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AHIMA Standards Team –External Activities Meeting Report

HL7 Mobile Health Work GroupF2F WGM January 19, 2015, San Antonio, TX.

Purpose of Meeting: Founded in 1987, Health Level Seven International (HL7) is a not-for-profit, ANSI-accredited

standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. HL7's 2,300+ members include approximately 500 corporate members who represent more than 90% of the information systems vendors serving healthcare.

HL7 International Working Group Meetings are held three times per year at varying locations. These Working Group Meetings serve two important purposes:

o They give the HL7 International work groups a chance to meet face-to-face to work on the standards as well as the opportunity to network with industry leaders from around the world

o They provide an invaluable educational resource for the healthcare IT community.

Attendees:January 20, 2015 – Joint Meeting with EHRS-FM - Q1

Mission

The HL7 Mobile Health Work Group creates and promotes health information technology standards

and frameworks for mobile health.

Charter

Identify data standards and functional requirements that are specific to the mobile health

environment

Identify and promote mobile health concepts for interoperability as adopted and adapted for

use in the mobile environment

Coordinate and cooperate with other groups interested in using mobile health to promote

health, wellness, public health, clinical, social media, and other settings

Provide a forum where HL7 members and stakeholders collaborate in standardizing to enable

the secure exchange, storage, analysis, and transmission of data and information for mobile

applications and/or mobile devices.

MHR-S Functional Framework Gora Datta [email protected] Matt Graham [email protected] Harry Rhodes [email protected]

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mailto:[email protected]



Tim McKay [email protected] Nathan Botts [email protected] John Ritter [email protected] Gary Dickinson Pat VanDyke Patrick Cannady Anneke Goossen Mark Janczewski [email protected] Ken Toyoda [email protected] Asha Ravichandon [email protected] Krytal Shaw [email protected] Darek Woznica [email protected] Han Taehwa [email protected]

Outline of Proceedings:

Joint Meeting with EHRS-FM - discussion of option – MHR-R Functional Framework MH –F Profile from EHR-FM MH – F profile from PHR-FM (Consumer Mobile Application Functional

Framework) MH –Hybrid Profile from EHR-FM and PHR-FM (Consumer Mobile Application

Functional Framework) MH – Functional Model

Most of Patient Portal applications have much of the functionality. But, one area that is hard to achieve is location tracking and patient scheduling; especially in large facilities. Mobile applications are better suited for patient scheduling and tracking.

Action Items:o Move PHR- S FM to EHR Profile Designer Tool (and from R1 to R2 format).o Integrate Mobile Health projects into the longitudinal EHR.o Advance the LMIC Group project.o Develop a Consumer Mobile Application Functional Framework PSS for PHR Profile –

Tim McKay. “We need to address the “What” of Mobile Health. We have the “How” in place, but need to define the “What”. Also, need to establish a framework for emerging privacy and security issues.

MHWG Co-Chairs Planning Meeting – January 20, 2015 – Q2 Attendees:

Gora Datta [email protected] Matt Graham [email protected] Harry Rhodes [email protected] Nathan Botts [email protected]

Outline of Proceedings:1. Nathan to pull together a 2nd level presentation for Mobile Framework for Healthcare

Adoption of Short-Message Technologies (mFHAST) (previously the Mobile Health LMIC/Rural Health sub-workgroup series). – PSS















2. Plan on attending PHER & OASIS WG session in Q2 on Thursday, January 22th. To present on mFAST project. Plan to partner with Public Health and Emergency Respone (PHER). Matt has already visited with PHER Co-Chairs and they are interested in collaborating with us.

3. Going forward, we will need to focus on communication of MHWG two active projects:a. mFHAST – Mobile Framework for Healthcare Adoption of Short-Message

Technologies (mFHAST) (previously the Mobile Health LMIC/Rural Health sub-workgroup series). -Nathan Botts

b. Consumer Mobile Application Functional Framework – Tim McKay4. mFHAST - Mobile Framework for Healthcare Adoption of Short-Message Technologies

(mFHAST) (previously the Mobile Health LMIC/Rural Health sub-workgroup series).Project:a. HL7 New Product/ISO Jointb. HL7/ISO/ AHIMA/OASIS/IEEE/AMIA/HIMSSc. SMS Structured Messagingd. Partner with HL7 Public Health Emergency Responsee. Broadcast Messaging /Alerts/Public Servicef. Multi-point Aggregation of Data

i. Disease Reportingii. Public Health

iii. Environmental Reportingiv. Public Service, Education Service

MHWG Co-Chairs Working Group Meeting – January 21, 2015 – Q1

Attendees: Gora Datta [email protected] Matt Graham [email protected] Harry Rhodes [email protected] Nathan Botts [email protected] Amlau Dasgupta [email protected] JoAnne Johnson [email protected] Koichiro Matsumoto [email protected] Ashu Raviahander [email protected] Brady Keeter [email protected] Byoung-Kee Yi [email protected] Jimji Hua [email protected] Dave Carlson (VA) [email protected]

