candidate standards analysis by transaction 0 sdc solution diagram
TRANSCRIPT
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Candidate Standards Analysis by TransactionSDC Solution Diagram
Outputs
1. Validate candidate standards list
2. Draft Solution diagram
3. Analyze candidate standards per HITSC criteria to narrow list of standards
4. Perform technical feasibility analysis
5. Map UCR to standards
6. Develop gap mitigation plan
7. Review with community
Gap mitigation plan
Requirements Traceability Matrix
1. Validate solution plan
2. Confirm data model approach
3. Modify/harmonize existing standard(s) to produce final standards
4. Achieve community consensus or agreement
Final standards
1. Using final standards, develop Implementation Guide document
2. Document IG Conformance Statements in RTM
3. Develop Examples to inform implementers
4. Validate examples5. Achieve community
consensus or agreement
Implementation Guidance
1. Survey SDO or standards organization options
2. Select balloting approach
3. Align timeline with ballot cycles
4. Submit PSS (HL7)5. Submit NIB (HL7)6. Submit Content
(HL7)7. Conduct balloting
cycle & reconciliation per SDO guidelines
Balloted standards
Evaluate Standards
Plan for Solution and Final standards
Develop Implementation
GuidanceSDO Balloting
Standards Development & Harmonization:Workflow
Week TargetDate All Hands WG Meeting Tasks Homework
due Tuesday COB
Evaluate Standards
1 5/2Standards & Harmonization OverviewIntroduce: S&H Processes, Candidate Standards List, Solution Diagram
2 5/9 Solution Diagram Review: Solution Diagram Review: Solution Diagram
3 5/16Solution Diagram, Standards
Evaluation CriteriaFinalize: Solution DiagramReview: Standards Evaluation Process
Review: Standards Evaluation Template
4 5/23 Standards Evaluation Review: Standards Evaluation Process Review: Standards Evaluation Template
5 5/30Standards Evaluation, Technical
Feasibility Analysis
Finalize: Standards EvaluationReview: In-scope Requirements, Information Interchange Functions
Review: In-scope Requirements, Information Interchange Functions
6 6/6Technical Feasibility, UCR to
Standards MappingReview: UCR to Standards Mapping
Review: UCR to Standards Mapping Template, In-scope Requirements, Information Interchange Functions
7 6/13Technical Feasibility, UCR to
Standards Mapping, Gap Mitigation Plan
Finalize: In-scope Requirements, Information Interchange Functions, UCR to Standards MappingReview: Gap Mitigation Plan template
Review: Gap Mitigation Plan Template
8 6/20 Gap Mitigation Plan Review: Gap Mitigation Plan Review: Gap Mitigation Plan
9 6/27 Gap Mitigation Plan Review Finalize: Gap Mitigation Plan
Plan for Solution and Final standards
Develop Implementation Guidance
Structured Data Capture InitiativeProposed Standards & Harmonization Timeline
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• Discussed current understanding of four standards for SDC (slide 6)
• Provided inputs on SDC Solution Diagram (slide 7)• Reviewed interoperability standards for Use Case transactions and
discussed items to remove or add to each category (slide 8)– Goal was to narrow down the list to 8-10 standards for each
category to increase the efficiency of downstream Harmonization activities
Tiger Team Review Summary
CDE Library
Form Library
Template Library
5
2
xx
John Doe x
x x
x x 6
1
4Provider
EHR System
External DataRepository
SpecifiedForm/Template
AHRQ CDEs[Common Formats]
Clinical ResearchCDEs
DisplayedForm
Structured Captured Data
Selects
form
/template
Inputs data
Stores/ transmits data
Finds form/template
Caches data
3Converts, populates & displays form
7Extract, Transform,
& Load Data by
form/ template
EHRSystem
Provider/End User
Actor Key
End User
Structured Data Capture Conceptual Workflow
Other domainCDEs
Patient SafetyForms [Common Formats]
Other domain-specified Forms
Domain-specifiedTemplates
CDE Library
Form Library
Template Library
5
2
xx
John Doe x
x x
x x 6
1
4Provider
EHR System
External DataRepository
SpecifiedForm/Template
AHRQ CDEs[Common Formats]
Clinical ResearchCDEs
DisplayedForm
Structured Captured Data
Selects
form
/template
Inputs data
Stores/ transmits data
Finds form/template
Caches data
3Converts, populates & displays form
7Extract, Transform,
& Load Data by
form/ template
EHRSystem
Provider/End User
Actor Key
End User
Structured Data Capture – Standards Overlay
Other domainCDEs
Patient SafetyForms [Common Formats]
Other domain-specified Forms
Domain-specifiedTemplates
1. CDE Standard
2. Structure Standard
4. Pre-populate Standard
3. EHR InteractionStandard:Find, display, cache, store/transmit
