Halfpenny+Technologies+Pilot+Brief


 * PROJECT BRIEF: Halfpenny Technologies, Inc. - LRI "Black Box" Implementation **

**Sponsor(s)/Contact(s): ** Halfpenny Technologies (HTI), Gai Elhanan (drgai@halfpenny.com) AthenaHealth, Kathleen O'Neill (kmoneill@athenahealth.com) Epic, Thanos Tsiolis (Thanos@epic.com) RML, Kent Parkins (Kent.Parkins@sjmc.org Sunrise Clinical Laboratory, FL, Miftah Kemel, (941.626.6908) Sunrise, NY, TBD

**Objectives ** **Demonstrate: **
 * Feasibility of creating/converting current labs results formats into an LEI IG compliant format
 * Demonstrate the use and value of 100% lab results LOINC coding by LOINC mapping labs' test compendiums
 * The value of discrete, normalizd lab results within EHRs
 * The use of SNOMED (where appropriate) and UCUM codes
 * Proper use of OIDs
 * Feasibility of a system integrator as a facilitator of meaningful use compliance
 * How a hub approach can simplify implementation and use of LRI IG for both labs and EHRs/practices

=Pilot Term= As desired by ONC

**Team Composition: **


 * **Organization ** || **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Participant/Stakeholder ** || **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Roles and Responsibilities ** ||
 * Halfpenny Technologies, Inc. || Gai Elhanan || Coordinator, System integrator ||
 * AthenaHealth || Kathleen O'Neill || Coordinator, EHR ||
 * Epic || Thanos Tsiolis || Coordinator, EHR ||
 * Sunrise Clinical Laboratory, FL || Miftah Kemel || Coordinator, Lab/LIS ||
 * RML || Kent Parkins || Coordinator, Lab/LIS ||
 * Sunrise, NY || TBD || Coordinator, Lab/LIS ||