Outline of Proceedings:Wednesday Q1 9:00 - 10:30am (90 Minutes)

1. State of the Mobile Overview – Gora Datta- 45 minutesa. Discussion of the rapid development of mobile health environment.b. Review of Mobile Health Work Group Charterc. Review Mobile Health Stakeholders

i. Technologyii. Science

iii. Policyiv. Business














v. Society – CultureAudience Member – Amlau Desgupta, Epic – suggested that Security should be added to Stakeholder list. Dave Carlson, VA pointed to work done by the FHIR in the area of Security. Suggested that we reach out to Mike Davis, Security Expert from the VA to access guidance in this area.

d. Audience member – Amlau Desgupta, Epic asked about initial focus on mobile phone, noting that mobile health is much more than just Smart Phone.

e. MHR Framework overview discussed with audencef. Mobile Health and Meaningful Use – overview of requirements for Stages 1, 2, &3.

2. LMIC/Rural Presentation - Mobile Framework for Healthcare Adoption of Short-Message Technologies (mFHAST) (previously the Mobile Health LMIC/Rural Health sub-workgroup series).– Nathan Botts – 45 minutes

1. SMS Barriers: Ad-hoc Implementations Lack of Interop Security/Privacy/Consent Message size Statelesss –at its most basic implementation, no attached thread.

2. Audience member – JoAnne Johnson, Kiaser Permanente – Asked if we are planning of cooperate with any existing vendors to address this SMS Barriers.

3. Reported out on Maternal and Child Health Initiative4. Reported out on Disease Management Initiative5. Discussed TB SMS Use Case6. mFHAST - Mobile Framework for Healthcare Adoption of Short-Message

Technologies (previously the Mobile Health LMIC/Rural Health sub-workgroup series).:

What is the issue? What are the critical variables? Who will initiate and consume the message? Who are the SMS Actors? Discussion of various communication methods and structures

7. Next Steps: January 21, 2014 – 2nd presentation of mFHAST overview 2015 First Quarter – PSS Submission – Documentation, Education, Use Case

development, and Requirements gathering/ 2015 Second Quarter – Harmonization & Specifications 2015 Third Quarter – Pilot & Testing 2015 Fourth Quarter – 1st Product Draft


Attendees:


Gora Datta [email protected] Matt Graham [email protected] Harry Rhodes [email protected] Nathan Botts [email protected] Amlau Dasgupta [email protected] JoAnne Johnson [email protected] Koichiro Matsumoto [email protected] Ashu Raviahander [email protected] Brady Keeter [email protected] Byoung-Kee Yi [email protected] Jimji Hua [email protected] Dave Carlson (VA) [email protected] Tim McKay [email protected]

Outline of Proceedings:Wednesday Q2 11:00 - 12:30 pm (90 Minutes)

1. Introductions of Work Group Attendees: (Consumer Mobile Application Functional Framework) Tim McKay with Kaiser Permanente spoke about the difficulties in developing a comprehensive mobile profile. Plan at KP is to create an new project that will attempt to leverage existing models and address mobile healths unique security and privacy needs. The key work is for developing mobile applications is practical. A model where by sections, certain criteria will be applicable and others would not. Plan to use more of a FHIR point of view, choosing to implement functionality that is more practical and interoperable.

1. LMIC/Rural Presentation Mobile Framework for Healthcare Adoption of Short-Message Technologies (mFHAST) (previously the Mobile Health LMIC/Rural Health sub-workgroup series). Project Scope Statement– Nathan Botts

a. Discuss as to why we are choosing focus on the Transport Layer of messageing?b. Stay true to the core concept of what are you trying to communicate to the Consumer?c. Co Sponsor Work Groups – Public Health Emergency Response – Level of

involvement with be limited to periodic updates provided by Mobile Health Work Group.

d. Noted by Amlan Dosgupta, Epic that Short Message Technologies (SMS) is the communication standard for the world. With over 3 billion active users. Composed of approximately 160 characters depending device. Biggest Use Case functionality for vendors is the ability to send out reminders. Currently no known standard for adoption and implementation of short messaging technologies within the healthcare domain.

