Health eDecisionsRI/ Pilots

Sub-Workgroup

February 11th, 2013

10/11/2011 1

Agenda

• Announcements• Review of Goals• Review of RI/Pilot Sub-WG Timeline• Review of Materials for Pilot• Pilot project presentations• Questions and Answers • Review Action Items, Next Steps

Announcements

• We will be continuing our work … • Next meeting February 25th, 2013 (plan for a 90 minute

meeting)• We will continue the presentation of Project Plans• The Feb 18th meeting is canceled due to President’s day holiday

– We received our first completed Pilots Document from Medexter!!

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Pilots

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Organization Pilot Lead Email Organization’s Role

Wolters Kluwer Health Sue Johnson/Steve Claypool/Howard Strasberg/Christy May

sjohnson@uptodate.comsteve.claypool@wolterskluwer.com howard.strasberg@wolterskluwer.com christy.may@wolterskluwer.com

Service Supplier/Artifact Supplier

OpenCDS David Shields david.shields@opencds.org Service Supplier

Zynx HealthClaude Nanjo (primary)Bernadette MintonVictor Lee

CNanjo@zynx.com (primary) bminton@zynx.comVLee@zynx.com

Service Supplier/Artifact Supplier

OZ Systems K. D. Pool, MD kpool@oz-systems.com Service Supplier

Medexter Healthcare Klaus-Peter AdlassnigKarsten Fehre

kpa@medexter.comkf@medexter.com Service Supplier

Elsevier Jonathan Teich j.teich@elsevier.com Service Supplier

newMentor Julie SchererMatt Pfeffer

jscherer@newmentor.com mpfeffer@newmentor.com Service Supplier/Artifact Supplier

CDCHilary WallKate ShawNikolay Lipskiy

hwall@cdc.govkmshaw@cdc.govdgz1@cdc.gov

Government /Service Supplier/Artifact Supplier

NextGenDr. Sarah CorleyDr. Jeff FriedlinGary Wietecha

scorley@nextgen.com, jfriedlin@nextgen.com,Gwietecha@nextgen.com

EHR Vendor

Practice Fusion Lauren FifieldMichael Poremba

lfifield@practicefusion.com mporemba@practicefusion.com EHR Vendor

AllScripts Douglas GentileRobin Williams (primary)

Douglas.Gentile@allscripts.com Robin.Williams3@allscripts.com (primary) EHR Vendor

Support Team• Support Team:

• Pilots Lead: Jamie Parker: jamie.parker@esacinc.com• Pilot Support: Rebecca Angeles: rebecca.angeles@esacinc.com • Subject Matter Expert: Aziz Boxwala: aziz.boxwala@meliorix.com• Subject Matter Expert: Bryn Rhodes: bryn@veracitysolutions.com • Use Case 1: Dave Shevlin: d.s.shevlin@accenturefederal.com • Harmonization: Cem Mangir: cmangir@deloitte.com • SDO Support: Anna Langhans: anna.langhans@accenture.com

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HeD Pilots Goal

Goal

The goal of this initiative is to produce and consume implementable CDS interventions.1. Event Condition Action Rules (ECA Rules)2. Order Sets3. Documentation Templates

Pilot Scope

4. Health eDecisions will apply defined aspects of the Implementation Guide in a real-world setting.

5. Modify the Implementation Guide to ensure it is usable 6. The real-world pilots evaluate not only the technology, standards and

model (VMR), but also provide a test bed to evaluate the interaction of technology, implementation support, and operational infrastructure required to meet Health eDecisions use case 1 objectives at the stakeholder or organization levels.

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Timeline

10/11/2011

Goal & Activities Week Dates Deliverables

Kickoff /Establish Goals & Partnerships: - Review HeD Initiative Goals - Review Piloting Process & Resources - Define Value Statement - Define HeD Pilot Goals & Success Metrics - Establish & Approve Pilots - Develop Pilot Briefs

1-2(4wks)

1/07-2/25 (we missed 2 meetings in January pushing our Dates back)

-Wiki Capturing Pilot Deliverables-Established Partnerships-Documented Value Statements and Success Metrics-Documented Pilot Briefs

Pilot Configuration: - Establish Pilot Test Environment & Resources - Establish Pilot Implementation & Testing Process - Develop & Review Pilot Configuration

3-4(2 wks.)

2/25-3/4

-Use Case is Updated with HL7 Comments (3/4)-Approved Pilot Briefs -Committed Pilot Resources-Documented & Reviewed Pilot Configuration Guide-Weekly Feedback on Use-Cases & IG Alignment

Pilot Development : - Setup & Develop Pilot Prototypes - Review prototypes

5-10(6 wks. or

less depending

on Pilot activity)

3/4 – 4/15

-Use Case is Updated with HL7 Comments (3/4)-Weekly Pilot Development Status Updates-Weekly Feedback on Use-Cases & IG Alignment-Updates to Pilot Configuration Guides

Pilot Testing & Showcase : - Complete Testing - Prepare Solution Showcase

11-12(2wks)

4/15-5/6 -Weekly Pilot Testing Updates & KPIs-Showcase-Prepare for HL7

Pilot Wrap-up : - Develop Lessons Learned an ONC Feedback - Review Initiative Goal Alignment - Establish Next-Steps

13-14(2 wks.)

