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HL7 CIC – Keynote addresses as part of the

Plenary SessionLocation: Chicago, IL

Date: 9/15/2014Time: <Monday Q1 | Time: 8:30am – 12:30pm Central Time

Facilitator Anita Walden Note taker(s) Dianne Reeves

Attendee Name AffiliationSee Attached Roster

Quorum Requirements Met:

Richard Platt – Epidemiologist and PCORI PIo Talked about the best learning health system, which uses evidence-based practice, drives discovery

and fuels innovation. Mentioned the FDA Mini-Sentinel program – which uses a common data model for ETL scripted submissions.

o PCORNet – Patient powered networkso Francis Collins, NIH Director, has said that we cannot continue to support large-scale clinical trials

much longer.o NIH Collaboratory – networks all share the same data system. But each network has its own

governance based on their own model. o Discussed the problems with EHR data, with an example of 60 different units of measure used to

report platelet result values. Marc Overhage – Talked about JSON and PCAST reports –

o Offered pragmatic thoughts about interoperability. JASON is an independent scientific consulting group formed in 1959 for scientific and technology problems.

o We don’t have meaningful interoperability – less than 40% of healthcare offices have any type of interoperability, and most often some lab interfaces. We need a core architecture to which we could migrate legacy systems.

o “It would be a mistake to follow the proposed JASON Architecture”…”but ONC should help to shape what is being developed, not create something new…” A loosely coupled model is preferred. There is also implementation variability across EHR vendors. We must lead with granularity in data differences.

o Real barriers include misaligned incentives, competing priorities (Meaningful use vs. interoperability), and semantic variations. We will need to live with ‘mediocrity’ for a while priorities and needs are clarified.

o Presenter had some recommendations for us during this interim period of mediocrity: Avoid chasing bright new options – there is no silver bullet. In what he called ‘Trench Warfare’ he said there will be a state of gradual migration that

may go on for decades. Embrace mediocrity – meaning don’t get study looking for a ‘perfect’ answer. Don’t trip over the long tail cases – meaning focus on the high volume cases, and less on the

outliers and anecdotal scenarios. Ken Goodman – Chair of Biomedical Ethics, U of Miami

o A very thought-provoking discussion that proposes that interoperability is an ethical issue. Because failure to achieve interoperability is a betrayal to our patients.

o Losing data from clinical trials is different from other research, because the data is coming from human beings. Patients are not mere stakeholders. They need something different, a more critical level of commitment to interoperability.

Report from Chuck Jaffe, CEO of HL7 Introduced the HL7 Terminology Authority (HTA) headed by Ed Hammond and with appointed membership.

The US realm representative is Jim Case. The members are appointed by the Board. It is a single Point of contact for any external terminology SDO with which HL7 has a working relationship.

The HTA will review new Projects for their correct placement with sponsor WGs, particularly if proposals come in from the outside (like ONC). 22% of our projects are US realm.

This group must review and approve PSSs – Melva suggested that for this first trimester we send them to the DESC and to HTA at the same time, to avoid slowing down the workflow.

This group will have F2F meetings at the WGM sessions, associated with NLM. They have conference calls every other week.

New HL7 website rollout 9/22/2014. MedInfo 2015 will be August in Sao Paolo. IHIC Conference will be held in February 2015. Abstracts are due in October.

HL7 CIC – Cochairs Dinner and MeetingLocation: Chicago, IL

Date: 9/15/2014Time: <Monday Time: 5:15pm to 7:00 pm Central Time

Facilitator Note taker(s) Dianne Reeves

Attendee Name Affiliation

We should start each Quarter by asking about first time attendees Any PSSs need to be submitted to Lynn Laasko and Melva Peters (DESD) at the same time. Lynn will send

the PSS to the FHIR Management Group. New version of the PSS document has instructions for US Realm review embedded on them. Help Desk Escalation – Help Desk wants a POC liaison from each Workgroup. The escalation and handling

of tickets through the Help Desk will be evaluated for handling and impact for the next 3 months, with a report expected at the next WGM in January.

