LRI+-+UCR+Workgroup+Charter

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1.0 Use Case and Requirements Workgroup Composition

 * **Initiative Coordinator:** || Jitin Asnaani, ONC S&I Framework ||

S&I Framework Team Members
Ed Larsen || John Stinn || Andriy Selivonenko Tom Boal Joan DuHaime Chitra Ragu || Charles Ndunda Anjali Gupte Chitra Ragu || Chad Clay || Marc Bernard || Neal Richards ||
 * **S&I Team** || **Laboratory Results Interface Initiative** ||
 * Use Case || Merideth Vida
 * Harmonization || Jillian Wanner
 * Implementation Specifications || Jillian Wanner ||
 * Reference Implementation || Michael Nenashev
 * Demonstrations and Pilots || Dave Colbert
 * Certification and Testing || Chris Brancato
 * Tools || Kevin Puscas ||
 * Architecture || Dragon Bashyam
 * Federal Health Architecture || Erik Pupo

**Committed Members**
This list will be updated on Tuesdays and Fridays. If you notice a change that needs to be made, please send your request to admin@siframework.org so that we can update it in all of our records.
 * **Workgroup Member** || **Organization** ||
 * Robert Hunter, DO, FACOEP, FACOFP || American Osteopathic Association of Medical Informatics ||
 * Seonho Kim || ApeniMED (formerly MEDNET) ||
 * Srinath Remala || Association of Public Health Laboratories (APHL) ||
 * Wes Kennemore || Association of Public Health Laboratories (APHL) ||
 * Robert Dieterle || Cal eConnect ||
 * Glen Moy || California HealthCare Foundation ||
 * Nikolay Lipskiy || CDC ||
 * Gary Dickinson || CentriHealth ||
 * Andrea Pitkus || College of American Pathologists ||
 * Jim Harrison || College of American Pathologists ||
 * John Ritter || College of American Pathologists ||
 * Walter Henricks, MD || College of American Pathologists ||
 * Julie Cantor-Weinberg, MPP || College of American Pathologists ||
 * Jim Carlson || College of American Pathologists ||
 * Wayne King || Covisint ||
 * Chris Doucette || Deloitte ||
 * Randolph Sanks, MBA || Deloitte (Health and Life Sciences) ||
 * Robert Coli, MD || Diagnostic Information System Company ||
 * Steve Hufnagel || DoD Military Health System ||
 * Vassil Peytchev || Epic ||
 * Thanos Tsiolis || Epic ||
 * Robert Lutolf || Gensa Corporation ||
 * Robert Hausam, MD || HL7 ||
 * David Cheng || IBM ||
 * Riki Merrick || iConnect Consulting ||
 * Ken Willett || Ignis Systems ||
 * Scott Serich || IJIS Institute ||
 * Mary McGinnis || Illinois Office of Health Information Exchange (OHIT) ||
 * Cindy Johns || Laboratory Corporation of America ||
 * Kathy Walsh || Laboratory Corporation of America ||
 * Jonah Frohlich || Manatt Health Solutions ||
 * Corey Spears || McKesson ||
 * Eric Heflin || Medicity ||
 * Paul Edge || Microsoft ||
 * Gary Teichrow || Mirth Corp ||
 * Jonathan Bartels || Mirth Corp ||
 * Robert Snelick || National Institute of Standards and Technology (NIST) ||
 * Carrie Adams || NeHII ||
 * Cindy Vinion || Northrop Grumman Information Technology, CDC/OSELS/PHITPO ||
 * Nick VanDuyne || NYeC ||
 * James McCormack, MT(ASCP) || Oregon Health & Science University ||
 * Brian Ahier || Oregon HIE Technology Workgroup ||
 * Freida Hall || Quest Diagnostics, Inc. ||
 * Ken McCaslin || Quest Diagnostics, Inc. ||
 * Roger Hornsby || Quest Diagnostics, Inc. ||
 * Andrew Splitz || S&P Consultants, Inc ||
 * Austin Kreisler || SAIC ||
 * Michael Trebatoski || SAIC ||
 * Lester Keeper Jr. || Secure Hitech LLC ||
 * Ernest Grove || Secure Hitech LLC ||
 * Hans Buitendijk || Siemens ||
 * William Ormerod || Siemens ||
 * Lorre Pacheco || Sunquest Information Systems ||
 * Arturo Sanchez || U. of North Florida - School of Computing ||
 * Terry Hearn || Wellpoint ||

2.0 Use Case and Requirements Workgroup Mission, Vision, and Objectives
//Vision//: The Vision of the Use Case and Requirements Workgroup is to deliver guidance to the health information technology community on how to achieve healthcare delivery improvements through healthcare data exchange and interoperability.

