Electronic Submission of Medical Documentation (esMD) Electronic Determination of Coverage Harmonization August 14, 2013

Meeting Etiquette Please announce your name each time prior to making comments or suggestions during the call Remember: If you are not speaking 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 = very frustrated speakers and participants This meeting, like all of our meetings, is being recorded –Another reason to keep your phone on mute when not speaking! Feel free to use the “Chat” or “Q&A” feature for questions or comments NOTE: This meeting is being recorded and will be posted on the esMD Wiki page after the meeting From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute 2

Agenda 3 TopicPresenter Announcements and Administrative ItemsZach May eDoC PMD User Story Review eDoC PMD Data Set changes Jenny Brush Mark Pilley eDoC Harmonization Kick-off Harmonization/Standards Overview eDoC Harmonization Challenges Review Dataset Requirements Zach May Viet Nguyen Mark Pilley Dan Kalwa

Switch to Word file… PMD User Story

Standardization Development & Harmonization: Targeted Activities Outputs 1.Validate candidate standards list 2.Analyze candidate standards per HITSC criteria to produce selected standards 3.Map UCR to selected standards in documented crosswalk 4.Perform technical feasibility of analysis 5.Develop gap mitigation plan 6.Review with community and achieve consensus Gap mitigation plan Requirements Traceability Matrix 1.Develop solution diagram and plan 2.Confirm data model approach 3.Develop new standard(s) 4.Modify/harmonize existing standard(s) to produce final standards 5.Achieve community consensus or agreement Final standards 1.Using final standards, develop Implementation Guide document 2.Develop and Submit PSS (HL7) prior to finishing IG 3.Document IG Conformance Statements in RTM 4.Develop Examples to inform implementers 5.Validate examples 6.Achieve community consensus or agreement Implementation Guidance 1.Survey SDO or standards organization options 2.Select balloting approach 3.Align timeline with ballot cycles 4.Submit NIB (HL7) 5.Submit Content (HL7) 6.Conduct balloting cycle & reconciliation per SDO guidelines Balloted standards 5

The S&I Framework esMD eDoC Standards Evaluation Process Goal of the S&I Framework Standards Evaluation Process: To achieve consensus on an applicable and relevant standard to be modified or further developed as a resolution to the health information exchange challenge addressed by the esMD eDoC Initiative Each phase of the process narrows the initial Candidate Standards List toward a Selected Standard to be developed into the eDoC Implementation Guide Based off HITSC proposed approach for standards analysis Developed and honed best practices through S&I Framework use Encompasses standards analysis criteria and evaluation tools Builds implementation guidance, conformance requirements, templates and tools 6

esMD eDoC Harmonization Challenges 1.Two Implementation Guides to be developed – Administrative Companion to C-CDA and Standard Guide for S&I specifying metadata and transport options 2.Assessment of transport requirements and transport constraints 3.Relation to prior use cases and implementation guides Use Case 1 – Message to send a registration request and response Use Case 2 – Message to send Structured Content Structured Content – Document – The eMDR Object was envisioned as a persistent document, distinct from the message it is sent in Author of Record

Switch to Excel file… Review Data Set Requirements