HL7 CIC – Trauma Group DiscussionLocation: Chicago, IL

Date: 9/16/2014Time: <Tuesday Q1Time: 9:00am - am Pacific Time

Facilitator Mitra Rocca Note taker(s) Anita Walden

Trauma Topic - Notice of Intent to Ballot for JanuaryMotion

Abdul Malik-Shakir moves to ballot the Trauma Submission CDA in JanuaryJay Lyle second the motion

Vote:8 Affirmatives0 Against0 Abstain

Status Current Status in DSTU all implementers have tested the interface. A DSTU meeting will take

place next week. In the introduction of the ballot may want to describe the process of resolution of the comments.Three Criteria-to pass DTSUGenerated file

Conform to schema Conform to schematron Passes Digital Innovations validator level two

Open Issues Injury Type code is needed from LOINC (body region and severity have been coded). Only one or

two are left to be coded. If not coded by December 1st an American College of Surgeons (ACS) code will be used. Currently, waiting on LOINC they have to coordinating information with Triple Association of Automotive Medicine (airbag research, child restraints)

NAICS Industry codes are not completed (PHIN VADS). All geography has been resolved. CDC is using ICD 10 to map to injury type. Will Trauma use these codes? ICD 10 will also be

collected for Traumatic injuries. All vendors are participating in DSTU including ESO Solutions. Will it be an issue that those who are not HL7 members will not have free access to the standard

for a period of time? Their access to the specification even during DSTU is not clear. There is a concern that the vendors will be in violation during the wait period. How does the regulatory body communicate the changes so they will not be in violation?

There should be an implementation plan based on the timing and availability of the standard. Anyone can participate in the development should have access to the standard. There are 5

vendors.

Publication Cycle The cycle will be similar to EMS project cycle – (see attached slide). The DSTU has been really good this time around. Currently on release 4 of the implementation

guide. Meeting every other week. Monday morning 10am EST Meeting Time Tuesday Q1 - Trauma

Notes from Dianne Reeves PSS is planned – November 10th is the ITB deadline; December 1st is date when all final materials due. PSS for Trauma approved for Submission in January 2015.

o Vote taken on this item by the membershipo Negative – 0 voteso Abstain – 0 voteso Affirmative – 8 voteso PSS for Trauma was approved by the CIC membershipo 1 open item related to a requested LOINC concept.o The Trauma project group meetings every other week

ATTACHMENT II, Pg 24 – Slides Presented

HL7 CIC – Joint WG Meeting With EHR Location: Chicago, IL

Date: 9/16/2014Time: <Tuesday Q2 Time: am Central Time

Facilitator Note taker(s) Dianne ReevesAttendee Name Affiliation

See Attached RosterQuorum Requirements Met:

John Ritter led the discussion about EHR usability. The group has been reviewing a large number of

publications, and generating a matrix of criteria that make up usability.

John identified that although the new work has been ongoing, the team did not address the issue of

interrater reliability. So the team is taking the time to review the content from that perspective now.

Data provenance concerns must be included and the EHR system must display the source of the data, and

include reasons that the data may not be believable. Like a device battery may wear down making the data

faulty, etc.

HL7 CIC – EMS Group DiscussionLocation: Chicago, IL

Date: 9/16/2014Time: <Tuesday Q3Time: am Central Time

Facilitator Mitra Rocca Note taker(s) Dianne Reeves

Scope of current work in new PSS is to increase the PSS to 3.3.5

Targeting the new PSS for a May ballot, after the next NEMSIS release.

Changes are mostly related to LOINC terminology. The ACS releases annual normative releases in HL7.

Jay Lyle presented, Clay Mann was not present. They are using a CDA to create transition of care documents. Discussion about length of time it takes to get a LOINC code assigned – minimum of 6 months, can be up to up to 18 months or more to get codes registered.

Slides – Attachment I, pg. 22

HL7 CIC – Joint Session with RCRIMLocation: Chicago, IL

Date: 9/16/2014Time: <Tuesday Q4Time: 3:45 pm – 5:00 pm - am Central Time

Facilitator RCRIM Host Note taker(s) Dianne Reeves

Discussion of FHIR. The FDA is interested in doing a FHIR pilot to see if it is easier to use. Point of discussion from the meeting – FHIR is not version 4, it is version 2.x Version 3 has been successful in Europe – but it is difficult, takes a lot of resources, and has a very steep

learning curve. If v3 is successful, why is FHIR needed? CIC has interest in the clinical data elements that emerge.

