org Project Management & Pilots Lead – Lynette Elliott (lynette.elliott@esacinc.com)lynette.elliott@esacinc.com Use Case & Functional Requirements Development – Becky Angeles (becky.angeles@esacinc.com)becky.angeles@esacinc.com Standards Development Support – Angelique Cortez (angelique.j.cortez@accenture.com)angelique.j.cortez@accenture.com Harmonization – Atanu Sen (atanu.sen@accenture.com)atanu.sen@accenture.com 23

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25. Use Case Outline Tailored for each Initiative 25 1.0 Preface and Introduction** 2.0 Initiative Overview – 2.1 Initiative Challenge Statement** 3.0 Use Case Scope – 3.1 Background** – 3.2 In Scope – 3.3 Out of Scope – 3.4 Communities of Interest** 4.0 Value Statement** 5.0 Use Case Assumptions 6.0 Pre-Conditions 7.0 Post Conditions 8.0 Actors and Roles 9.0 Use Case Diagram 10.0 Scenario: Generic Provider Workflow – 10.1 User Story 1, 2, x, … – 10.2 Activity Diagram o 10.2.1 Base Flow o 10.2.2 Alternate Flow – 10.3 Functional Requirements o 10.3.1 Information Interchange Requirements o 10.3.2 System Requirements – 10.4 Sequence Diagram 11.0 Risks, Issues and Obstacles 12.0 Dataset Requirements Appendices – Related Use Cases – Previous Work Efforts – References ** Leverage content from Project Charter