1. Health eDecisions (HeD) All Hands Meeting June 27th, 2013

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 Hold = Elevator Music = frustrated speakers and participants This meeting is being recorded 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. Send comments to All Panelists so they can be addressed publically in the chat, or discussed in the meeting (as appropriate). From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute All Panelists

3. Agenda TopicTime Allotted Announcements5 minutes Work Stream 1 Update: HL7 Meeting Update 5 minutes Work Stream 2 Update: Pilots5 minutes Work Stream 3: Use Case 2 IG discussion 65 minutes Wrap up/Questions10 minutes

4. Announcements July 4 th All Hands meeting is canceled We are having a pilots open house July 8 th from 1:00-2:00 –Chance for the community and other federal partners, business community, vendors and FACA leads to virtually come see what we have accomplished Date and Time: July 8, 2013 1:00 pm Dial In: +1-650-479-3208 Access code: 664 366 291 URL:https://siframework1.webex.com/siframework1/onstage/g.php?t=a &d=664366291+1-650-479-3208 URL:https://siframework1.webex.com/siframework1/onstage/g.php?t=a &d=664366291 Announcement also on our HeD Wiki homepage: http://wiki.siframework.org/Health+eDecisions+Homepage http://wiki.siframework.org/Health+eDecisions+Homepage

5. Weekly Meeting Schedule Stay tuned for additional working meetings to ensure we meet the HL7 Ballot deadline (5 weeks and counting….) WeekdayMeetingTime MondayPilots (UC 1)1-2:30 ET MondayVocabulary and Terminology12-1:00 ET TuesdayCDS-HeD Working Meeting3:00-4:00 ET TuesdayVocabulary and Terminology4:00-5:00 ET WednesdayStandards Sub work Group Call1:00-2:00 ET ThursdayAll Community Call11:00-12:30 ET

6. HL7 Update We have completed a working final Draft of the IG – it is being circulated to the support team once we are finished we will put it out on the wiki for comment and review The Vocabulary and Terminology work for UC 1 will now be rolled into a “Master HeD” terminology spreadsheet that will include Data Elements and mappings for all of UC 1 and 2

7. HeD Pilots Update – WE ARE DONE!!!!!!!!!!!!!!!! We met this week to review findings Pilots Update –CDC and AllScripts–ECA Rule --- DONE –NewMentor and AllScripts – ECA Rule DONE –Zynx and DesignClinicals - Order Set DONE –VA and Wolters Kluwer - Documentation Template DONE Please come to our open house to support to see what we have accomplished and the major milestone for the HeD initiative we have just crossed!!! (invite your friends)

8. HeD Pilots Goal Goal The goal of this initiative is to produce, consume and where feasible, execute implementable CDS interventions. 1.Event Condition Action Rules (ECA Rules) 2.Order Sets 3.Documentation Templates Pilot Scope 1.Health eDecisions will apply defined aspects of the Implementation Guide in a real- world setting. 2.Modify the Implementation Guide to ensure it is usable 3.Submission of explicit feedback to sub workgroups such as vMR and Vocabulary and Terminology work group to close gaps 4.The real-world pilots evaluate not only the technology, standards and model (VMR), but also provide a test bed to evaluate the interaction of technology, implementation support, and operational infrastructure required to meet Health eDecisions use case 1 objectives at the stakeholder or organization levels. 5.Demonstrate intent of artifact (specifically structures and semantics) are communicated either by direct execution or by translation to native format 6.Ensure completeness and consumability of artifact New

9. Timeline 10/11/20119 We are Here Goal & Activities EST. Time DatesDeliverables Kickoff /Establish Goals & Partnerships: - Review HeD Initiative Goals - Review Piloting Process & Resources - Define Value Statement - Define HeD Pilot Goals & Success Metrics - Establish & Approve Pilots - Develop Pilot Briefs 4 wks. (reality 5 weeks) 1/07-2/25 (we missed 2 meetings in January pushing our Dates back) -Wiki Capturing Pilot Deliverables -Established Partnerships -Documented Value Statements and Success Metrics -Documented Pilot Briefs Pilot Configuration: - Establish Pilot Test Environment & Resources - Establish Pilot Implementation & Testing Process - Develop & Review Pilot Configuration 2 wks. (reality- 4 weeks) 2/25-3/25 -Use Case is Updated with HL7 Comments (3/4) -Approved Pilot Briefs -Committed Pilot Resources -Documented & Reviewed Pilot Configuration Guide -Weekly Feedback on Use-Cases & IG Alignment Pilot Development : - Setup & Develop Pilot Prototypes - Review prototypes 6 wks. or less depending on Pilot activity 3/25 – 5/6 -Use Case is Updated with HL7 Comments (3/4) -Weekly Pilot Development Status Updates -Weekly Feedback on Use-Cases & IG Alignment -Updates to Pilot Configuration Guides Pilot Testing & Showcase : - Complete Testing - Prepare Solution Showcase 2wks (In Reality this was closer to 10 weeks 5/6 -5/20-Weekly Pilot Testing Updates & KPIs -Showcase -Prepare for HL7 Pilot Wrap-up : - Develop Lessons Learned an ONC Feedback - Review Initiative Goal Alignment - Establish Next-Steps 2 wks.6/10– 6/24-Documented ONC Feedback - Next Steps Action Plan