HL7 CIC – CEO Report in Morning BriefLocation: Chicago, IL

Date: 9/17/2014Time: <WednesdayTime: am Central Time

Chuck Jaffe reported the results of the recent election. Doug Fridsma was elected Chair of the Board of Directors. He also reported that membership has flattened over the past 4 months and is not set to begin to grow again.

Stan Huff gave the Chair Report. The approved formation of the EU HL7 Advisory Board to advise on strategic issues was announced.

Stan also announced that the Board will publish meeting minutes from the Board meetings.

HL7 CIC – CoChair MeetingLocation: Chicago, IL

Date: 9/17/2014Time: <Wednesday – Q1Time: am Central Time

Cochairs discussion of semantics and mapping of content between terminologies. These collaborative ventures require senior people.

HL7 CIC – Mega Joint Meeting with EHR, PC,Location: Chicago, IL

Patient Care reported on Care plan templates, Health Concern DAM, and FHIR resources CQI reported on expression of support measures based on what is in the EHR/Care plan PHER reported on Child Health – needs of children with complex needs BRIDG is balloting in May 2015 the new version of BRIDG that includes LSDAM S&I Framework reported on their initiatives CIC – Anita Walden reported on TB v2 DAM reconciliation, EHRS specification for usability, other activities. EHR reported on Tooling and Profiles

HL7 CIC – Joint Meeting with BRIDGLocation: Chicago, IL

Facilitator CIC Host Note taker(s) Dianne Reeves

BRIDG was balloted for comments only, generated only about 20 comments that have all been resolved, and approved by the membership.

Ontologic shortcomings in BRIDG are highlighted in BRIDG Model v4.0 includes LSDAM plus an extensive set of Transplantation content from National Marrow Donor

Program and CIBMTR. BRIDG was supposed to be approved by JIC – but this took much too long and did not occur. Will BRIDG be

balloted in JIC or is the balloting process not ideal for joint HL7-ISO standards?

Notes from Mitra Rocca (Co-Chair)

BRIDG received 20 comments One of the ballot commenter recommended using OWL as an example One of the shortcomings of BRIDG is that it needs improvement; you can see it in OWL model. In BRIDG

it is not visible. Updates to BRIDG:

Add LS DAM to BRIDG. 4.0 Latest version of SDTM Update the RIM version of BRIDG

The workgroup is considering redesign of BRIDG; review of how this is laid out. Provide official training, BRIDG needs an Implementation Guide (IG), which will be part of redesign of the BRIDG model, There is a need to develop a BRIDG help desk HL7 has a help desk and are developing a user group. Perhaps BRIDG WG can use it.

HL7 CIC – Update on Mental Health ActivitiesLocation: Chicago, IL

Lori Simon – update on Behavioral health requirements project plan

She is a psychiatrist part of APA. Mental Health Technology committee there is working on a requirements project. In 2012 Lori started a detailed requirements document for EHR, mental health, what psychiatrists need. HL7 created a Behavioral Health functional profile for EHR. Consolidated with another effort and combined it with other aspects of mental health, research, and identifies the setting for an individual requirement.

These requirements are intended for vendors, and there are not a lot out there. Behavioral health is not just for behavioral health. Primary care also has an element of behavioral health in their assessments. Vendors should support more of the behavioral health world. Also for providers, this has all the requirements as a way to pick out what they need.

Lori is hoping to get some funding from SAMHSA to develop a proposal and obtain feedback from vendors. Plan to have 4 sessions in the future, 25 slots per session for attendee vendors in the future. This session will be sponsored by APA and HL7. Attendees will ask about their involvement in behavioral health, are they using HL7 tools now, how do they decide right now about functionality to include.

Phase I is scheduled for 12/1/14 to develop the questionnaire for vendors. Then Phase II is going to CBCC.

