1. EU-US eHealth/Health IT Cooperation Initiative Interoperability of EHR Work Group March 19, 2014 0

2. Meeting Etiquette Participants automatically enter the webinar in “listen only” mode. The organizer will then unmute all participants. We ask if you are not speaking to manually mute yourself NOTE: VoIP participants have the ability to “Mute” themselves by clicking on the green microphone. However, if you would like to speak, only you can unmute yourself. If you are dialing in using a telephone and NOT using the VoIP you MUST dial the audio pin in order for the organizer to unmute you – if you do not use the audio pin and just push # when prompted the Organizer cannot unmute you

3. Meeting Etiquette CONTINUED If you are calling from a telephone, please do not put your phone on hold. If you need to take a call, hang up and dial in again when you have completed your other call This meeting is being recorded Another reason to keep your phone or your VoIP on mute when not speaking Use the “Chat” or “Question” feature for questions, comments and items you would like the moderator or other panelists to know. 2

4. Agenda TopicTime Allotted General Announcements5 minutes Value Set Mapping Discussion50 minutes Next Week Logistics5 minutes 3

5. Meeting Times 4 Washington, DC 10:00am (ET) Washington, DC 10:00am (ET) London 2:00pm/14:00 (GMT) London 2:00pm/14:00 (GMT) Germany 3:00pm/15:00 (CET) Germany 3:00pm/15:00 (CET) Athens 4:00pm/ 16:00 (EET) Athens 4:00pm/ 16:00 (EET) Interoperability Work Group meets every Wednesday Please note new EU times until April 2 nd NOTE: These times have been updated to reflect the daylight savings time that will begin in the United States on Sunday, March 9 th. The European countries which participate in daylight savings time, will then change on Sunday, March 30 th. As a result, European participants will be attending the Interoperability webinars 1 hour earlier through March 30 th.

6. General Announcements To join our weekly webinars, visit the EU-US eHealth Collaboration Wiki Homepage for the latest meeting information: http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative 5 To subscribe to our mailing list, simply complete the EU-US MOU Project Signup Form: http://wiki.siframework.org/EU- US+MOU+Roadmap+Project+Sign+Uphttp://wiki.siframework.org/EU- US+MOU+Roadmap+Project+Sign+Up To submit a brief biography of yourself (150 words or less), review the criteria listed at http://wiki.siframework.org/Interoperability+of+EHR+Work+Group #Work Group Members and e-mail your bio and photo (optional) to Gayathri Jayawardena at gayathri.jayawardena@esacinc.com http://wiki.siframework.org/Interoperability+of+EHR+Work+Group #Work Group Membersgayathri.jayawardena@esacinc.com To access current and archived meeting materials, visit the Project Meeting Artifacts section: http://wiki.siframework.org/Project+Meeting+Artifac ts http://wiki.siframework.org/Project+Meeting+Artifac ts

7. 6 (Clinical Summary Form) (Clinical Summary Form) (document ID, author, patient ID…) (document ID, author, patient ID…) [Body] [Procedures] (Colonoscopy) [Gastroscopy] [CABG] … (Colonoscopy) [Gastroscopy] [CABG] … [Current Medications] … [ASA] [Warfarin] [CABG] [ASA] [Warfarin] [CABG] Phase 1 Section level mapping between epSOS and CCD Phase 2 Header’ Data Element mapping Phase 3 Sections’ Data Element mapping Phase 4 Value Set mapping Completed Remaining Data Granularity and Complexity Phases of Harmonization

8. Comparative Analysis: In Numbers Analysis/Mapping Type CCDAepSoSStatusGaps Header Data Elements (DEs) ~100 DEs Review complete. All but several epSoS DEs are mappable to CCDA. Mapping and gap details documented in excel (for now) CCDA provides a lot more DEs and attributes than epSoS. epSoS contains some DEs (such as primary health care provider for EU citizen traveling to another EU country) not in CCDA. Section Level18 sections16 sectionsAll sections mapped. Gaps identified. epSoS Active Problems and Hx of Past illnesses map to Problem Section in CCDA. CCDA sections such as Advance Directive, Encounters, Family History and Payers are not in epSoS. Section Data Elements (DEs) Significantly more DEs (~2x or more) ~70 DEsFirst Pass completed.Overall, CCDA CCD has significantly more Data Elements than epSoS. There are about 10 epSoS DEs not in CCDA CCD. IG guides on both ends do not specify all information that CDA schema allows. Value Sets74 Value Sets45 Value SetsCurrently under review (~50% completed). Review scope: only VS in PS (not entire CCDA) In-depth of several Value Sets performed at code-level.