10. Vendor Partners 10/11/201110 EHRArea of InterestMatches Design ClinicalsOrder SetsZynx AllScriptsNQF – 068 Million Hearts ECA Rule NewMentor AllScriptsSan Diego Pertussis ECA RuleCDC VAUTI Documentation Template Wolters Kluwer

11. Use Case 2

12. SDS & Harmonization HeD Timeline Overview HeD UC2 vMR Mapping Template Update DSS Profile Update vMR Profile Update Ballot Work Products Update 12

13. SDS & Harmonization HeD Timeline Overview HeD UC2 vMR Mapping Template Update DSS Profile Update vMR Profile Update Ballot Work Products Update 13

14. 14 HeD Use Case 2 Timeline vMR Extension & Alignment DSS HeD UC2 Guidance Community Review & Ballot Preparations DSS Update & Profile Development 6/4-6/28 Jun ‘13Jul ‘13Aug ‘13 Update Mapping with C- CDA/QRDA data elements, cardinality, data type, value restrictions 6/17-7/1 Develop vMR Container/ Payload Profiles 6/19-6/28 Update vMR DAM with Harmonized Semantics 7/11-7/18 Include vMR templates and mapping in DSS IG 7/12-7/22 Determine Functional Interaction Type Examples 6/17-6/19 DSS Update & Profile Review & Packaging 6/25-7/9 vMR XML & HeD UC1 IG Review & Packaging 7/22-8/2 New DSS IG Review & Packaging 7/22-8/2 vMR XML IG Review & Packaging 7/22-8/2 Extend vMR for HeD UC2 7/1-7/18 Develop Mapping Template 6/4-6/13 Harmonize vMR with CCDA/QRDA 7/1-7/10 Update Mapping with HeD UC2 data elements, cardinality 6/17-6/28 Today (6/27) Update Mapping with vMR data elements, cardinality, data types 6/10-6/21 Update Mapping with vMR/HeD Value restrictions 6/18-6/28 Add DSS profiles to IG along with place holders for vMR mapping and vMR profiles 6/26-7/11 Finalize context and section introductions within IG 7/12-7/21 vMR DAM Review & Packaging 7/12-7/25 HL7 NIB Prep & Submission 6/25-7/7 HL7 Initial Content Prep & Submission 7/5-7/14 HL7 Final Submission Deadline (Aug 4) HL7 Notification of Intent to Ballot (July 7) HL7 Initial Content Deadline (July 14) Incorporate vMR DAM changes 6/28-7/10 Update vMR XML IG 7/12-7/19 Update HeD UC1 IG 7/12-7/19

15. Key Milestone Dates for September Ballot Administrative Deadlines: HL7 Notification of Intent to Ballot: July 7 HL7 Initial Content Deadline: July 14 Content Deadlines: End-to-End Review Period: –Initial DSS Update & Profile Review & Packaging : 6/25 – 7/9 –Initial vMR DAM Review & Packaging: 7/12 – 7/25 –Initial vMR XML IG Review & Packaging : 7/22 – 8/2 –Initial vMR XML HeD UC1 IG Review & Packaging: 7/22 – 8/2 –New DSS IG Review & Packaging: 7/22 – 8/2 There will be end to end reviews of each section as they are completed at earlier dates HL7 Final Content Deadline: August 4 HL7 Examples Deadline: August 19 HL7 Final Content Deadline: August 4 HeD Consensus Review Period: August 19 – September 2 –Comments will be received during balloting from August 19 – August 26 –Comments will be vetted by the community Submit Comments to HL7 on September 3 15

16. SDS & Harmonization HeD Timeline Overview HeD UC2 vMR Mapping Template Update DSS Profile Update vMR Profile Update Ballot Work Products Update 16