Go to psych.org, and look at the Psychiatric EHR requirements link.

Not sure if APA can use the EHR functional profile. Lori said she doesn’t know enough about the profile yet. Programs that require ePrescribing can acquire those systems as stand-alone without an electronic health record system. Suggests that the professional organizations, like the APA, could represent the clinicians with the vendors to get priorities implemented by the vendors.

ONC recognized behavioral health earlier this year. Hearings completed earlier this year, released a 2015 Voluntary Certification for EHR content. Will reach out to other professional organizations probably in 2015.

Usability requirements discussion for the behavioral health content. Described walking through several use cases. A new Project Scope Statement will be presented to HL7 for a new mental health project for Bipolar and General Anxiety Disorder. The new process states it has to be routed through the US Realm Task Force first before it is voted on by the working groups.

HL7 CIC –– Clinician Outreach and EngagementLocation: Chicago, IL

Russ Leftwich attending at invitation of CIC CoChairs

In the last meeting in Phoenix, Ed Hammond talked about various strategies for engaging clinicians in HL7. Most of our clinician involvement in CIC has been through attendance at their professional meetings.

How should HL7 be engaging clinicians in standards development?

What are the benefits for clinicians of HL7 participation?

We want to talk with clinicians in HL7 first to understand how the message should be crafted. Some clinicians see the benefit or don’t have the time to engage. A number really want to work with HL7 but are struggling because the language is so foreign to them. What is the message that should go out to outline benefits to clinicians?

The Health professional membership is only $100/year with everything except a vote. This lowers the barrier for cost for clinicians.

Talking point – know more than your vendor does about standards before you buy a product.

Talking point – being a member and attending gives access to experts on standards.

Not a lot of uptake by clinicians, but some folks did for Child Health. Things not tried to full potential: Engage the academic settings in the meeting location before the meeting occurs to invite them to

sessions at the meeting. One limitation is that we keep returning to the same locations. User Group could potentially be clinically oriented. Links to professional groups may give them a cut rate

on membership to attend HL7 meeting once or twice a year. The main interest may be in the networking that is engaged first, and standards development second. Russ thinks it is successful because it’s organized around a workflow, not a specialty or domain. WHO IS a member? Is it a clinician, a registrar, or someone else?

Clinicians do not appreciate the HL7 consensus process or how things work here. They think we develop software.

Should we not ask for all the typical artifacts we request, and just concentrate on the data elements? Are you familiar with MDepinet? Passion registries – their plan is to set up registries for all cardiac

devices. A national registry for each of these device types. EpiNet is having a think tank around registries. Whatever is good for a patient registry should be applicable for the use of other registries. For analyzing, collecting data, electronic entry of data.

Should they come to us, or should HL7 come out to meet them? Perhaps the User Group approach is a good hybrid for this effort.

ONC is pursuing the creation of a library of paper forms, and then populate the forms with data from the EHR.

Is the timeline for the HL7 group going to work for groups like PCORI that work much more quickly? ONC wanted to vote on ballots without being a member.

What can CIC do to help? Come to a consensus about what would be a good group. Talk with Duke about the Passion registries. HL7 needs to weigh in on this as well. The Device WG may be interested, and the group that just published the Cancer Registry form. Several WGs could be used to orchestrate a user group.

What are the benefits of User Group participation? The interoperability potential that can be met with the standards should be effective.

John Hatem is the facilitator of the Immunization User Group. Get in touch with him to set up. Meeting October 14 – 16 at FDA headquarters that is a think tank for the Immunization group. Other potential partner in this is the Devices WG.

Todd Cooper who is co-Chair and is West Health in San Diego as a health care transformation and development group.

Consider also the help of a Marketing Director with setting up a User Group.

ACTION: Anita will reach out to John Hatem to see if we can meet with him on a regular call or on a separate call.