2. FHIRFrame –Christopher Doss – deferred, presenter absent.3. Mobile Medication Admin Profile – Matthew Graham


Attendees: Gora Datta [email protected] Matt Graham [email protected]

















Harry Rhodes [email protected] Nathan Botts [email protected] Amlau Dasgupta [email protected] Tim McKay [email protected] Rien Wertheim [email protected] Kevin Shekleton [email protected] Koichiro Matsumoto [email protected] Dave Shaver [email protected]

Outline of Proceedings:Wednesday Q3 1:45 – 3.00 pm (90 Minutes)

1. Mobile Medication Admin Profile – Matthew Graham

a. Solve a common problem for general population.b. Develop a Use Case Modelc. Define a FHIR Profile for Patient Medication Administration,d. Standard could be a defined set of Profiles. Profiles are specifically bound to a

particular country or region. Question was asked could we just assign an extension to a Profile. Would it be feasible to create a profile or the U.S. and another for a specific country. Or, could we create a suite of profiles.

e. Would like to build the patient medication management template based on an existing FHIR Framework.

f. Would need to write the Use Case and then take the Use Case to the FHIR workgroup.g. May need to build customizable profile and allow for variation globally.h. FHIR DSTU 2 resources for Pharmacy and Care Plans will have substantive changes.i. FHIR has refactored Profile resource to Profile and Extension.j. FHIR Tooling and is evolving.

2. LMIC/Rural Presentation Mobile Framework for Healthcare Adoption of Short-Message Technologies (mFHAST) (previously the Mobile Health LMIC/Rural Health sub-workgroup series).Project Scope Statement– Nathan Botts (Continued)

a. Continue to populate and edit Project Scope Statement

MHWG Co-Chairs joint with Health Care Devices (Hosting) WGM – January 21, 2015 – Q4o Attendees:

Gora Datta [email protected] Matt Graham [email protected] Harry Rhodes [email protected] Nathan Botts [email protected] Tim McKay [email protected] Koichiro Matsumoto [email protected] Christian Hay [email protected] Stan Wiley [email protected] John Rhoads [email protected] Kathryn Bennett [email protected]




















Becca Poindexter [email protected] Todd Cooper [email protected] Sadamu Takasaka [email protected] Chris Courville [email protected] Jan Wirrenbler [email protected] Ken Fuchs [email protected] Teri Neal [email protected] Paul Schluter [email protected]

o Outline of Proceedings:Wednesday Q4 3:30 – 5:00 pm (90 Minutes)

Update on status of MHWG projects: LMIC/Rural Presentation Mobile Framework for Healthcare Adoption of Short-

Message Technologies (mFHAST) (previously the Mobile Health LMIC/Rural Health sub-workgroup series) Project Scope Statement

Mobile Medication Admin Profile – Medications on FHIR – Matthew Grahamo John G. Rhoads, Ph.D.posted Mobile Medication presentation to Devices

WG documents page. Consumer Mobile Application Functional Framework PSS - Tim McKay

o The proposed project will develop a framework against which Mobile Health Smartphone-based apps can be certified for conformance. The focus is on security, privacy and data controls. As a starting point it will pull relevant conformance criteria directly from the PHR-S Functional Model. At least in this phase it will NOT include domain content. It is entirely possible in the future to extend the model to encompass the idea of a modular PHR in which claimed certification would only include the domain areas in scope for a PHR which includes a number of functional elements (e.g., secure messaging + lab review only).

MHWG Co-Chairs joint with PHER (Hosting) WGM – January 22, 2015 – Q2

Gora Datta [email protected] Harry Rhodes [email protected] Rob Savage, Rob Savage Consulting [email protected] John Roberts, Tenn Dept of Health [email protected] Joginder Madra, Madra Consulting [email protected] Amit Popat, EPIC

Gora presented LMIC/Rural Presentation (MFHAST) Project Scope Statement to PHER WG. PHER membership approve proposed partnering with MHWG.

PHER attendees agreed to partner with MHWG on mFHAST PSS - Mobile Framework for Healthcare Adoption of Short-Message Technologies (mFHAST) (previously the Mobile Health LMIC/Rural Health sub-workgroup series)..

Action Item: Plan to meet with PHER going forward on Thursday’s Q2 at future HL7 Working Group meetings.















Takeaways:1. mPHAST PSS Submission in 2015 First Quarter – Documentation, Education, Use Case

development, and Requirements gathering2. Mobile Medication Admin Profile – Matthew Graham3. New PSS for Consumer Mobile Application Functional Framework - Tim McKay

Follow-up:Schedule meetings with PHER - Q2 at future HL7 Working Group meetings.

Comments:

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