1. Data Provenance Tiger Team May 19 th, 2014 Johnathan Coleman Johnathan Coleman - Initiative Coordinator Lynette ElliottLynette Elliott – Tiger Team Support Bob Yencha Bob Yencha – Subject Matter Expert Ioana Singureanu Ioana Singureanu – Modeling Facilitator Kathleen Connor Kathleen Connor – Subject Matter Expert Neelima ChennamarajaNeelima Chennamaraja - Modeling Facilitator

2. Agenda 2 Topic Time Allotted General Announcements1 minute HL7 Project Scope Statement Update1 minutes Timeline and Task Activity50 minutes Next Steps/Wrap Up5 minutes

3. Meeting Etiquette Please mute your phone when you are not speaking to prevent background noise. – All meetings are recorded. Please do not put your phone on hold. – Hang up and dial back in to prevent hold music. Use the “Chat” feature to ask questions or share comments. – Send chats to “All Participants” so they can be addressed publicly in the chat, or discussed in the meeting (as appropriate). 3 Click on the “chat” bubble at the top of the meeting window to send a chat.

4. Data Provenance Tiger Team HL7 Project Scope Statement Update Project Scope Statement (PSS) submitted for “Provenance for Clinical Document Architecture (CDA R2) Documents Implementation Guide” – Approved by HL7 US Task Force (4/29/14) – Discussed with Domain Experts Steering Division (DESD) on 5/5/14 in Phoenix. Feedback received from several WGs and incorporated into PSS – Revised PSS approved by HL7 Community Based Collaborative Care (CBCC) WG (5/7/14) with substantial input from Security WG – Revised PSS submitted to DESD for approval (voting to close no later than 5/28/14) Next Steps: – Pending DESD approval, PSS will be submitted to Technical Steering Committee (TSC) for approval 4

5. The Star and Swoosh, Putting the I in Health IT, the Putting the I in Health IT composite logo, HealthIT.gov, the HealthIT.gov composition logo, HealthITBuzz, and the HealthITBuzz composite logo are service marks or registered service marks of the U.S. Department of Health and Human Services. Office of the National Coordinator for Health Information Technology May- Jun ‘14Jul- Aug ‘14Sept- Oct ‘14Nov- Dec ‘14 Milestones HL7 Ballot (Aug 8- Sept 8) Data Provenance HL7 Project Scope Statement (May 18) Consensus/ End-to-end Review HL7 HL7 Notification of Intent to Ballot (June 29) HL7 Initial Content Deadline (Jul.13) HL7 WG Meeting (Sept 14-19) HL7 Final Content Due (Aug. 3) Data Provenance Tiger Team HL7 September 2014 Ballot HL7 Ballot Reconciliation (Sept. 8-Nov. 21) Today HL7 DSTU Publication Dec. ‘14

6. Tiger Team Timeline DayDate Mon28-AprKick off Mon5-MayNo meeting - HL7 Mon12-May Set-up, begin analysis Model and example doc review, gather requirements & related materials for review Mon19-May Analysis Requirements review Mon26-May Analysis Address requirements Mon2-Jun Analysis Address requirements Mon9-JunHarmonization requests due Analysis HL7 Harmonization Committee Schedule: Initial Proposal Deadline: Sunday, June 15, 2014, Midnight Technical review: Tuesday or Wednesday June 17-18, 2014 Mon16-Jun Analysis Mon23-Jun Analysis Mon30-Jun Analysis Final Proposal Deadline: Sunday, July 6, 2014, Midnight Harmonization Mtg: Tuesday through Friday, July 15-18, 2014 Mon7-JulAnalysis/review draft ballot Mon14-JulReview draft ballot Mon21-JulReview draft ballot Mon28-JulFinal ballot review and sign-offNext 3 days will be used to finalize pubs package Fri1-AugBallot Submission

7. Draft Guide and Model See the TT Wiki page for links to G-Forge – No log-in required – Most current version of draft document will always be available there – Provide comments via the TT wiki page

8. Requirements Review CDA Source of Information - Guidelines and Strategy v1.0 092811_FOR RELEASE.pdf Topics – Creating CDA Use of CDA header elements Authors and informants, e.g., primary document authors and contributors Aggregator vs. author – Aggregate CDA Traceability of parts as docs move across affinity domains – Lifecycle/lifespan parameters Implications at the document, section and entry level