HL7 CIC –– Updates on CIC ProjectsLocation: Chicago, IL

Date: 9/18/2014Time: <Thursday – Q1Time: am Central Time

Facilitator Anita Walden Note taker(s) Mitra Rocca

Updates on the CIC projects

Update on the Trauma project A question was asked, if this project focuses on the physical trauma or also emotional trauma? Tuberculosis DAM (TB R2) went thru a ballot cycle. Since the clinicians involved are not attending the

HL7 Sept. 2014 WGM, the ballot reconciliation will occur over the phone. Trauma ballot Updates:

o Notice of Intent to Ballot November 6 deadline Initial content 11/10; final 12/1

o DSTU criteria: 1 generated file that Conforms to XSD Conforms to schematron Passes DI level 2

o DSTU Progress All implementers have tested DI interface 80% of fields implemented in DI validator

100% to be available by month’s end Target: complete DSTU by 2nd Monday of October

In addition, we need to move our DAMs to normative. Need to update the Trauma DAM. (Normative) We can wait till the trauma CDA is normative. We need to have traceability between the trauma CDA and the trauma DAM. CIC trauma team should plan to meet with ArB to take the trauma DAM to normative

EHR usability project

A joint project with EHR, CIC and CQI workgroup focusing on reviewing literature focusing on usability, developing usability heuristics and developing a functional profile for the EHR usability.

Community Based Collaborative Care (CBCC) workgroup members recommended adding small physician’s offices healthcare providers to the group. Also to have patient’s representative on the EHR-S Usability workgroup.

Review the SAMSHA (REM) EHR-S, which is an open source on GITHUB Develop focus groups Encourage the group to go out and work on it. There is no financial incentive for the EHR vendors to work on usability.

Include other countries beyond US in this project.

Max tools

Modern automated exchange tool, often we build DAMs in UML. We find it easier, taking stuff out of the tool and place them in the excel spreadsheet. Enterprise Architect (EA) is what is used for DAM modeling, and then the artifact is exported from EA to Excel.

Challenges: There is no way to get data back from the Excel into EA.

This is a joint initiative between HL7 tooling and CIC working groups. We work with CIC to work on a set of requirements, partition them in 3 categories

1. Requirements that are in the tool2. Requirements that need to be in the tool3. Requirements where we need additional information

Some of them will be done and some cannot be done. We have built a user manual. The requirements came out of cardiovascular imaging and the requirements came from working with the

physicians. Make the tool available from the tool section in HL7, since some do not have gForge. How is FHIR different than EA tools? FHIR is an implementation capability to create a streamlined interoperable environment. FHIR gives you an infrastructure to exchange that piece of information. FHIR gives you exchange format in XML or JSON. EA is for modeling tool. CIC has a DAM style guide. Help create DAMs. It is more tailored to clinical domains, not IT domains. DAMs have data elements in them and the Functional Profiles do not have the data elements in them. The DAM style guide is based on the BRIDG style guide.

Clinical Outreach plan

We are spending time at Q3 (Thursday) on how to expand our outreach to dif. Professional societies

Schizophrenia and MDD Therapeutic Areas (TA) You talked about ways to harmonize with CBCC’s Behavioral Health (BH) functional profile. Continue

mental health (General anxiety disorder) and bipolar. Get the data elements from the FDA’s Case Report Forms (CRFs) Look across all the forms and come up with a list of data elements. Q: Are the questions on the CRFs not open ended?

o A: No Obtain data elements from DSM-IV and DSM-V. Once we synthetize the data elements, the review division

will convene a stakeholder community and they look at the content and compare with what they use in the practice.

Q: Is this geared for the clinical research?o A: yes. However, if we come up with data elements that are in clinical care, they can be added.

Took a look at the DAMs, it is not optimal to do it by illness, There was a scenario that was in one and not the other one. The treatments are similar. eCD (?) treatment is used not only in MDD but also in schizophrenia. Data element should be illness and content should be schizophrenia and MDD. Approach: when you do a decision tree and is based on what the content of the trees are. Based on symptoms, how do you slice and dice the data, You can have a field that say schizophrenia Yes and no. vs. illness with schizophrenia, MDD, … How do you view it? Automate this by using the software tool. A clinician who is not computer oriented cannot understand, the content is for them to see in a usable way.