**<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 18px;">Description **
 * 1) <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">**General:** Utilizing its proprietary Canonical Translator and [|ITF-SecureConnect] connectivity layer, Halfpenny Technologies, Inc. (HTI) will provide its cloud-based Integration Technology Framework hub ([|ITF-Hub]) to create and deliver LRI IG compliant lab results messages, and integrate discrete results within EHRs. **For pilot outline, please see the diagrams below**. The proposed pilots will test the following:
 * 2) <span style="color: #000000; display: block; font-family: Calibri; font-size: 14.6667px; text-align: left;">Ability to formulate a compliant LRI IG format by the “black box”
 * 3) Ability to transmit the IG format to a practice EHR (potentially including SNOMED codes)
 * 4) Conversion of the LRI format to the EHR native format if the EHR is unable to consume LRI format
 * 5) Ability of the practice EHR to display the message content properly (possibly excluding SNOMED codes)
 * 6) Ability to confirm result delivery back to the lab
 * 7) **Describe how you will demonstrate all of the In Scope items of the S&I Framework Use Case:**
 * 8) Desired tests will be selected from participating labs
 * 9) Compliant format will be generated
 * 10) LOINC codes will be applied
 * 11) Possibly use of OIDs, UCUM, and SNOMED will we applied
 * 12) Compliant format will be delivered to the practice side EHR
 * 13) Data authenticity and consistency will be verified as related to the practice EHR's results display and database. The interface will be verified to be CLIA-compliant.
 * 14) **List which S&I Framework in scope tests you will include:**
 * 15) The complete spectrum of desired tests is planned
 * 16) All additional test types that flow through a specific interface are planned to be included as well
 * 17) Microbiology tests are planned in accordance with the ability of participating labs to produce discrete microbiology reports
 * 18) **List which Implementation Guide Profiles you will include:** LRI Common Profile + GU, RN, and as compliant with participating EHR(s)
 * 19) **Source of test data:** Actual production transactions from participating labs and practices.
 * 20) **Contribution of team members:**
 * 21) Laboratory: RML, Sunrise
 * 22) Contribution:
 * 23) Provide test data
 * 24) Sponsor/Identify participating practices
 * 25) CLIA reporting requirements will be covered by the system integrator HTI including result reports and statuses; preliminary, final, appended, corrected and/or amended.
 * 26) LIMS vendor: N/A due to the "Black Box" approach
 * 27) System Integrator: Halfpenny Technologies, Inc. (HTI)
 * 28) Contribution:
 * 29) Overall pilot leadership and recruitment
 * 30) Lab-ITF interface
 * 31) ITF-EHR interface
 * 32) Generation of LRI compliant content
 * 33) Interface and content validation and certification
 * 34) Describe any transformations that you will be doing between the LIMS output and EHR input.
 * 35) Data is expected to be received from the lab LIS in a HL7 2.3.1 format
 * 36) Data will be uploaded into the ITF-Hub where format conversion will occur to the LRI IG format, possibly including the use of OIDs
 * 37) Within ITF-Hub all data normalization will occur including: LOINC coding and applying UCUM and SNOMED codes, if applicable.
 * 38) Describe your transport system that is being used in Production environments:
 * 39) Established network and policy infrastructure to enable consistent, appropriate, and accurate information exchange across provider systems, data repositories and locator services. This includes, but is not limited to:
 * 40) Methods to identify and authenticate users; These are planned to be system-to-system interfaces utilizing a proprietary, highly secure, HIPAA-compliant connectivity layer - HTI's ITF-SecureConnect. All communications are doubly encrypted utilizing recognized 256 bit protocols. VPNs are used as desired by clients. All human required interventions are conducted via web-based secure portal with appropriate user authentication and logging.
 * 41) Methods to identify and determine Providers of care; Standard use of NPI numbers and other information as provided by the LIS.
 * 42) Methods to enforce data access authorization policies; Roles-based access where relevant.
 * 43) Methods to ensure the veracity of data; See above.
 * 44) How the transport mechanism will provide guaranteed delivery and error handling; ITF-HUB includes delivery tracking, which follows a result through from start to finish and logs each successful step through the process. The end result is a series of logs indicating the time a result was received in ITF-HUB, and the time that same result was acknowledged by the destination system as received. If an error occurs at any point along the way, automated alerts are generated, and may be internal or sent directly to the laboratory depending on the nature of the error.
 * 45) Describe your approach to how detailed audit trails are kept as necessary by all participating systems. All transactions are executed via ITF-Hub which provides comprehensive logging capabilities for all aspects of data transactions, transformations, communication, and access.
 * 46) EHR Vendor
 * 47) Contribution: Provide a LRI-compatible ambulatory EHR that is able to incorporate the format and its data
 * 48) Describe how will you capture the EHR input message for compliance verification? Based on the EHR-providers established mechanism
 * 49) Describe how you will obtain evidence that the EHR can incorporate test data from the laboratory message as standardized structured data. GUI and DB testing of sample data, user/physician feedback and comparison, etc.
 * 50) Ambulatory Provider(s)
 * 51) Contribution: Practice EHR
 * 52) If there are no providers on your team, address which team member will be responsible for the provider functions and describe your approach to addressing the provider functions.



Alternatively, if an LRI IG-compatible EHR is not available the pilot will provide a practice-side back-converter module that will enable the EHR to incorporate discrete, normalized data from the LRI IG format (see diagram below).


 * **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Step # ** || **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Actor ** || **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Event/Description ** || **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Inputs ** || **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Outputs ** ||
 * 1 || Lab || Generates a lab result ||  || Lab result in a LIS-native format ||
 * 2 || HTI || LIS-native format submitted to ITF-Hub || LIS-native format ||  ||
 * 3 || HTI || Converts LIS-native format to LRI IG-compatible format ||  || LRI IG-compatible format ||
 * 4 || HTI || Trsansmit LRI IG-compatible format to practice ||  ||   ||
 * 5 || HTI || Optional - Convert LRI IG-compatible format to practice EHR format || LRI IG-compatible format || EHR-compatible format ||
 * 6 || EHR || Incorporate discrete results into EHR's DB and UI display ||  ||   ||

=High Priority Focus Items= Describe your approach to addressing the following High Priority Focus items. The approach should include short term (3months) and long term(9 months)
 * LOINC - All lab tests will be LOINC coded from the start of the project. LOINC coding and data normalization is an integral part of ITF-Hub. For the participating labs, HTI will provide compendium LOINC-mapping at the start of the project. For LISs that are unable to contain LOINC codes, ITF-Hub loads the relevant test compendiums and provides on-the-fly LOINC mapping.
 * SNOMED - TBD. Currently planned to be used for microbiology results (codes and qualifiers), if such results can be provided discretely by the participating labs.
 * OIDS - Planned as part of the generation of LRI compliant format within ITF-Hub
 * UCUM - TBD. Planned to be used utilizing translation tables within ITF-Hub.

