1. Electronic Submission of Medical Documentation (esMD) Electronic Determination of Coverage (eDoC) Workgroup August 21, 2013

2. 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 2 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

3. Agenda TopicPresenter Administrative Items and Announcements Sweta Ladwa eDoC Use Case Review PMD User Story Dataset Requirements Sweta Ladwa/ Dr. Mark Pilley eDoC Use Case Harmonization Scope Review Activity Spreadsheet Dr. Viet Nguyen/ Zach May 3

4. Friday, 2 - 3 PM: eDoC Structured Data SWG Meeting Schedule

5. The eDoC IG for S&I will add structure around the HL7 C- CDA companion guide Standards: –C-CDA –Standards identified in Author of Record: XAdES for digital signatures SAML for delegation of rights IHE DSG for signing bundles –Transport standards (see slide 8) eDoC S&I IG Scope

6. Covers: Ambulatory, consults, op notes, procedures, hospital discharge, and time-based information Framework for data collection: Complete encounter– –Event-based (procedure) –Time-based –Single encounter eDoC S&I IG Scope

7. Organization of the IG: Not specifying the implementation, but rather, the behaviors of implementation: 1.Creation How & when to create documents Required for creation Multiple signatures 2.Maintenance and retrieval Records can’t be modified Availability Storage –Internal (EHRs) –External (repositories) –Document management, XDS eDoC S&I IG Scope

8. 3.Sending / Transmission Transport Mechanisms –X12 (275 / 277 / 278) – metadata is part of the messaging standard –Direct / Connect – information used by the sender/recipient must be in metadata wrapper –Serialization, XDR Dealing with multiple systems –Administrative systems support X12 for registration, payer-provider billing, practice management –Clinical systems don’t support X12 unless they are integrated systems eDoC S&I IG Scope

9. Additional considerations: –Sent CDAs ought to be signed – optional or required? If it’s sent by a 3 rd party, the receiver may require that it be signed –A transaction may include a CDA along with external, related elements that were not included within the CDA—everything but the single encounter will be a bundle eDoC S&I IG Scope