The information within a field is a better way to go. Collect atomic level and develop a CDS. Get nutrition into the mix. Patients who have schizophrenia, their episodes get worse, when they are

introduced to gluten. CRFs are the starting point and the FDA reviewers are also practicing providers, we also go to professional

societies.

Q: for these new 2 items, what is needed from CBCC? Data should be collected within EHRs, guidance Within the EHR domain, you should have a mental illness model. ONC SDC initiative is focusing on rendering forms within EHR systems.

ATTACHMENT III, Pg. 26– Meeting Slides

HL7 CIC –– Update from CBCCLocation: Chicago, IL

UPDATE FROM CBCC

Develop proposal for SAMSA

Obtain feedback from the EHR vendors

Determine profile structure/columns (may be revised as requirements work proceeds)

We need to include other elements of BH, to include research, Social work, etc.

Develop initial user requirements for each content area (appointments, billing, patient documentation, patient information (general), patient info (clinical), order entry, patient access, general documentation, reporting, system requirements (by consolidating BH FP, APA requirements, CCHIT requirements, and HL7 DAMs)

Phase I: 12/1/2014Phase II: 1/15/15Phase III: 1/31/15Phase IV

Our goal is to have these requirements available for the EHR vendors.

Bring vendors into the fold. We had a webinar at the end of June and invited a 160 vendors, we had 30 vendors coming, the intend of this was that Behavioral Health exists, what is going on with SAMSA, APA,

Why is this good for vendors?

What we are going to do, we will have 4 sessions, 25 slots per session.

Open ended, sponsored by APA and HL7

Created a feedback form . Make it a condition for registry.

Need to complete survey form in order to register

Open discussion centered around the following topics: Vendors current problems, how can APA help How are vendors currently deciding what functionality to include in their SW? Potential use of requirements in a DB

http: //www.pysch.org/EHRWe are evaluating EHR vendorsOur functional requirements

Fields specific requirements Settings Priority Included in EHRP=private practice E- Essential FullyC= clinical setting I= important PartialI= Inpatient N = NiceCH = Child /adolescentA = All setting

Reach out to other professional organization. Capture user requirementsAPA 85 % of BH specialists are in solo practice. Half of our members do not take Medicare or Medicaid. The solo docs are not computer savvy. The EHRs for primary care are expensive. Psychiatric hospitals are not conforming to the Meaningful Use (MU) regulations. It is a voluntary certification for BH. Q: What percentages of your docs do research?A: Not many. Reach out to ISCTMWe will develop the DAMs, EHR FP and APA and will work later with CIC. Etc. EA is what we need to get educated on.

Usability requirements will be included. Dif. Levels of usabilityUnderstanding what users of systems need. Usability of EHR systems are at 2 levels:

Standards, for example font size Working with users of the Software to understand the needs.

When does a doc know their patient need a psychiatric treatment?The way you transfer to patients to the psychiatric Ward. Training on how to use the system. Someone goes to OR from inpatient unit, when do orders need to be stopped and restartedUsability is on multiple levels

Clinical Information Modeling Initiative (CIMI)

Is an international collaboration that is dedicated to providing a common format for detailed specifications for the representation of health information content so that semantically interoperable information may be created and shared in health records, messages and documents.

Based on ISO 11179 The whole structure is used to reuse the data sets, questions or answers. Created for reuse

CIMI is developing a MDR for all the models.

ACTIONS-A.Walden will set up a call with Lori Simon to provide an overview of Enterprise Architecture, the tool used to house the DAM materials.

HL7 CIC –– MAX Tool PresentationLocation: Chicago, IL

Facilitator Dianne Reeves Note taker(s) Anita Walden

Michael Van der zel discussed the status of the MAX Tool.

• The tool hasn’t changed much since the last demo. A suggestion was made that the requirements gathered in a call between B. Wilgus, A. Shakir and D. Reeves would be shared with Michael so he can compare what the tool can accomplish versus the requirements.

