HITSP Project Medications Management Use Case Presentation to CCHIT Steve Wagner and Scott Robertson July 27, 2007

Topics What is Medication Management Who are the stakeholders Analysis Update HITSP Constructs Next Steps

What is Medication Management Focuses on patient medication and allergy information exchange between consumers, clinicians (in multiple sites and setting of care), pharmacists, and organizations that provide health insurance and pharmacy benefits Provides reconciliation of medication lists/therapies Allows for application of clinical decision support to therapy selection Enhances management of medication therapy Looked at from 2 settings and 3 perspectives. Settings: inpatient care and ambulatory care Perspectives: clinicians, pharmacists, and consumers Long-term care setting is included within these settings where appropriate

Who are the Stakeholders Clinicians Consumers Drug Knowledge Suppliers Health Information Exchange (HIE) Healthcare Entities Healthcare Payors Medication Network Intermediaries (MNIs) Patients Pharmacists Pharmacy Benefit Managers (PBMs) Public health Agencies (local/state/federal)

Analysis Update Initial analysis of inpatient scenario for all perspectives has been completed. Initial analysis of clinicians perspective of ambulatory care scenario has been completed. Currently analyzing pharmacist perspective of ambulatory care events. Expect to complete initial analysis of ambulatory care scenario on next call. Have found many similarities between settings and are able to reuse much of inpatient UML diagrams for ambulatory setting, with only minor changes. Potential Standards Gaps being identified during analysis Information exchange with knowledge vendors

HITSP Constructs ISC-32 Registration and Medication History Document Potential reuse for medication history, demographics, clinical information (e.g., problems, conditions, diagnoses), allergies ISC-35 EHR Lab Terminology Potential reuse for clinical terminology ISC-37 Lab Report Document Potential reuse for clinical information contained in laboratory documents Need to evaluate for complete coverage of requirements Other existing constructs for potential reuse (e.g., Security and Privacy) Extensions to existing constructs New constructs are yet to be identified

Next Steps Complete analysis of ambulatory care events Check UML model for consistency Prepare RDSS for public comment in early September