17. HeD UC2 vMR Mapping 17 WorkstreamOwner & Resources Current StatusUpdate vMR MappingHeD Internal Team and Vocab and Terminology Work Group Initial mapping complete Updates to the vMR DAM to be completed on June 27 These changes will be updated in the vMR Mapping Google doc on June 28 CCDA Mapping HeD Internal Team CCDA mapping is in process Completed tabs: Problems, Demographics, Observations, Encounters, Medications and Adverse Events Looking to have rest complete by June 28th QRDA Mapping Mark Roche QRDA mapping is in process Looking to have done by 7/1

18. HeD UC2 vMR Mapping (continued) 18 WorkstreamOwner & Resources Current StatusUpdate HeD UC2 Mapping Bryn Rhodes and HeD Internal Team Initial mapping of clinical data elements complete Updates to the vMR DAM to be completed on June 27 Bryn to complete mapping of other data elements and changes from vMR DAM by June 28 Proposed Templates Dave Shields Dave Shields has begun populating the proposed template tab with potential templates for each category, and will have complete by June 28 th Templates for vMR will have one general version that is very broad Will try to create templates that match CCDA and QRDA. Next Step: Each tab will then be populated with these templates and will be used for the actual harmonization beginning 7/1

19. HeD UC2 vMR Mapping Due to dependencies between our vMR mapping and the vMR DAM, a freeze on updates to the vMR DAM will occur on Friday, June 28th o If updates to the vMR and vocab and terminology are a moving target, the google doc will never be up to date o With a freeze date, we can ensure that no further updates will be made in the short term, and that the google doc can be synched up with the most recent updates o These updates will need to be vetted with the CDS WG next week, and Aziz will update harmonization group on any changes There is also a dependency between the vMR Mapping document and the Vocab and Terminology document o There are current discussions on which document will be the source or truth 19

20. vMR Harmonization (continued…) Below is the suggested strategy for harmonization, which will begin Monday: Kick off harmonization meetings o Hold 3 live working sessions a week o First meeting will be Monday 7/1 at 11:00 o Utilize Monday/Tuesday Vocab and Terminology WG o Wednesday SWG, o Complete work offline as needed o Resource familiar with each standard/work stream should be present at all meetings »vMR – Bryn Rhodes/Dave Shields/Aziz Boxwala/Claude Nanjo »CCDA – David Tao/Elvino Saldanha »QRDA – Mark Roche »Value Restrictions – Victor Lee/Rob McClure/Mark Roche Begin harmonization efforts on the Problems tab on Monday 7/1 o Option 1: Review tab line by line for updates and then complete harmonization simultaneously o Option 2: Complete all updates first, then begin harmonization 20

21. SDS & Harmonization HeD Timeline Overview HeD UC2 vMR Mapping Template Update DSS Profile Update vMR Profile Update Ballot Work Products Update 21

22. DSS Profile Update 22 TaskOwner & Resources Current StatusUpdate Develop DSS Profile for Request with REST Bryn Rhodes Created WSDL for REST Working through validation errors Section defining the RESTful profile for inclusion in the IG complete Develop DSS Profile for Response with REST Bryn Rhodes Created WSDL for REST Working through validation errors Section defining the RESTful profile for inclusion in the IG complete Develop DSS Profile for Request with SOAP Dave Shields Has done initial analysis, should not be big changes Tentatively complete by EOW for DSS Profile Develop DSS Profile for Response with SOAP Dave Shields Has done initial analysis, should not be big changes Tentatively complete by EOW for DSS Profile Update DSS Standard with REST guidance, including modifications to the standard itself (as necessary) and guidance on use of REST for general use cases (not HeD UC2-specific) Bryn Rhodes/Da ve Shields (as needed) Dave Shields has pu t a list together of DSS standard sections and artifacts that need to be updated No changes for DSS standards on request transactions Updates to DSS standard will be complete by EOW

23. SDS & Harmonization HeD Timeline Overview HeD UC2 vMR Mapping Template Update DSS Profile Update vMR Profile Update Ballot Work Products Update 23

24. vMR Profile Update 24 TaskOwner & Resources Current StatusUpdate Develop vMR Container Profile for Request Aziz Boxwala/Dave Shields Will use UC1 as a reference There are a number of new data elements needed in the cdsInput container for the Request Develop vMR Container Profile for Response Aziz Boxwala/Dave Shields Will use schema for UC1 Significantly constraining this schema Wrote set of constraints in plan English that can translate into schematron Has shared google doc with this information Develop vMR Request Payload Profile for specific functional profile interaction types Dave Shields/Claude Nanjo/ Victor Lee/Bryn Rhodes Develop HeD S/vMR Response Payload Profile for specific functional profile interaction types Dave Shields/Claude Nanjo/ Victor Lee/Bryn Rhodes

