LOI+Meeting+Minutes+-+2012-03-30

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**Time: 1:00 - 2:00 PM ET**
For the word version of the meeting minutes click [|here.]

1:00 – 2:00 PM ET ||
 * **Subject** || LOI Kick Off Meeting || **Date / Time** || 3/30/2012
 * **Facilitator** || John Feikema || **Scribe** || Merideth Vida ||
 * **Location** || Conf. Call/WebEx || **Materials** || [|LOI Kickoff Deck] ||


 * **Action Items** ||
 * **Subject** || **Item** || **Owner** || **Due Date/ Timeline** ||
 * F2F || Register for F2F and book hotel rooms || Community Members || COB 4/2/12 ||
 * Initiative Charter || Review and provide comments on Initiative Charter || Community Members || COB 4/5/12 ||


 * **Agenda** ||
 * * Introductions
 * S&I Framework Overview
 * LOI Introduction
 * Initiative Summary
 * Background
 * Target Goals & Outcomes
 * Scope
 * Timeline
 * F2F
 * Next Steps Overview ||
 * **Key Discussion Points** ||
 * * Initiative Coordinator John Feikema kicked off the meeting by walking through the S&I Framework overview
 * LOI Introduction
 * **Initiative Summary**
 * LOI is going to be built on the excellent work of CHCF
 * Build on what’s in the NPRM in terms of LRI and create the LOI that aligns with that and by doing so leverage the work done at CHCF on ELINCs Orders that’s been completed to date
 * With the large amount of work that has been completed to date LOI will follow an accelerated timeline but it will still follow the S&I Framework process so that the community can be involved in developing an IG for electronic ordering of laboratory tests in the ambulatory care settings
 * Involving the community in these efforts will result in EHR and LIS vendors having an IG that is easily implementable
 * We also want to make sure the LOI IG is supportable and usable with a compendium so LOI will be looking at eDOS and ensuring that the work efforts are lined up with one another
 * **Background**
 * Process to date has been consistent with past S&I Framework initiatives
 * Tiger Team has been meeting since January, working on solidifying the charter and objectives
 * Tiger Team has talked about how to align the LRI IG while developing the LOI IG
 * The Tiger Team will continue to work to prepare work products for the community to review and provide feedback on these work products include but are not limited to the Use Case, Draft LOI IG (aligning ELINCs Orders and the LRI IG) and a preliminary vocabulary review
 * The Tiger Team will focus on getting the ball rolling so that the alignment process can move quickly and efficiently over the next couple of months
 * The Tiger Team will stop meeting after the initial work products are developed
 * **Target Goals & Outcomes**
 * One of the major goals is to reduce complexity in the market for the implementation of Laboratory Orders interfaces
 * Our goal is to build an IG/framework that can be built upon in the future to cover other areas of Laboratory Orders in doing so we want to make sure that public health and acute care are not precluded in any way
 * In order to have LOI be successful we are looking pilot participants who are interested in piloting LRI, LOI and the compendium. In other words we are looking for pilot participants that are interested in testing out the whole laboratory process from orders to results
 * **Scope**
 * Develop an IG to support electronic laboratory ordering between an EHR System and a LIS in an ambulatory care setting.
 * In Scope
 * Development of an Orders IG that aligns with the LRI IG and ELINCS Laboratory Orders IG
 * Incorporation of support for the adoption and use of the Test Compendium Framework, i.e., eDOS
 * Out of Scope
 * Non-US laboratory ordering use cases
 * Referral orders placed between laboratories
 * Laboratory orders in the acute setting (EHR System to LIS all within the hospital)
 * **Timeline**
 * S&I Framework Phases & Activities: S&I Framework phases will be followed the activities within each phase that we will be following/conducting are listed on slide 9
 * The timeline was discussed at a high level (slide 10) emphasizing the upcoming F2F which will be used to validate the Use Case and continue Tiger Team activities (which are open to all community members)
 * We realize this is an aggressive timeframe but we feel its achievable since we are able to leverage from other work efforts
 * Questions from the Community
 * Q: Is there a publically available copy of the presentation?
 * A: Yes, it can be found on the LOI Home wiki page, half way down the page in the work space section under Meeting Agendas, Attendees, and Presentation & Minutes.
 * Q: Is the ELINCs Orders Implementation Guide available to review to better understand the business context?
 * A: Yes, the ELINCs Orders Specification can be downloaded from the CHCF [|website], the link to this website will also be added to the LOI wiki
 * Q: Will community members have the ability to sign up to participate in the workflow discussions?
 * A: In the announcement email there is a link of how to get involved. If you follow that link you can sign up as a committed member for the initiative. Once you sign your statement of commitment you will be included in all of the LOI communications. This link can also be found at the bottom of the LOI wiki page see the “How to Get Involved” section of the wiki page.
 * Q: Can you elaborate on the Public Health portion that you discussed on slide 7? I understand the reporting of results to public health but from the orders standpoint are we talking about the case of an order being placed that can only be conducted by a PH laboratory?
 * A: That would be one potential Use Case for Laboratory Ordering in the PH environment. There could also be laboratory to laboratory orders and PH jurisdictional related laboratory ordering. Our goal is to build an IG/framework that can be built upon in the future to cover other areas of Laboratory Orders in doing so we want to make sure that public health and acute care are not precluded or excluded in any way. Clarification: PH laboratory orders are not part of the current scope. With that being said, we want to be as consistent as possible when communicating Laboratory Order & Results across settings.
 * Q: What type of vocabulary will be used for the Initiative? Are you going to be using vocabulary from national standards from Logical Observation Identifiers Names and Codes (LOINC) from the Reportable Condition Mapping Table (RCMT) guide? Where will you be pulling the codes from for these laboratories?
