1. PDMP & Health IT Integration All-Hands Meeting May 13 th, 2014

2. Meeting Etiquette 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 meeting is being recorded – Another reason to keep your phone on mute when not speaking Feel free to use the “Chat” feature for questions, comments or any items you would like the moderator or participants to know. NOTE: This meeting is being recorded and will be posted on the Meeting Artifacts Wiki page after the meeting From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute 2

3. Agenda TopicTime Allotted General Announcements5 minutes PDMP & HITI Standards and Harmonization Finalize Gap Mitigation Plan Outcomes 40 minutes Introduce Solution Planning Workgroup10 minutes Next Steps/Questions5 minutes

4. General Announcements… We will be resuming the normal timeframe of 12:00-1:00 pm (ET) Tuesdays for our All-Hands meetings. We will be hosting a Concert Series presentation “Prescription Drug Monitoring Programs and the PMIX Architecture” on May 21st at 3pm ET – https://siframework1.webex.com/siframework1/onstage/g.ph p?t=a&d=665199761 https://siframework1.webex.com/siframework1/onstage/g.ph p?t=a&d=665199761 – Dial In: 1-650-479-3208 – Access code: 665 199 761 4

5. General Announcements Continued To join our weekly webinars, visit the PDMP & Health IT Integration initiative Homepage for the latest meeting information: http://wiki.siframework.org/PDMP+%26+Health+IT+Integration +Homepage http://wiki.siframework.org/PDMP+%26+Health+IT+Integration +Homepage 5 To subscribe to our mailing list, simply complete the PDMP & Health IT Project Signup Form: http://wiki.siframework.org/PDMP+%26+Health+IT+Inte gration+Join+the+Initiative http://wiki.siframework.org/PDMP+%26+Health+IT+Inte gration+Join+the+Initiative To access current and archived meeting materials, visit the Project Meeting Artifacts section: http://wiki.siframework.org/PDMP+% 26+Health+IT+Integration+Meeting+Art ifacts http://wiki.siframework.org/PDMP+% 26+Health+IT+Integration+Meeting+Art ifacts Note: Please check the meeting schedule weekly to get the most up-to-date meeting information

6. PDMP & Health IT Integration Standards and Harmonization May 13 th, 2014

7. PDMP Harmonization Timeline MarchAprilMayJuneJuly 3/25 Harmonization Kick-off Standards Evaluation Candidate Standards List UCR-Standards Mapping Gap Mitigation Plan HITSC Evaluation* Solution Planning IG Development Solution Plan Create IG Template IG Development End-to-end Review & Community Consensus (Today) 7/29 Harmonization Close

8. Week Target Date (2014) All Hands WG Meeting Tasks Review & Comments from Community via Wiki page due following Monday @ 12 noon 13/25 Harmonization Kick-Off & Process Overview Introduce: Overview of UCR-Standards Mapping Review: N/A 24/1Introduce: Candidate Standards List & UCR-Standards MappingReview: Candidate Standards List 34/8 Finalize: Candidate Standards List Review: UCR-Standards Mapping 44/15Review: UCR-Standards Mapping -4/22 Cancelled for National Rx Summit 54/29 Finalize: Outcome of UCR-Standards Mapping Introduce: Gap Mitigation Plan Review: Gap Mitigation Plan 65/6Review: Gap Mitigation Plan 75/13 Finalize: Gap Mitigation Plan Introduce: Solution Planning Workgroup Review: N/A 8-95/20-5/27 Introduce & Review: Solution Plan & Outcomes of Workgroup Sessions Review: Solution Plan 106/3 Finalize: Solution Plan Introduce: Implementation Guide (IG) Template Review: Implementation Guide Template 11-156/10 – 7/8Review: Implementation Guide 16-177/15 – 7/22End-to-End Community Review of Implementation GuideEnd-to-End Review of Implementation Guide 187/29Consensus Vote Harmonization Weekly Timeline