=Participants/Stakeholders= Others - TBD as needed || Coordinator, System integrator ||
 * **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Organization ** || **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Participant/Stakeholder ** || **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Roles and Responsibilities ** ||
 * Halfpenny Technologies, Inc. || Gai Elhanan
 * AthenaHealth || Kathleen O'Neill || Coordinator, EHR ||
 * Epic || Thanos Tsiolis || Coordinator, EHR ||
 * RML || Kent Parkins || Coordinator, Lab/LIS ||
 * Sunrise Clinical Laboratory, FL || Miftah Kemel || Coordinator, Lab/LIS ||
 * Sunrise, NY || TBD || Coordinator, Lab/LIS ||

=LRI Pilot Project Time Line= Include at least the following Milestones
 * **Milestone** || **Target Date** ||
 * Start date || 1/26/2012 ||
 * LIMS generates the first in scope test result || Start + 1mo ||
 * Transport system available and tested || Start + 2mo ||
 * Transformations available and tested || Start + 3mo ||
 * EHR receives and incorporates first test result || Start + 3mo ||
 * LIMS can generate all in scope test results || Start + 3mo ||
 * EHR can receive and incorporate all in scope test results || Start + 3mo ||

=Validation Suite= Most likely. Extent: TBD

=Success Metrics=
 * 1) Describe the artifacts and verifications that will be used to confirm pilot success.
 * 2) Describe how you will collect data for input to the LRI Success Metrics

=Required Artifacts and/or Support= Describe any artifacts and support that you need from the LRI Pilots Workgroup, workgroup support staff or ONC.


 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 18px;">LRI Anticipated Available Pilot Resources **
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Personnel: <=3
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Infrastructure: Existing
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">S&I Contractor technical assistance/support:LRI IG interpretation
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Other

**<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 18px;">Pilot Project Time Line **
 * **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Milestone ** || **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Target Date ** || **<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Responsible ****<span style="font-family: 'Arial','sans-serif'; font-size: 13px;">Resource ** ||
 * <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">Pilot Acceptance || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">10/6/2011 || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">Full LRI RI/DP WG ||
 * <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">Pilot Nomination || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">10/7/2011 || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">Chitra Raghu ||
 * <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">HIMSS Registration Fees || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">10/14/2011 ||  ||
 * <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">SI Framework F2F || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">10/16/2011 || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">All Participants ||
 * <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">Virtual Integration || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">12/15/2011 ||  ||
 * <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">ONC Testing || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">1/13/2012 ||  ||
 * <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">HIMSS 2012 Interoperability Showcase || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">2/20/2012 || <span style="display: block; font-family: arial,sans-serif; font-size: 13px; text-align: left;">All Participants ||

**<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 18px;">Success Metrics ** Describe how success of this pilot will be determined and measured//.// <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Success will be determined by:
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Demonstrating successful integration into EMR Solution:
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">% of selected pilot tests successfully introduced and discreetly displayed in a provider's EHR
 * % of non-pilot selected tests successfully integrated and discreetly displayed in a provider's EHR
 * Provide metrics, as available, regarding implementation steps provided by the project management team
 * Provide feedback regarding the LRI IG implementation as compared to currently used internal and external HL7 formats
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Demonstrating the ability to repeat additional integration projects more quickly and with less work
 * Halfpenny addresses any new project as a "reusable connector" and will provide feedback as to the effectiveness of the LRI IG towards reusability compared with its experience with existing connectors.

**<span style="color: black; font-family: 'Arial','sans-serif'; font-size: 18px;">Other Notes **
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">EMR Vendor and EMR Solution will be added to project within the next two weeks
 * <span style="color: black; font-family: 'Arial','sans-serif'; font-size: 13px;">Project Participants are requesting that HIMSS Registation Fees be eliminated or greatly reduced to Pilot Participants who are donating their time and travel expenses