//Mission//: The Mission of the Use Case and Requirements Workgroup is to define the necessary components and artifacts to develop Use Cases and their associated Functional Requirements. In developing these Use Cases the workgroup will define a valuable set of integrated functions and processes to achieve harmonized interoperability for healthcare information exchange for any warranted Initiative. More specifically, for the Laboratory Results Interface Initiative, the workgroup will define business needs for exchange and interoperability between laboratories and healthcare providers in an ambulatory setting.

Specifically, the Laboratory Results Interface Initiative presents the following Challenge to be discussed and evaluated when developing an Initiative specific Use Case: //There are at least two standard specifications for ambulatory laboratory reporting, neither of which are adopted universally across industry. The cost and time to initiate new electronic laboratory results interfaces hampers broad adoption of such interfaces. The field by field details of HL7 v2 implementation guides used by clinical labs and EHRs vary, creating a need for mapping or configuration per interface, and the prevalence of core subsets of LOINC codes for common tests and analytes also varies, causing downstream issues in decision support and quality reporting.//

The Scope of this Initiative is limited to
 * Address the challenge of lab reporting to ambulatory primary care providers. This will be driven primarily by the needs of internal medicine, family practice and pediatrics, but may also be leveraged by other providers and settings.
 * Optionally: enable pilots that demonstrate electronic results delivery through the agreed-upon standard, including linkages with directories and transport

The Main Goal of the Laboratory Results Interface Initiative is the achievement of Meaningful Use:

//Incorporate laboratory results into EHR as structured data. Supports objectives for Decision Support, Quality Reporting, Transitions in Care, and Electronic copies of Clinical Summaries and Discharge Instructions.//

Objectives of the Use Case and Requirements Workgroup are the following:
 * 1) Engage Stakeholders as Committed Members, Invited Experts, or Interested Parties in the creation of the Use Case(s) for the Laboratory Results Interface Initiative
 * 2) Publish a finalized Use Case or set of Use Cases that contain necessary content, supported by artifacts, to enable Harmonization and subsequent S&I Framework efforts to occur.
 * 3) Establish the Use Case or set of Use Cases and supporting artifacts in a reusable fashion to support future health information exchange initiatives.
 * 4) Create a finalized Use Case or set of Use Cases that demonstrate value and supports the proposed goals and success criteria for the Laboratory Results Interface Initiative. Specifically, success criteria for this Initiative are the following:
 * Number of Providers using Lab Results Interface Initiative Outputs
 * Number of Labs using Lab Results Interface Initiative Outputs
 * Number of Lab Results Reporting transactions using Lab Results Interface Initiative Outputs
 * Number of vendors (EHRs, PHRs, LIS Vendors, HIEs) using Lab Results Interface Initiative Outputs
 * Time Reduction to Create a New Lab Interface
 * Cost Reduction to Create a New Lab Interface
 * Meaningful Use Alignment

3.0 Deliverables

 * **Deliverable Name** || **Draft Due Date** || **Final Due Date** ||
 * Lab Results Interface Initiative Use Case Timeline || 01/15/11 || 01/31/11 ||
 * Lab Results Interface Initiative Use Case Template Draft || 01/31/11 || 01/31/11 ||
 * Review Log of Comments/Feedback of the Lab Results Interface Initiative Use Case || 02/03/11 || 04/29/11 ||
 * Finalized Lab Results Interface Initiative Use Case || 04/28/11 || 04/29/11 ||

4.0 Key Stakeholders
The Use Case and Requirements Workgroup will work as part of the Standards and Interoperability (S&I) Framework. The Workgroup serves as the primary interface with various Stakeholders of the healthcare technology community that have interest and expertise related to the specific Initiative. Specifically, the Stakeholders to be interfaced with for this Workgroup include the following:
 * Patients
 * Consumers
 * Care Coordinators
 * Clinicians
 * Laboratories
 * Provider Organizations
 * Standards Organizations
 * Federal Agencies
 * Electronic Health Record/Personal Health Record Vendors

The Workgroup will work to develop and evolve key Use Cases in alignment with the Initiatives, as selected by prioritization criteria, to elicit future recommendations. These efforts will form a foundation for healthcare interoperability in the US.