9. Gap Mitigation Summary Analysis May 13 th, 2014

10. Standard Reviewed Gap SummaryMitigation Summary Impact on Stakeholders Technical Feasibility Practical Feasibility Content & Structure Standards HL7 V2.X ADT / Orders / Query Broad query response capabilities; not well defined for PDMP controlled medication history report. Does not address all necessary content. Supports the transmission of information, not the internal processes of creating the query. Does not perform authentication. PDMP-specific query response could be developed with moderate effort. PDMP-specific IG including data attributes would need to be developed. Structure would need to be developed to define standardized format, as well as develop mechanism to perform authentication. 1. PDMP: Moderate to High 2. HIT: Low YN HL7 FHIR Container could function as request/response, but does not fit the needs for medication history of controlled substances. Portions of the container in query/response transactions would have to be customized to fit the needs of PDMP. New concept and draft process with limited knowledge resource as of now, thus requiring heavy modification and development of entirely new set of resources. 1. PDMP: High 2. HIT: Moderate to High NN

11. Standard Reviewed Gap SummaryMitigation Summary Impact on Stakeholders Technical Feasibility Practical Feasibility Content & Structure Standards ASAP Web Services No gaps identified for generation of query-response and structure of specified formatting, authentication, and packaging. Lacks only a few data elements specific to system or transaction identifiers, and information regarding authorized user – specifically: 1.Requester Routing ID 2.State of request 3.Requestor Location 4.Requested states 5.Authorized user credentials and information 6.Response ID 7.Message ID (response) Add required data elements to request and response categories. 1. PDMP: Low 2. HIT: Low YY PMIX-NIEM No gaps identified for generation of query-response and structure of specified formatting, authentication, and packaging. Does not support all data elements required in UC within request transactions – specifically: 1.Requestor’s internal patient ID 2.State of Request 3.Requested state(s) 4.Authorized user credentials and information within payload 5.Request/routing ID 6.Summary of Response Modify to include required data elements within payload and/or container (metadata), where appropriate. 1. PDMP: Low 2. HIT: Moderate YY

12. Standard Reviewed Gap SummaryMitigation Summary Impact on Stakeholders Technical Feasibility Practical Feasibility Content & Structure Standards NCPDP SCRIPT No gaps identified for generation of query-response and structure of specified formatting, authentication, and packaging. Does not support all data elements required in UC for general request, authorized user request, and general response categories – specifically: 1.State of Request 2.Requestor’s internal patient ID 3.Requested state(s) 4.State of Response 5.Summary of Response 6.Role of Healthcare Professional Modification to derive requesting state either through SCRIPT or intermediary. Include Role within Authorized User credentials (could be overcome with use of DEA or license # - burden on registration process) Modification to derive responding state and summary through SCRIPT or intermediary. 1.PDMP: Moderate 2. HIT: Low YY Click the icon to open the Excel file

13. Standard Reviewed Gap SummaryMitigation Summary Impact on Stakeholders Technical Feasibility Practical Feasibility Terminology & Code Value Standards RxNorm No gaps identified across information interchange and system requirements. RxNorm required within EHR system – would have to translate NDC codes received by PDMPs or Intermediaries EHRs would have to bear burden of converting NDC codes to RxNorm terminology to present drug information 1. HIT: High 2. PDMP: N/A YY NDC No gaps identified across information interchange and system requirements. N/A YY

14. PDMP & HITI Solution Planning Approach May 13 th, 2014

15. Recap of Harmonization Progress & Status PDMP & HITI Initiative Current Status S&I Harmonization Activity PurposeDate Completed Outcome# of StandardsParticipating Stakeholders Candidate Standards Analysis Identify, describe, and categorize all possible standards relevant to PDMP data exchange. 4/8/2014Full set of seemingly relevant standards, descriptions, and resources for further information. Sets framework for standards evaluation. 15 (C&S, Vocab)PDMP, Pharmacy, HIE, Data Exchange Networks UCR Standards Crosswalk Map technically feasible use case requirements to candidate standards, identifying high-level gaps. 4/29/2014Identify standards that fit the needs of the PDMP&HITI Use Case requirements, eliminating less suitable standards from further analysis. 15 (C&S, Vocab) Gap Mitigation PlanExplore gaps in detail, determine feasibility of standards, and assess impacts to stakeholders. 5/13/2014Identified: 1.Gaps/issues 2.Mitigation plan 3.Technical feasibility of implementation 4.Modifications 5.Impact to systems 7 (5 C&S, 2 Vocab) 1.SCRIPT 2.ASAP 3.PMIX 4.HL7 FHIR 5.HL7 V2.x 6.RxNorm 7.NDC