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SDC’s 4 Standards (Working Definition)
Standard Details WG Responsible
1. CDE Standard
Standard for the CDEs that will be used to fill the specified forms or templatesIncludes: data representations that are consistent and reusable across forms
Form SWG
2. Form / Template Container Structure Standard
Standard for the structure or design of the form or template (container)Includes: Form / Template Information – what is being sent back to the EHR System?Examples: Name, Type of Data, Ranges, Codes, OtherOptional: Population of EHR-System derived patient data Standard to define the structure of the data sent from EHR System for storage in External Data Repository
Form SWG
3. EHR-Interaction Standard
Standard for how EHR Systems interact with the form or template:Includes: two components• How form is queried for and retrieved by EHR System from Form/Template Repository• How incorporated into EHR workflow
Standards SWG
4. Auto-populate Standard
Standard to auto-populate form or templateIncludes:• Auto-populate by EHR-derived patient data sent to an external system• EHR System population of relevant patient data
Standards SWG
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Form / Template RepositoryEHR System
1. Request for form/template1(a). 0ptionally with patient data
3. Sends requested form/template
External Data Repository
2. Receives request for form/template2(a). Conditionally populates form
4. Receives form/template4(a). Conditionally auto-populates form
5. Displays form/template
6. Provider inputs datainto form/template
8. Receives form/templatestructured data
9. Stores form/templateStructured data
7. Sends completed form/template structured data
6(a). Optionally storeStructured data
SDC Sequence Diagram:SDC’s 4 Components by Transaction
A CDE
B Container (including structured data)
C EHR interaction
D Auto-populateA
B
C
D
B C
D
B CA
B
A B
A B
A B
A B
A
A
A B
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# Transaction Content and Structure Vocabulary and Code Set
Transport and Security Cross-Category
1 Request for form/template
• CDA R2• C-CDA• ICSR• RFD• XUA• RPE
• CAP 135• CTS2• ODM• XD*• ISO/IEC
11179• Common Formats• CPT• CVX• MVX• PHIN-VADS• HCPCS• ICD-9-CM• ICD-10-CM• ICD-10-PCS• LOINC• UCUM• Multilex DDF• NDC• C80• C154• SNOMED-CT• MEDCIN• UMLS• RxNORM• MedDRA• VSAC
• ODM (T)• XD* (T)• SOAP (T)• REST (T)• Direct (T)• HTTPS (S)• TLS (S)• ATNA (S)• XUA (S)• BPPC (S)• SAML (S)• XACML (S)• HL7 IG for CDA,
R2: Consent Directives, R1
• Healthcare Privacy and Security Classification System
• esMD Author of Record Level 1 IG
• XAdES
• CDEs• CDASH• USHIK• SHARE• CIMI• FHIM• vMR• caDSR• XMI• MDMI• FHIR• HL7 IG for CDA
R2: Form Definition Document, R1
• HL7 IG for CDA R2: Questionnaire Response
1(a) Optionally with Patient Data
• CDA R2• C-CDA• ICSR• RFD• ISO/IEC 11179
• RPE• CAP 135• CTS2• CDASH• vMR
3 Sends requested form/template
• CDA R2• C-CDA• ICSR• ISO/IEC 19763-13• ISO/IEC 11179• XHTML• Javascript
• RFD• RPE• CAP 135• CTS2• CDS
Knowledge Sharing IG
7Sends completed form/template structured data
• CDA R2• C-CDA• HL7 V2.x• HL7 V3
• ICSR• ISO/IEC
19763-13• RFD
SDC Use Case:Interoperability Standards
Links and Definitions
Week TargetDate All Hands WG Meeting Tasks Homework
due Tuesday COB
Evaluate Standards
1 5/2Standards & Harmonization OverviewIntroduce: S&H Processes, Candidate Standards List, Solution Diagram
2 5/9 Solution Diagram Review: Solution Diagram Review: Solution Diagram
3 5/16Solution Diagram, Standards
Evaluation CriteriaFinalize: Solution DiagramReview: Standards Evaluation Process
Review: Standards Evaluation Template
4 5/23 Standards Evaluation Review: Standards Evaluation Process Review: Standards Evaluation Template
5 5/30Standards Evaluation, Technical
Feasibility Analysis
Finalize: Standards EvaluationReview: In-scope Requirements, Information Interchange Functions
Review: In-scope Requirements, Information Interchange Functions
6 6/6Technical Feasibility, UCR to
Standards MappingReview: UCR to Standards Mapping
Review: UCR to Standards Mapping Template, In-scope Requirements, Information Interchange Functions
7 6/13Technical Feasibility, UCR to
Standards Mapping, Gap Mitigation Plan
Finalize: In-scope Requirements, Information Interchange Functions, UCR to Standards MappingReview: Gap Mitigation Plan template
Review: Gap Mitigation Plan Template
8 6/20 Gap Mitigation Plan Review: Gap Mitigation Plan Review: Gap Mitigation Plan
9 6/27 Gap Mitigation Plan Review Finalize: Gap Mitigation Plan
Plan for Solution and Final standards
Develop Implementation Guidance
Structured Data Capture Initiative:Activities Planned for Next Week