• Michael provided an overview of the use cases for the tool.• According to Russell Leftwich, ChildHealth may have projects that may be able to use the tool as well, they

have a functional model project in Neonatology It was proposed by attendees, Wed Q1 in San Antonio, a Demo of the MAX Tool with Child Health, Patient

Care or other co-chairs so they can see the functionality of the tool. • Michael requested that we have a pilot project to test the requirements of the working group. A. Walden

may have a pilot project to test the MAX tool. Simon also indicated that CBCC may be interested in seeing the MAX tool demo and suggested meeting

with CIC and Patient Care.

ACTIONS:• A. Walden will talk with Michael about identifying a project for the pilot.• Michael and Anita will set up a Go to Meeting -24OCT14 –afternoon.

ATTACHMENT I

ATTACHMENT II

ATTACHMENT III

PLEASE ü YOUR NAME AND UPDATE INFORMATION

NameAffiliation E-mail Address

Tuesday 9/16 Wednesday 9/17 Thursday 9/18 Friday 9/19Last First Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3

Acker Beth VA beth.acker@med.va.gov Allard Crystal FDA crystal.allard@fda.hhs.gov Baker JD Sparx Systems jbaker@sparxsystems.com Beeler George Beeler Consulting woody@beelers.com Bennett John Lancet Technology John.Bennett@LancetTechnology.com Berger Stacy COH sberger@coh.org

Bojicic SashaCanada Health Infoway sbojicic@infoway-inforoute.ca

Bolte Scott GE Healthcare scott.bolte@ge.com Boone Keith GE keith.boone@ge.com Briggs Bonnie Wolters Kluwer Bonnie.Briggs@Wolierskluwer.com Brown Andy ESO/Nemsis Andy.brown@esosolutions.com Case Jim NIH james.case@mail.nih.gov Change Wo NIST wchange@nist.gov Cote Danielle Zoll dcote@zoll.com Datta Gora Cal2Cal gora@cal2cal.com Daviss Steven APA drdaviss@gmail.com DeYoung Lizzie MITRE/OASIS edeyoung@mitre.org Dickinson Gary Centri Health gary.dickinson@ehr-standards.com

Dittloff MargaretAcademy Nutrition & Dietetics MKD@CBORD.com

Dittmer Grant ACS gdittmer@dicorp.com Daoust Norman Daoust Assoc. norman@daoustassociates.com Duteau Jean DDI Jean@Duteaudesign.com Eisenberg Floyd NQF feisenberg@qualityforum.org Evans Julie CDISC jevans@cdisc.org Fendt Kaye Duke kaye.fendt@duke.edu Gabriel Davera UC Davis davera@ucdavis.edu Gallego Evelyn ONC/SDC PM evelyn.gallego@siframework.org Gonzaga Zabrina Lantana Zabrina.gonzaga@lantaragroup.com

Gonzales-Webb Suzanne VA Suzanne.Gonzales-Webb@va.gov X Goosseu William Results4Care wgoossou@results4care.nl Greim Patricia VHA Patricia.Greim@va.gov Hale Richard ESO/NEMSIS Richard.Hale@esosolution.com Hammond Ed Duke william.hammond@dm.duke.edu Hastak Smita SceuPro Shastak@sceupro.com Havener Lori NAACCR lhavener@naaccr.org Helton Edward NIH/NCI Edward.helton@nih.gov Hobbs Allen Kaiser allen.hobbs@kp.org X Hoeft Chris AS NTDB choeff@facs.org X Hufnagee Steve DOD Hufnagee@ACM.org Isler Maria ACC?AHA misler@acc.org Jaccard Don FDA donald.jaccard@fda.hhs.gov James Lenel BCBSA lenel.james@bubsa Janky Justin Zoll jjanky@zoll.com Jones Elysa Oasis elysajones@yahoo.com Kahn Hetty CDC/NCHS hdk1@acc.org Kallem Crystal AHIMA crystal.kallem@ahima.org Kallas Nichole ACC nkallas@acc.org Kennedy Mary SAICF/caHUB kennedy@mail.nih.gov Khalid Arsalan ACC arsalank@hotmail.com

