1. 2015 Edition Certification NPRM April 1, 2015 Semantic Standards Workgroup Becky Kush, co-chair Jamie Ferguson, co-chair

2. Membership 1 MembersOrganization Co-Chairs Jamie FergusonKaiser Permanente Becky KushClinical Data Interchange Standards Consortium (CDISC) Members John CarterApelon, Inc. Todd CooperBreakthrough Solutions Foundry, Inc., Center for Medical Interoperability Stan Huff Intermountain Healthcare Rosemary KennedyeCare Informatics, LLC, Thomas Jefferson University Harry RhodesAHIMA Eric RoseIntelligent Medical Optics (IMO) John Speakman New York University Langone Medical Center Asif SyedAmerican Medical Association (AMA) Andy Wiesenthal - liaison memberDeloitte Consulting, LLP Ex Officio Members Steve BrownVeterans Administration (VA) Margaret HaberEnterprise Vocabulary Services, National Cancer Institute (NCI) Betsey HumphreysNational Library of Medicine (NLM) Mitra RocaFood and Drug Administration (FDA) ONC Staff Lead Patricia GreimOffice of the National Coordinator for Health IT

3. Federal Regulations What is a Federal Regulation? – After Congressional bills become laws, federal agencies are responsible for putting those laws into action through regulations (also known as “rule”). The public plays an extremely important role in the rulemaking process by commenting on proposed rules to help improve them. Why Comment? – We value the publics input. HHS must seek public review and comments before finalizing a regulation. This action is called a “Notice of Proposed Rulemaking” (NPRM) When are Comments Due? – The proposed rule includes a 60 day comment period. Comment period will close on May 29th. After the comment period closes, ONC will publish a “final rule” which may change the NPRM based upon the comments received. 2

4. Process for Responding Cert. NPRM Introduction Small Group Consensus Develop Consensus Review Comments with HITSC 3 Cert. NPRM Overview Discuss process Make assignments Review deadlines Members draft comments and work with small group to prepare consensus comments Prepare materials for assigned meeting Small group reviews comments with workgroup Workgroup refines comments Chairs brief HITSC April 1Offline work April 17, 21 TBD May 18, 11 May 20 HITSC Meeting

5. Workgroup Assignments 4 Group 1Group 2 Pharmacogentics Data – Standards Question, p.239 There are existing or developing standards applicable to the capture, storage, display, and exchange of potentially clinically relevant genomic data, including the pharmacogenomic subset Common Clinical Data Set Definition - vocabulary standards p.246 National Drug Codes for Administered Vaccinations, p.170 Transmission to Public Health Agencies – all sections, p.176 Immunization History and Forecast, p.174 Additional items, per Jamie’s request Family health history, p.16 “Minimum Standards” Code Sets, p.32 Object Identifiers (OIDs) for Certain Code Systems, p.32 Demographics, p.44 Vital Signs, Body Mass Index (BMI), and Growth Charts, p.49 Smoking status, p.67 Social, Psychological, and Behavioral Data, p.81 Work Information – Industry/Occupation Data, p.89 U.S. Uniformed/Military Service Data, p.92 Encounter Diagnoses, p.105 Medication Dosing, p.118

6. Semantic Standards – Certification Rule Workplan MeetingsTask April 1, 2015 12:00 PM ET Certification NPRM Introduction Process for commenting on NPRM Break into groups April 17, 2015 11:00 AM ET Report out from Group 1 Meeting date TBD Report out from Group 2 May 18, 2015 10:00 AM ET Finalize NPRM Comments May 20, 2015 HITSC Meeting Certification NPRM Comments