9. Mapping Review/Validation: Resources and Process All harmonization/mapping work is done on Google spreadsheet: – Link: https://docs.google.com/spreadsheet/ccc?key=0AiAfdYPeAnM- dG1mczY3dXN4WEl5eEpYVE5fV0pFWUE&usp=drive_web#gid=11https://docs.google.com/spreadsheet/ccc?key=0AiAfdYPeAnM- dG1mczY3dXN4WEl5eEpYVE5fV0pFWUE&usp=drive_web#gid=11 – Access: anyone with link – Privileges: “View and Comment” – everyone with link (the one above) “Edit” – selected – EU: one designated XML/epSoS PS subject matter expert – US: Mark Roche (for now) » Above may be reviewed/updated as project continues Review Process: – Review/validate mapping outcomes after each phase with community – Review points: Mapping completeness Mapping accuracy Mapping gaps 8

10. Phase 2: Header Data Element Mapping Continue giving feedback on completeness, accuracy, and gaps of the Header Data Element Mapping on the Google Doc spreadsheet https://docs.google.com/spreadsheet/cc c?key=0AmrxdaeLhHzXdDlqZXFZZ2Y3OU5R bjJMODRpb3JXaWc&usp=drive_web#gid=3 https://docs.google.com/spreadsheet/cc c?key=0AmrxdaeLhHzXdDlqZXFZZ2Y3OU5R bjJMODRpb3JXaWc&usp=drive_web#gid=3 9

11. Phase 3: Section Data Element Mapping Phase 3 completed Section Data Element Mapping Comment form available 10

12. Mapping SWG made considerable progress in mapping Value Sets, and individual codes within Value sets between epSOS and CCD Value Set Mapping Comment form available 11 Phase 4: Value Set Mapping

13. 12 Next meeting will be on Wednesday, March 26 th, 2014 at 10:00 am (ET)/16:00 (EET) Please attend the next Mapping Sub-Work Group on Tuesday, March 25 th, 2014 at 9:00 am (ET)/15:00 (EET) Next Meeting

14. 13 US Point of Contacts – Mera Choi, Mera.Choi@hhs.govMera.Choi@hhs.gov – Jamie Parker, jamie.parker@esacinc.comjamie.parker@esacinc.com – Gayathri Jayawardena, gayathri.jayawardena@esacinc.comgayathri.jayawardena@esacinc.com – Amanda Merrill, amanda.merrill@accenturefederal.comamanda.merrill@accenturefederal.com – Mark Roche, mrochemd@gmail.commrochemd@gmail.com – Virginia Riehl, virginia.riehl@verizon.netvirginia.riehl@verizon.net EU Point of Contacts – Benoit Abeloos, Benoit.ABELOOS@ec.europa.eu Benoit.ABELOOS@ec.europa.eu – Frank Cunningham, frank.cunningham@ec.europa.eufrank.cunningham@ec.europa.eu – Catherine Chronaki, chronaki@gmail.comchronaki@gmail.com Project Support Team

15. Initiative Resources EU-US Wiki Homepage – http://wiki.siframework.org/EU- US+eHealth+Cooperation+Initiative http://wiki.siframework.org/EU- US+eHealth+Cooperation+Initiative Join the Initiative – http://wiki.siframework.org/EU- US+MOU+Roadmap+Project+Sign+Up http://wiki.siframework.org/EU- US+MOU+Roadmap+Project+Sign+Up EU-US Initiative Reference Materials – http://wiki.siframework.org/EU- US+MOU+Roadmap+Project+Reference+Materials http://wiki.siframework.org/EU- US+MOU+Roadmap+Project+Reference+Materials Interoperability of EHR Homepage – http://wiki.siframework.org/Interoperability+of+EHR+Work+Gr oup http://wiki.siframework.org/Interoperability+of+EHR+Work+Gr oup 14