LRI+Public+Health+WG+Meeting+Minutes+2011-5-11

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 * __Date__:** 5/11/11

__**Meeting Title:**__ LRI – Public Health Workgroup Meeting 3

__**Agenda/Objectives:**__ [|Lab Reporting Scope Diagram.] [|Relationships Between Existing PH Work] || 4:00 - 4:20 ||
 * **Topic** || **Time Allotted** ||
 * Review Scope Diagrams
 * Rebranding of Workgroup Name || 4:20 - 4:30 ||
 * Review of AHIC Public Health Care Reporting Use Case. || 4:30 - 4:40 ||
 * Review of [|DRAFT S&I Framework Reportable Lab Results Use Case] || 4:40 - 4:55 ||
 * Next Steps || 4:55 - 5:00 ||

__**Attendees:**__
 * Workgroup Attendees:** Virginia Sturmfels, Riki Merrick, Kate Hamilton, Tom Boal, Nikolay Lipskiy, Bob Yencha, Hal Jiang, Kathryn Calderone, John Ritter, Robert Hunter,DO, Bob Lutolf, Smriti Singal, John Roberts, Ken Gerlach, Kosta Makrodimitris


 * Panelist Attendees:**
 * Merideth Vida
 * Ed Larsen
 * Erik Pupo
 * Amy Berk

__**Action Items:**__
 * **Action Item** || **Status/Next Steps** || **Lead** || **Contributors** || **Due Date** ||
 * Sign up to be Community Leads || In Progress || Workgroup Members || Riki Merrick and Anna Orlova have signed ||  ||
 * Post CSTE Harmonized Data Elements document to Wiki || In Progress || Support Leads || Riki Merrick || 5/13/11 ||
 * Post HL7 Implementation Guide downloading instructions and link to Wiki || In Progress || Support Leads || n/a || 5/15/11 ||
 * Nikolay and Kosta will work offline to update the venn and scope diagrams. || In Progress || Nikolay and Kosta || n/a || 5/18/11 ||
 * Change the name of the workgroup to, LRI Public Health Reportable Lab Results Workgroup. || In Progress || Support Leads || n/a || 5/15/11 ||
 * Review S&I Framework Reportable Lab Results Use Case focusing on the User Story, Activity Diagram, Sequence Diagram, Functional Requirements and Dataset Considerations. || In Progress || Workgroup Members || n/a || 5/18/11 ||

__**Workgroup Discussion:**__


 * __General Topics:__**
 * Key Discussion Points:**
 * Workgroup is still looking for a lead from the community. If anyone wants to sign up for this they can do so on the Wiki.
 * Riki Merrick volunteered to be one of the Community Leads
 * A question arose throughout the session regarding the purpose of the Public Health Workgroup as it was ruled out of Scope as part of the LRI Initiative.
 * Response: The topic of results reporting to public health was ruled out of scope for the LRI Use Case, many workgroup members stressed its importance which is why this problem focused WG was kicked off. The WG is responsible for building a roadmap on how the S&I Framework should address Public Health reporting concerns both in the short and long term.
 * CSTE Harmonized data element sets that were worked on last year to IG leads and Vocabulary leads will be posted to the Wiki for others to view.
 * Participants were curious as to whether the HL7 Implementation Guide could be posted as well.
 * Support leads will look into this, but as last time, those who are not HL7 members will have to sign a waiver before downloading the document to avoid any Intellectual Property issues surrounding that document. There will be more information on the Wiki about this soon.
 * Resolution(s):**
 * Workgroup Members will sign up to be Community Leads if they are interested.
 * CSTE Harmonized data elements document will be posted to the Wiki.
 * Link to HL7 implementation guide will be posted with directions for signing the waiver should any participant want to download this material.