5.0 Key Activities, Timing, and Milestones
The following activities and milestones per the Use Case and Requirements Workgroup are fundamental in producing the final Use Case Deliverable. It is to be noted that the Use Case and Requirements Workgroup’s main focus is on Discovery activities; however, the Workgroup will remain engaged throughout the entirety of the S&I Framework. Requirements Workgroup || * Formation of Use Case and Requirements Workgroup || * Completion of Project Charter || Laboratory Results Interface Initiative || * Review of Existing Use Cases Wiki for Feedback || * Compile and Publish Use Case to Wiki for Stakeholder/COI Feedback/Comment || * Receipt of Stakeholder/COI Harmonization Team || * {color:#000000}Transition of Finalized Use Case {color}and Functional Requirements to Harmonization Team || * Transition final Use Case and Functional Requirements to Harmonization Function of S&I Framework ||
 * **Focus Area** || **Major Activities** || **Milestones** ||
 * Call for Participation || * Broadcast of Call for Stakeholders || * Confirmation of Stakeholder Participants ||
 * Laboratory Results Interface Initiative Kick-Off || * Introduction of S&I Framework
 * Introduction of Use Case
 * Complete Roles & Responsibilities
 * Introduce Agenda of Workgroup Sessions || * Complete Roles and Responsibilities
 * Confirmation of Workgroup Attendees
 * Confirmation of Topics to be discussed at Workgroups per Use Case ||
 * Establish Use Case and
 * Conduct Research Related to
 * Share Findings with Participants || * Incorporation of Gaps into Use Case Documentation ||
 * Document Business Processes || * Draft Content
 * Present to Stakeholders for Feedback
 * Resolve Feedback by Casting of Votes
 * Update Use Case with Feedback || * Confirmation of Business Processes ||
 * Document Use Case Diagrams || * Draft Content
 * Present to Stakeholders for Feedback
 * Resolve Feedback by Casting of Votes
 * Update Use Case with Feedback || * Confirmation of Use Case Diagrams ||
 * Document Business Scenarios || * Draft Content
 * Present to Stakeholders for Feedback
 * Resolve Feedback by Casting of Votes
 * Update Use Case with Feedback || * Confirmation of Activity Diagrams
 * Confirmation of Sequence Diagrams
 * Confirmation of Business Scenarios ||
 * Document Functional Requirements || * Draft Content
 * Present to Stakeholders for Feedback
 * Resolve Feedback by Casting of Votes (2 Workgroup Sessions)
 * Update Use Case with Feedback || * Confirmation of Functional Requirements ||
 * Publish Use Case to the
 * Feedback/Comment ||
 * Finalize Use Case with Initiative Coordinator || * Finalize Content of Use Case || * Update Use Case with Feedback/Updates ||
 * Publish Final Use Case to Wiki || * Publish Final Use Case to Wiki || * Use Case Published on the Wiki ||
 * Transition of Use Case to
 * Use Case Workgroup Sessions || * Discussion of Use Case
 * Documentation of Use Case
 * Capturing of Feedback/Comments || * Documentation of Use Case
 * Updates to Use Case ||
 * Communications || * Updates/Feedback to Use Cases || * Documentation of Review Log of Use Case Feedback/Comments ||