5/13-5/29 -Documented ONC Feedback- Next Steps Action Plan

We are Here

Materials for Project Plans:

• Wiki Page:• http://wiki.siframework.org/Health+eDecisions+Pilots

• Process:1. Register as a “committed member” and attend Pilot Sub-WG calls.

2. Complete Pilot Project Documentation and present it to the Pilots Work Group

– Think of this as “what do you intend to pilot”– See Pilots wiki for the document:

• http://wiki.siframework.org/Health+eDecisions+Pilots

3. Pilot RI/ Pilot implementation – Development, Testing.

4. Provide feedback to ONC and HeD All Hands Community Meeting– Select a community member to represent our work at these meetings.

Pilot Project Schedule• We will do 4 – 10 minute project presentations each week• February 11th, 2013

1. 1:10-1:20 –Julie - NewMentor

2. 1:20-1:30 – Dave Shields

3. 1:30-1:40 - Medexter????

4. 1:40-1:50• February 25th, 2013

1. 1:10-1:20 - Zynx

2. 1:20-1:30

3. 1:30-1:40

4. 1:40-1:50• March 4th, 2013 (HIMSS WEEK) – might be a conflict so we are canceling this meeting

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Action Items & Next Steps

• Continue developing the Pilots Work Plans• If you need help with this activity please contact:

• Jamie Parker (jamie.parker@esacinc.com) • Becky Angeles (rebecca.angeles@esacinc.com

• Begin thinking about ways to connect Vendors, Content Producers and Content Supplier

Meeting Reminder

• Pilots Work stream meets (next meeting: February 25th, 2013) • Every Monday• 1-2:30 pm EDT (we have increased the duration of this call to 90

minutes in order to complete our work knowing we are canceling the Feb 18th and March 4th meetings)

• See Wiki homepage for meeting details: http://wiki.siframework.org/Health+eDecisions+Homepage

• NOTE the Feb 18th meeting is canceled due to President’s day

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Appendix A: Success Criteria

NOTE: This is a work –in-progress we will need to re-evaluate this after Pilot Project Plans• Discuss Pilot Success Criteria:

• Individual Criteria• Initiative Criteria

• EHR Involvement - DONE• Production (at least one of each artifact and consumption of those artifacts)

– Addressed as part of the Pilot Project Plans (who will be doing which artifacts)• Successful implementation of artifacts

– EHR involvement» Validate artifact – perhaps Pilots focuses on this ?» Execute the artifact

• Cross initiative function» Potential Alignment with eDOC and esMD » SDC

• Alignment with MU 3 objective» 10% knowledge based engine (align 402b)» ACTION ITEM: Review MU3 Criteria» Determine the delivery model we want to pilot

• External (i.e. cloud service)• Assets are portable (can be run locally)

• Discuss this with the group10/11/2011 12

Appendix B

In Scope/Out of Scope

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Scope of Use Case 1

• This Use Case defines the requirements to build a standard for the contents of CDS Knowledge artifacts.  The use case focuses on the following artifact types: Event Condition Action (ECA) Rules, Order Sets, and Documentation Templates. To support this purpose the Use Case has one scenario:  A CDS Knowledge Artifact Supplier makes computable CDS Knowledge Artifact available to CDS Artifact Integrator (From HeD Use Case: CDS Artifact Sharing)

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In Scope

• Standards to structure medical knowledge in a shareable and executable format for use in CDS

• In Scope Artifact Types (definitions for these artifact types can be found in Appendix A)

– Event Condition Action Rules– Order Sets – Documentation Templates

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Out of Scope• Tools:

– Authoring tools, source “content” management.– Terminology server and mapping tools including management of concept coordination.– Semantic processing of text, including structured string processing and natural language processing.

• System Functions– Messaging Layer– Means of sharing– Security

• Authoring, creation and maintenance of clinical decision support knowledge• Knowledge Repository Design• Search and query mechanisms• Implementation in systems• User presentation, Transport layers• Market factors: regulatory incentive/mandate, liability shield, IP shield (patent/licensing litigation),

certification body, marketplace design, test procedures, FDA rules• Clinical Decision Support Services (this will be covered in Use Case 2 CDS Guidance Services)• CDS Content Development Activities, including the distribution and sharing of artifacts• Context-Aware information retrieval (HL7 Information Button) – This will be covered in UC 2 (CDS

Guidance)

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Pre and Post Conditions• Pre-Conditions

– CDS Artifact Supplier makes CDS artifacts available for search and consumption by CDS Artifact Integrators _ ACTION ITEMS (Clarify this –what is a precondition for this to be useful)

– CDS Artifact integrator has the means to obtain the knowledge artifact from a CDS Repository (e.g. they have either browsed or queried the CDS Repository for available artifacts)

– CDS Artifact Integrator Selects Artifacts of Interest to Use in their CDS System

• Post Conditions– The CDS Knowledge Artifact Supplier has sent the CDS Knowledge Artifact to the

requesting CDS Artifact Integrator– CDS Artifact has been received by CDS Integrator and is available for processing– CDS Artifact is available for mapping, structural transformations and local adaptation– Strategy

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Decision: In the pilot activities we will not directly address these as part of our pilot. We will focus the pilot activities on those tasks which occur between the pre and post condition