9. Discussion points Authoring Entities – Medical devices & software – Humans – Providers, administrative staff from various organizations, etc. Validate the need to differentiate patient, provider, or payer information: – Revise the ParticipationFunction codes proposed to identify patient, payer, and providers sourcesParticipationFunction – “PAT”, “PAYOR”, “PROV” Record target – Identify all the patient identifiers in the document header instead of using an extension for secondary identifiers Author vs. Aggregate – Author – to create new content – Aggregation – combine from existing sources Algorithmically derived vs. “copy and paste” with new content 9

10. Original CDA Documents 10 Document Informant: Qualified Organization Entry Informant: Sub-organization overrides Sub-organization of… Document Author Device: Aggregation Software Represented organization Entry Author: Aggregation Software One document per organization Document Record Target: Patient id (primary and alternates) Entry Record: Org-specific patient id Secondary identifier may be redundant

11. Original CDA Documents 11 Document Informant: Qualified Organization Entry Informant : Identified Provider Overrides individual provider, same org. Document Author Device: Aggregation Software Represented organization Entry Author: Aggregation Software One document per organization, author overriden Document Record Target: Patient id Document Informant Provider –

12. Aggregate CDA Documents 12 Document Informant: State HIE Section Informant: Organization overrides Entry Informant: Sub-organization overrides Sub-organization of… Document Author Device: Aggregation Software Represented organization Section Author Device: Software Represented organization Entry Author: Aggregation Software Represented organization One document, auto-generated, from multiple organization and sub-organizations Document Record Target: Patient identifiers by organization Entry Record: Org-specific patient id Assigning organization Secondary identifier may be redundant Primary identifier may be accompanied by secondary identifiers

13. Data Provenance Tiger Team Next Steps Monitor wiki for updated draft based on todays work – Please use the comment capture form on the wiki Requests for community input – Submit any potential requirement not previously discussed or included in draft IG for discussion on next meeting on the wiki Requirements page – Identify any other candidate source IGs for review Next Meeting – Monday, June 2 @ 3:00PM ET 13

14. Questions? 14

15. Data Provenance Tiger Team Background Slides The following slides are included as references and for quick access when/if needed

16. Resources Tiger Team wiki – http://wiki.siframework.org/Data+Provenance+Tiger+Team http://wiki.siframework.org/Data+Provenance+Tiger+Team G-Forge repository for draft model/IG – http://gforge.hl7.org/gf/project/cbcc/frs/?action=FrsRelease Browse&frs_package_id=240 http://gforge.hl7.org/gf/project/cbcc/frs/?action=FrsRelease Browse&frs_package_id=240 Main Initiative wiki – http://wiki.siframework.org/Data+Provenance+Initiative http://wiki.siframework.org/Data+Provenance+Initiative HL7 project wiki – http://wiki.hl7.org/index.php?title=HL7_Data_Provenance_ Project_Space http://wiki.hl7.org/index.php?title=HL7_Data_Provenance_ Project_Space 16

17. Data Provenance Tiger Team Mission and Charter Tiger Team Mission and Charter To help achieve Data Provenance Initiative goals, the ONC Data Provenance Tiger Team will: Accelerate the progress of the Initiative by getting a head start on standards harmonization. Support the development of policy agnostic yet policy enabling technical standards that address prioritized initiative use case requirements. 17

18. Data Provenance Tiger Team Scope Focus on the initial set of standards required for Meaningful Use, and develop provenance-specific guidance and/or technical specifications for the initiative to use as building blocks in support of a more broadly applicable solution. Assist the initiative with detailed analysis of candidate standards for system functional requirements and interoperable exchange of data as directed by the initiative. Propose additional standards development activities to further initiative goals. 18

19. Tiger Team Initial Targets Develop a content specification for all CDA IGs to enhance Data Provenance support – Building blocks for re-use – Backwards compatible Transport is out of scope for TT, but we will monitor and inform the work as necessary Assume a generic workflow, e.g., Transitions of Care to guide analysis Document the value sets and vocabulary bindings to support provenance-related CDA data element as required by the initiative 19