6.0 Use Case and Requirements Workgroup Member Knowledge and Skills Coverage
This list will be updated on Tuesdays and Fridays. If you notice a change that needs to be made, please send your request to admin@siframework.org so that we can update it in all of our records.
 * **Workgroup Member** || **Organization** || **Role** ||
 * Jitin Asnaani || ONC S&I Framework || Initiative Coordinator ||
 * Merideth Vida || ONC S&I Framework || Support Lead ||
 * Ed Larsen || ONC S&I Framework || Support Lead ||
 * Robert Hunter, DO, FACOEP, FACOFP || American Osteopathic Association of Medical Informatics || Committed Member ||
 * Seonho Kim || ApeniMED (formerly MEDNET) || Committed Member ||
 * Srinath Remala || Association of Public Health Laboratories (APHL) || Committed Member ||
 * Wes Kennemore || Association of Public Health Laboratories (APHL) || Committed Member ||
 * Robert Dieterle || Cal eConnect || Committed Member ||
 * Glen Moy || California HealthCare Foundation || Committed Member ||
 * Nikolay Lipskiy || CDC || Committed Member ||
 * Gary Dickinson || CentriHealth || Committed Member ||
 * Andrea Pitkus || College of American Pathologists || Committed Member ||
 * Jim Harrison || College of American Pathologists || Committed Member ||
 * John Ritter || College of American Pathologists || Committed Member ||
 * Walter Henricks, MD || College of American Pathologists || Committed Member ||
 * Julie Cantor-Weinberg, MPP || College of American Pathologists || Committed Member ||
 * Jim Carlson || College of American Pathologists || Committed Member ||
 * Wayne King || Covisint || Committed Member ||
 * Chris Doucette || Deloitte || Committed Member ||
 * Randolph Sanks, MBA || Deloitte (Health and Life Sciences) || Committed Member ||
 * Robert Coli, MD || Diagnostic Information System Company || Committed Member ||
 * Steve Hufnagel || DoD Military Health System || Committed Member ||
 * Vassil Peytchev || Epic || Committed Member ||
 * Thanos Tsiolis || Epic || Committed Member ||
 * Robert Lutolf || Gensa Corporation || Committed Member ||
 * Robert Hausam, MD || HL7 || Committed Member ||
 * David Cheng || IBM || Committed Member ||
 * Riki Merrick || iConnect Consulting || Committed Member ||
 * Ken Willett || Ignis Systems || Committed Member ||
 * Scott Serich || IJIS Institute || Committed Member ||
 * Mary McGinnis || Illinois Office of Health Information Exchange (OHIT) || Committed Member ||
 * Cindy Johns || Laboratory Corporation of America || Committed Member ||
 * Kathy Walsh || Laboratory Corporation of America || Committed Member ||
 * Jonah Frohlich || Manatt Health Solutions || Committed Member ||
 * Corey Spears || McKesson || Committed Member ||
 * Eric Heflin || Medicity || Committed Member ||
 * Paul Edge || Microsoft || Committed Member ||
 * Gary Teichrow || Mirth Corp || Committed Member ||
 * Jonathan Bartels || Mirth Corp || Committed Member ||
 * Robert Snelick || National Institute of Standards and Technology (NIST) || Committed Member ||
 * Carrie Adams || NeHII || Committed Member ||
 * Cindy Vinion || Northrop Grumman Information Technology, CDC/OSELS/PHITPO || Committed Member ||
 * Nick VanDuyne || NYeC || Committed Member ||
 * James McCormack, MT(ASCP) || Oregon Health & Science University || Committed Member ||
 * Brian Ahier || Oregon HIE Technology Workgroup || Committed Member ||
 * Freida Hall || Quest Diagnostics, Inc. || Committed Member ||
 * Ken McCaslin || Quest Diagnostics, Inc. || Committed Member ||
 * Roger Hornsby || Quest Diagnostics, Inc. || Committed Member ||
 * Andrew Splitz || S&P Consultants, Inc || Committed Member ||
 * Austin Kreisler || SAIC || Committed Member ||
 * Michael Trebatoski || SAIC || Committed Member ||
 * Lester Keeper Jr. || Secure Hitech LLC || Committed Member ||
 * Ernest Grove || Secure Hitech LLC || Committed Member ||
 * Hans Buitendijk || Siemens || Committed Member ||
 * William Ormerod || Siemens || Committed Member ||
 * Lorre Pacheco || Sunquest Information Systems || Committed Member ||
 * Arturo Sanchez || U. of North Florida - School of Computing || Committed Member ||
 * Terry Hearn || Wellpoint || Committed Member ||

7.0 Operating Procedures and Conditions of the Use Case and Requirements Workgroup
In the short term, the Use Case and Requirements Workgroup will leverage the ONC announcement to seek external stakeholders with specific interest and subject matter expertise to participate in the Use Case and Requirements Workgroup, facilitated by the Use Case team and under the guidance of the Initiative Coordinator. Stakeholders will be asked to participate to greater or lesser extent based on their interests, contribution and commitments to the project by selecting to be an Initiative Committed Member, Invited Expert or an Interested Party. Once there is confirmation of Stakeholders, a Use Case and Requirements Kick-off will occur, which will provide the agenda and the expectations of the workgroup. Once established, this combined Use Case and Requirements Workgroup will draft, review, and update the Use Cases. Workgroup Meetings will occur on a weekly basis by conference call with possible face to face meetings to occur at the very end of the Discovery Phase. The process for which to document comments and feedback is one that promotes transparency and collaboration.

The S&I Framework Functions have chosen to use a table format to gather feedback from Committed Members, Invited Experts and Other Interested Parties. This table will also serve to capture the actions taken by the Workgroup Leads and/or Initiative Coordinators in relation to the comment and/or points for feedback. There is space throughout the table for Stakeholders to leave feedback, and then trace their own comments through each action taken by Workgroup Leads and the Initiative Coordinator. Ultimately, each stakeholder will be able to see how he or she was able to impact the final product. Every suggestion will be accounted for, promoting teamwork and a positive environment for those who have dedicated their time to participating in the separate Initiatives.