25. SDS & Harmonization HeD Timeline Overview HeD UC2 vMR Mapping Template Update DSS Profile Update vMR Profile Update Ballot Work Products Update 25

26. Ballot Work Products Update 26 Work ProductOwnerCurrent StatusUpdate Decision Support Service (DSS) IG Development: Atanu Sen Packaging for HL7: Saunya Williams Template for IG has been drafted DSS Profile for REST has been drafted DSS Profile for SOAP is in process Updated DSS Standard Development: Dave Shields & Bryn Rhodes Packaging for HL7: TBD (Ken Kawamoto?) David Shields & Bryn Rhodes conducted initial analysis to identify updates Updated vMR DAM Development: Aziz Boxwala & Claude Nanjo Packaging for HL7: TBD (Ken Kawamoto?) Finalizing updates to vMR DAM that were previously identified Harmonization may result in further updates to vMR DAM Updated vMR XML IG Development: Aziz Boxwala & Claude Nanjo Packaging for HL7: TBD (Ken Kawamoto?) Once vMR DAM updates finalized the updates to vMR XML schemas can begin Updated HeD UC1 IG Development: Aziz Boxwala & Claude Nanjo Packaging for HL7: TBD (Ken Kawamoto?) Once vMR DAM updates finalized the updates to HeD UC1 IG can begin Next step to determine if updates to HeD UC1 IG are necessary based on Pilots

27. Next Steps WeekdayMeetingTimeTopicsDetails July 1stPilots (UC 1)1-2:30 ETReview additional Pilot findings Review IG http://wiki.siframework.org/He alth+eDecisions+Homepag July 1stVocabulary and Terminology 12-1:00 EThttp://wiki.siframework.org/He alth+eDecisions+Homepage July 2ndCDS-HeD Working Meeting 3:00-4:00 EThttp://wiki.siframework.org/He alth+eDecisions+Homepage July 2ndVocabulary and Terminology 4:00-5:00 EThttp://wiki.siframework.org/He alth+eDecisions+Homepage July 3rdStandards Sub work Group Call 1:00-2:00 EThttp://wiki.siframework.org/He alth+eDecisions+Homepage July 4thAll Community Call 11:00-12:30 ET http://wiki.siframework.org/He alth+eDecisions+Homepage Canceled!!

28. Questions?

29. Contact Information For questions, please contact your support leads –Coordinator: Ken Kawamoto: kensaku.kawamoto@utah.edukensaku.kawamoto@utah.edu –Co-Coordinators: Aziz Boxwala: aziz.boxwala@meliorix.comaziz.boxwala@meliorix.com Bryn Rhodes: bryn@veracitysolutions.combryn@veracitysolutions.com –ONC Leadership: Alicia Morton: alicia.morton@hhs.govalicia.morton@hhs.gov –Project Management: Jamie Parker: jamie.parker@esacinc.comjamie.parker@esacinc.com –Use Case 2: Dave Shevlin: d.s.shevlin@accenturefederal.comd.s.shevlin@accenturefederal.com Virginia Rhiel: virginia.riehl@verizon.netvirginia.riehl@verizon.net –Harmonization: Lynette Elliot: lynette.elliott@esacinc.comlynette.elliott@esacinc.com Anna Langhans: anna.langhans@accenture.comanna.langhans@accenture.com

30. Useful Links Wiki –http://wiki.siframework.org/Health+eDecisions+Homepagehttp://wiki.siframework.org/Health+eDecisions+Homepage Use Case 1& 2 –http://wiki.siframework.org/Health+eDecisions+Use+Casehttp://wiki.siframework.org/Health+eDecisions+Use+Case –UC 2: Use Case 2: http://wiki.siframework.org/UC+2+- +CDS+Guidance+Servicehttp://wiki.siframework.org/UC+2+- +CDS+Guidance+Service Pilots –http://wiki.siframework.org/Health+eDecisions+Pilotshttp://wiki.siframework.org/Health+eDecisions+Pilots HL7 Ballot Submission: –http://wiki.siframework.org/Health+eDecisions+Reference+Materials #Ballothttp://wiki.siframework.org/Health+eDecisions+Reference+Materials #Ballot UC 1 Harmonization and IG: –http://wiki.siframework.org/Health+eDecisions+Harmonization+and+ Standards+%28Implementation%29http://wiki.siframework.org/Health+eDecisions+Harmonization+and+ Standards+%28Implementation%29 HeD Glossary –http://wiki.siframework.org/HeD+Glossaryhttp://wiki.siframework.org/HeD+Glossary