Kirnak AleanAm Immunization Registry Assoc akirnak@swpartners.com

Kiser John Abbvie John.Kiser@abbvie.com Kisler Bron CDISC bkisler@cdisc.org Klemn Juli NCI Iklemmj@mail.nih.gov Kretz Jim SAMHSA/HHS Jim.Kretz@samhsa.hhs.gov Kubrek Wayne CDISC wkubrek@cdisc.org Kuhn Thomason ACP tkuhn@acponline.org Kush Bart CDISC rkush@cdisc.org Leftwich Russell TN eHealth cmiotn@gmail.com X Lyle Jay Ockham jay@lyle.net X X Maddux Suzanne ASCO suzanne.maddux@asco.org Mann Clay NEMSIS TAC clay.mann@hsc.Utah.edu X X

McCourt Brian Duke brian.mccourt@duke.edu McDonald Clement NLM Clemmcdonald@nlm.nih.gov Mears Greg EMSPIC gmears@emspic.org Milius Bob MNDP bmilius@nmdp.org Miller Holly VA holly.miller@va.gov Mukesh Sharma Wash Univ in St. Louis sharman@wustl.edu Mulrooney Jackie JP Systems info@jpsys.com Mulrooney Galen JP Systems Galen.mulrooney@va.gov Mungal Salvatore Duke salvatore.mungal@duke.edu Nahm Meredith Duke Meredith.Nahm@dm.duke.edu Neal Melanie ACS NTDB mneal@facs.org Nelson Rene Zoll rnelson@zoll.com Oliva Armando FDA armando.Oliva@fda.hhs.gov Patock Michael Image Trend mpatock@imagetrend.com Price Chrystal ACS NTDB cprice@facs.org X X Raaen Marquerite IBM Mraaen@us.ibm.com Reeves Dianne NCI reevesd@mail.nih.gov X X X X X X X X X X Rhodes Harry harry.rhodes@ahima.org Ritter John johnritter1@verizon.net Roberts John TN DOH john.a.roberts@tn.gov X X X X Rocca Mitra FDA mitra.rocca@fda.hhs.gov X x X X X X Ryan Sarah Ockham ryansaraha1@earthlink.net Salyards Kenneth SAMHSA/HHS Kenneth.Salyards@SAMHSA.HHS.gov Savage Rob MGC/CDC h2u3@cdc.gov Schick Lisa SeenPro Ischick@scenpro.com Shah Vijay JBS International vshah@Jbsinternational.com

ShakirAbdul-Malik COH ashakir@coh.org X X

Shakir Salimah Shakir Consulting Salimahshakirconsulting.com Shanbhag Nandam ACC nshanbha@acc.org Simon Lori Am.Psychiatric Assoc. LoriR.Simon@gmail.com X X Sisto Jennifer Accenture Jennifer.t.sisto@accenturefederal.com Slack Maryanne FDA X Solgrig Harris Mayo Clinic Spellman Lisa Ahima-ISOTC215 lisa.spellman@ahima.org

Spiro ShelleyPharmacy HIT Collaborative shelly@spiroconsulting.net

Srinivasan Ganesan ACC gsriniva@acc.org Stevens Helen Stevens Healthcare helen.stevens@shaw.com

Summers JodyClinical Data Managment jody@c-d-m.com

Tewey Rob Digital Innovation rtwewy@drcorp.com Tolk Chris CDISC ctolk@cdisc.org Tripp Ed Tripp & Asssoc Edward.Tripp@ESTRIPP.com Vanderzel Michael UMCG m.van.der.zel@umcg.nl X Vreeman Daniel Regenstrief Institute dvreeman@regenstrief.org Walden Anita Duke anita.walden@duke.edu X X X X X Walker Max Health Vic Max.Walker@dhs.vic.gov.au Walker Mead MWC dmead@comcast.net Ward Steve Eli Lilly stw@lilly.com Washington Lycia AHIMA lydia.washington@ahima.org Whipple Troy Image Trend twhippel@imagetrends.com Wilgus Rebecca DCRI warli001@mc.duke.edu

Wood GrantIntermountain Healthcare grant.wood@imail.org

Woyak Andrew GE Healthcare andy.woyak@med.ge.com Younes Maryam Duke my60@duke.edu Zozus, Jr Robert Private Practice Zozus@icloud.com

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