Once realized, the final Use Case draft will be posted to the Wiki for public comment, which is another opportunity to engage additional stakeholders. Public comments will be evaluated and dispositioned by the Use Case and Functional Requirements Workgroup with guidance from the Initiative Coordinator and ultimately ONC.

The following types of Stakeholders are invited to participate as part of the Use Case and Functional Requirements Workgroup:

**Committed Member**
A Committed Member is an organization or individual who has a particular interest in solving the Challenge Statement and reaching the Initiative Goal and commits to actively achieve the Use Case Deliverables. The nature of the commitment will vary depending on the Use Case Deliverables, but must be meaningful and relevant. A meaningful commitment will not be fulfilled by merely attending required meetings but instead will require significant contributions outside of meetings.

The commitment will be documented in a public Statement of Commitment within the timeline of the Call for Participation. The Initiative Coordinator will be responsible for verifying that the Statement of Commitment is meaningful and relevant to the Use Case Deliverables. Should the Initiative Coordinator believe the Statement of Commitment is not meaningful or relevant; the Initiative Coordinator will inform the prospective member of the issue with the Statement of Commitment to provide an opportunity to address the issue. Should the prospective member feel the Statement of Commitment does meet the tests of relevance and meaningfulness; the member will have the right to a single written appeal to the S&I Steering Team. After the Call for Participation timeline, Statements of Commitment from prospective members may only be approved by the S&I Steering Team. Organizational Initiative Group members may assign multiple employees to participate in the Use Case Requirements workgroups, but will only have one vote in Consensus decisions. Organizations that provide S&I Staff may not be Use Case Requirements Workgroup members. When an individual represents an organization, the individual’s vote represents the organization’s vote. Lastly, organizations and individuals should not create “pseudo-organizations” to gain multiple votes in the Use Case Workgroup Consensus Process.

**Invited Experts**
Invited Experts are individuals who do not individually meet the requirements of the Use Case Requirements Workgroup and whose organization is not a Committed Member. These Experts are invited by the Initiative Coordinator to participate in discussions.

**Other Interested Parties**
Any interested party is invited to participate in discussions and can provide comments and feedback by joining the Wiki. However, only Committed Members have voting rights in the Use Case Requirements Workgroup Consensus Process.

Success of the Use Case and Functional Requirements Workgroup is dependent on Stakeholders’ vested commitment, interest and expertise.

8.0 Use Case and Requirements Workgroup Ground Rules

 * 1) Stakeholder participation in person or by phone; not by proxy
 * 2) Engage in Workgroup meetings in a professional manner, do not interrupt other Workgroup members when they are speaking
 * 3) Encourage Participation; bring forth subject matter expertise and knowledge relevant to the Initiative
 * 4) Actively Listen
 * 5) Present a United Front by Consensus
 * 6) Issues will be resolved in a timely manner within workgroups or offline and resolution of these issues are priority within the workgroups themselves
 * 7) Workgroup Minutes will be posted to the Wiki 48 hrs after each Workgroup

9.0 Use Case and Requirements Workgroup Code of Conduct

 * 1) Stakeholder participation in person; not by proxy
 * 2) Engage in Workgroup meetings in a professional manner; do not interrupt other Workgroup members when they are speaking.
 * 3) Encourage Participation; bring forth subject matter expertise and knowledge relevant to the Initiative
 * 4) Listen
 * 5) Vote by balloting
 * 6) Present a united front
 * 7) Reach Consensus

Related/Existing Use Cases
The following Use Cases are Related/Existing Use Cases that are relevant and have been leveraged for the Laboratory Results Interface Initiative.

**AHIC**

 * Public Health Case Reporting
 * Biosurveillance (Visit, Utilization, and Lab Result Data)
 * Electronic Health Record (Laboratory Result Reporting)
 * General Laboratory Orders
 * Order Sets

**NHIN Direct Project**

 * A Provider EHR orders a test
 * Laboratory reports test results for some specific conditions to public health
 * Laboratory sends lab results to ordering provider
 * Direct Specialist sends summary care information back to referring provider
 * Direct Hospital sends discharge information to referring provider

**HIMSS**

 * Biosurveillance - Monitoring and Detection
 * Cancer Reporting - Prostate Cancer, Chronic Lymphocytic Leukemia

**IHE**

 * Publishing of lab summary at discharge
 * Publishing of patient report into the regional patient health record
 * Ambulatory provider shares a laboratory report
 * Private and/or public laboratory publishes all its reports automatically
 * Health care institution produces a cumulative laboratory report of test performed on the patient
 * Public health laboratory shares report in a regional repository

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