16. Process Considerations Tier 1: 3 Content & Structure Standards | 2 Stakeholder Groups | 3 Use Types ASAP Integrated direct access to PMP Portals {EHR, Ph. IT} PMIX PMP - PMP Data Exchange | Direct to PMP Portals | Interstate Hubs SCRIPT Facilitates prescription data exchange for: 1. EHR – Pharmacy 2. Pharmacy - Payers Facilitates prescription data exchange for: 1. EHR – Pharmacy 2. Pharmacy - Payers Tier 2: 2 Content & Structure Standards | 1 Stakeholder Group | 1 Use Type HL7 V2.x HL7 FHIR EHRs: Hospital workflows, messaging to support admin, logistic, financial, clinical processing EHRs: Resources specifying clinical, admin, infrastructure modules Targeted Broad

17. Process Considerations 1.Standards analysis has yielded 7 “finalists” from which the initiative can develop a Solution Plan. 2.Of 7, 3 competing standards dominate (PMIX, ASAP, SCRIPT), all providing feasible solutions 3.Segmented stakeholder groups makes standard selection complex 4.Continuation of standards evaluations via additional S&I analysis tools may not provide for most effective and holistic outcomes 5.Limited EHR Vendor input provides for limited assessment of “technical feasibility” 6.Limited perspective of Pharmacy IT system configurations Formation of interdisciplinary work group focused on creation of technical architecture specific to PDMP Health IT System data exchange, acknowledging: – UC context diagram and data flow [all transactions] – Currently implemented solutions – Clinical and system-oriented needs across actors – Technology facilitators and impediments – Infrastructure differences between systems Resolution

18. Purpose: Interdisciplinary work group (WG) comprised of PMP, Pharmacy, and EHR to develop technical architecture across actors and system functions to accelerate solution planning. SWG will provide recommendations to at-large community based on development of technical architecture and system/business requirements. Address the following questions: 1.Differences in pharmacy and clinician workflows / data systems and expectations in PDMP data transmitted? 2.What components of PDMP report are extracted for decision support? 3.Can EHR and Pharmacy IT systems handle the proposed standards (in the context of PDMP systems)? 4.What standard(s) fit into message and workflow configuration per transaction type? 5.Are transactions collapsible in terms of capability of leveraging same standard? Solution Planning Workgroup

19. Next Steps Determine meeting time for SPWG: – Thursdays 12:00pm to 1:00pm EDT or IIIIIIII Review: Outcomes of Solution Planning Workgroup Next Meeting is Thursday May 15 th from 12-1 ET Next Meeting is Tuesday, May 20 from 12:00pm - 1:00pm ET Reminder: All PDMP & HIT Integration Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Harmonization materials, Use Case, Project Charter and general information will be posted on the PDMP Wiki page – http://wiki.siframework.org/PDMP+%26+Health+IT+Integration +Homepage http://wiki.siframework.org/PDMP+%26+Health+IT+Integration +Homepage

20. Contact Information – Initiative Coordinators: Johnathan Coleman jc@securityrs.comjc@securityrs.com Sherry Green sgreen@namsdl.orgsgreen@namsdl.org – ONC Leads: Mera Choi mera.choi@hhs.govmera.choi@hhs.gov Jennifer Frazier Jennifer.Frazier@hhs.govJennifer.Frazier@hhs.gov Helen Caton-Peters Helen.Caton- Peters@hhs.govHelen.Caton- Peters@hhs.gov – SAMHSA Leads Jinhee Lee Jinhee.Lee@samhsa.hhs.govJinhee.Lee@samhsa.hhs.gov Kate Tipping Kate.Tipping@samhsa.hhs.govKate.Tipping@samhsa.hhs.gov – Support Team: Project Management: Jamie Parker jamie.parker@esacinc.com jamie.parker@esacinc.com Ali Khan Ali.Khan@esacinc.com (Support)Ali.Khan@esacinc.com Use Case Development: Ahsin Azim Ahsin.Azim@accenturefederal.com Ahsin.Azim@accenturefederal.com Presha Patel presha.patel@accenture.com presha.patel@accenture.com Standards Development Support Alex Lowitt alexander.s.lowitt@accenturefederal.com alexander.s.lowitt@accenturefederal.com Harmonization Support Divya Raghavachari divya.raghavachari@accenturefederal.com divya.raghavachari@accenturefederal.com Atanu Sen atanu.sen@accenture.comatanu.sen@accenture.com Vocabulary and Terminology Subject Matter Expert: Mark Roche mrochemd@gmail.commrochemd@gmail.com For questions, please feel free to contact your support leads: