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

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

3. 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

4. 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)

5. 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

6. 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

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