__**Scope Diagrams:**__
 * Key Discussion Points:**
 * The first part of the meeting was spent going over diagrams to help outline the scope of the Public Health Lab Results workgroup.
 * First Scope Diagram: Venn Diagram
 * The four different domains in this diagram are, Public Health Case Reporting, Lab Result Reporting, Biosurveillance and Adverse Event Reporting.
 * The purpose of this diagram is to display the different domains involved in Public Health reporting and the overlap between them. This will in turn help to figure out the roadmap of how to harmonize and make reporting as consistent as possible.
 * This diagram was received positively by workgroup members as a way to deliver a roadmap for potential harmonization efforts.
 * The point was made that the portion of the AHIC Use Case that focuses on the bi-directional communications between providers and public health should be considered as one of the long term goals for the S&I Framework.
 * A question arose as to whether or not there is some part of the interfaces between these different domains that the group should be aware of, or even whether or not interfaces between these domains actually exist.
 * In response, it was noted that to the extent that all of the domains will involve a lab result, we would want to harmonize the data elements and message structure that are used, in order to minimize the work of the various reporting labs.
 * Subsequent discussion revolved around Adverse Event Reporting.
 * Some of the questions asked include:
 * Does adverse reporting depend on a single lab result?
 * Is a lab result used in adverse event reporting?
 * Workgroup members identified adverse events can be reported through the reference lab.
 * Adverse Event Reporting can be reported in for two distinct purposes. The first is related to disease (closely related to the patient) and the second is related to a product (closely related to a drug/vaccine).
 * While wrapping up this portion of the discussion it was suggested that, because this venn diagram is a good description of harmonization, it should be added long term vision and include adverse result reporting but not for this stage. This will add value to the long term description of where the Workgroup is going
 * Second Scope Diagram:
 * The discussion surrounding the second scope diagram focused mainly on challenges associated with qualifications for meeting Stage 1 meaningful use requirements and the certified EHRs that send messages vs. Public Health agencies that receive them.
 * From Meaningful Use Stage 1 first rule, the in-patient EHR systems have to be able to send reportable lab results to Public Health agencies using the HL7 2.5.1 and the HL7 lab reporting implementation guide. Whether it was the lab that did it or the EHR, it had to be certified to send the message to public health.
 * Our Workgroup is involved with creating the implementation guide that will try to harmonize with the reportable results Implementation Guide that is already been selected by ONC/CMS
 * Resolution(s):**
 * Nikolay and Kosta will work offline to update both the Venn and scope diagrams.


 * __Re-branding the Workgroup:__**
 * Key Discussion Points:**
 * The topic of Re-branding the purpose of the Public Health Workgroup under the S&I Framework came up as a topic of discussion during this week’s session.
 * This idea stemmed behind the thought of saying that there is a focus on Public Health reportable lab results and that the goal of this workgroup is to send lab results to public health.
 * There was some push back from various Workgroup members related to this idea because there already is another ELR Workgroup that focuses solely on lab reporting to public health. It was reiterated that the Workgroup’s focus was in fact to make sure that makes sure whatever Implementation Guide gets recommended as a result of the S&I Framework Initiatives, still supports Public Health Reporting and the Requirements of Public Health Reporting.
 * The idea was raised that there be more research conducted regarding the certification of proxy senders and how that would work from a Public Health agency view. In many cases, those agencies don’t care who is sending it as long as they get their information.
 * There were two options of re-naming the workgroup that were brought up at the end of this discussion:
 * Public Health Lab Results Workgroup
 * Or Public Health Workgroup (as is)
 * Resolution(s): **
 * Workgroup decided that it was not in conflict with the pre-existing ELR workgroup to name the Workgroup, LRI Public Health Lab Results Workgroup.

__**AHIC Use Case: **__
 * Key Discussion Points: **
 * It is important that the Workgroup incorporates the useful parts of the AHIC Use Case within the PH Use Case.
 * Because the Implementation guide has already been selected, we want to make sure that in creating these pieces we identify missing requirements and ways that we want to revise the implementation guide that’s already out there.
 * What we really need to do is to define the Public Health Lab Reporting requirements in a manner that we can make sure that the ambulatory group can understand so that they know what they have to align with.
 * Resolution(s):**
 * The Workgroup will not be doing a detailed review of the AHIC Use Case at this time due to the complexity; however, it will be used a reference where applicable moving forward.

__**S&I Framework Reportable Labs Use Case:**__
 * Key Discussion Points:**
 * It is important that the Workgroup members provide input on the Use Case that was drafted on behalf of the framework.
 * Since an implementation guide has already been selected the workgroup members were asked to create a Use Case “light”
 * To kick off the creation of the Use Case “light” the workgroup was assigned to review the User Story, Scenario, Activity Diagram, Sequence Diagram, Functional Requirements and Dataset Considerations.
 * Workgroup members were reminded that the Use Case was developed in January as a starting point and that it can be revised as necessary to meet the goals of the workgroup.
 * Resolution(s):**
 * The Workgroup Members have been tasked with reviewing and providing feedback on the User Story, Scenario, Activity Diagram, Sequence Diagram, Functional Requirements and Dataset Considerations sections of the S&I Framework Use Case before the next meeting.


 * __Wrap Up/Next Steps:__**
 * The Workgroup should focus on making sure the following pieces of the Use Case-like document are correct and/or appropriate:
 * User Story, activity diagram, sequence diagram, requirements and dataset considerations. The dataset considerations are especially important is because it is where we make sure that the appropriate data elements are captured by the ELR Guide.
 * Workgroup members should use the Discussion tab in Wiki to provide feedback. More instructions will be sent out in the follow up email.
 * Because of the HL7 meeting next week there was some hesitation around holding a meeting for this Workgroup; however, after polling those on the call, it turned out that the majority would be able to attend.
 * Those who are interested should sign up as Leads for this Workgroup
 * Resolution(s):**
 * Workgroup members will revise AHIC Use Case and provide feedback focusing on highlighted areas.
 * Instructions about leaving feedback on the AHIC Use Case will be sent out in the follow up email and posted to the Wiki.
 * Workgroup will meet next week.
 * Riki Merrick signed up to be a Lead for this Workgroup.

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