 * A: In general we will leverage what’s included in the LRI IG, which includes LOINC codes, to be consistent. In addition wherever there is national recognition of codes we will utilize those. Similar to how there was a vocabulary work group for LRI we envision there being a vocabulary work group for LOI that will address questions on what vocabulary to use when/where, if we are ready to use certain data elements or if they need to be tested out, will we be using a full set of vocabulary or a subset of vocabulary? We want to make sure it’s consistent across the board especially with LRI.
 * Q: Is there a way we can participate and/or follow the work of the vocabulary work group?
 * A: Yes, if you go to the LOI home page and follow the “How to Get Involved” link you can sign up as a committed member for the initiative you will be included in all of the LOI communications. All work group meetings will be included as part of the S&I Framework calendar, all of which are open to the general public, so you can participate in whatever group you are interested in. However, we do encourage you to sign up as a committed member.
 * CDC representative stated that a member from the RCMT team member will sign up to participate in the vocabulary work group and contribute where it makes sense.
 * Q: Will the orders include information on pregnancy status where it’s relevant?
 * A: If the Use Case indicates that the pregnancy status is relevant we will make sure the attribute is included in the IG.
 * Q: Is the Tiger Team considering in this existing Use Case ordering from commercial entities to Laboratories, i.e. drug testing of employees?
 * A: The Tiger Team as an initial step decided that we will be primarily looking at ELINCs Orders & LRI Guide to align them. The community will ensure the Use Case defines what we are trying to achieve. The Tiger Team will produce a draft guide that is properly aligned then the Use Case and vocabulary work will be used to validate the guide before moving forward.
 * F2F
 * F2F registration closes on Monday at 5:00 PM ET, this is also the deadline for booking your hotel at the discounted rate
 * The LOI sessions will be used to validate the Use Case and continue the Tiger Team work efforts
 * There will not be any phones or WebEx lines available, but the meeting notes will be posted as quickly as possible
 * Q: What about the community members who can’t attend? There will certainly be a number of individuals who will be interested in attending and without WebEx lines how will they be able to do so? I’d like to recommend having WebEx lines available; did you take this into account when you planned the F2F? I would be concerned that the right expertise won’t be available during these meetings.
 * A: We understand your concerns but due to budget limitations having phone lines and WebEx is not feasible. We will have notes posted as soon as possible, hopefully within 24 hours. The other point I’d like to make is that none of the work products developed during the F2F will be put up for consensus, we will wait to start the consensus process after the F2F to ensure that the entire LOI community has the opportunity to provide feedback on all work products.
 * A: John Feikema, we had a lot of internal debate over this. If there was federal office space large enough to host this meeting we would leverage that which might leave us with some budget to provide phone lines but since we have to use an outside venue it’s just not within the budget. Telecommunications costs are outstandingly large so it’s just not feasible. We certainly apologize and acknowledge that it can be limiting so we would be happy to spend some of the community working sessions to recap the work completed at the F2F.
 * Q: Speaking of budget, who covers the cost of the WebEx? ONC or a member of the Tiger Team?
 * A: ONC
 * Q: Referring to the agenda slide to the F2F, questions for the Tiger Team, can you give us an overview on what type of work will be conducted for the LRI/LOI alignment activities?
 * A: We have two documents that are similar in focus and scope but not aligned in terms of approach or methods. The objective is to determine what principles we want to apply when developing the LOI IG that will ensure its success. Once we determine what those principles should be we will go down another level and start the work. We haven’t determined exactly how we are going to about this but it will most likely be a side by side comparison two guides. We will walk through these guides section by section, comparing and contrasting along the way, to determine what concepts should be moved to the LOI IG to make it consistent across both IGs.
 * Q: Based on the F2F agenda it looks like you are going right from Use Case validation to alignment. Who is validating the Use Cases, I want to make sure that my community’s requirements are taking into consideration during this process. Is the Use Case going to be considered complete/final after the F2F sessions, or will it be open for community members to comment on for possible revisions?
 * A: As you can see from the timeline shared earlier, the Use Case development process has already kicked off. The community will have the opportunity to provide comments, suggested revisions, on the current draft of the Use Case prior to the F2F. We will walk through any comments submitted by the community during the F2F sessions. If community members who provided comments aren’t present during these discussions we can certainly address these during the community meetings after the F2F. We don’t anticipate getting through the full Use Case at the F2F and as previously mentioned the consensus process will not be kicked off until after the F2F. The main goal is to make progress.
 * Q: Is the WG leads meeting still being held on Wednesday AM?
 * A: Yes
 * Q: Is there any other background reading materials that we should look at other than the ELINCs Orders specification?
 * A: LRI Use Case, LRI IG, ELINCs Orders IG, HL7 v2.5.1 Standard; Chapter 4 Order Entry (this is the underlying standard that this work is based on)
 * o Q: Agenda for F2F is there any possibility this agenda can be changed?
 * A: Over 40 community members have already registered for these sessions so it would be difficult to change the agenda at this time. Recaps will be provided during the Thursday morning session.
 * Register for F2F
 * Review and provide comments on the LOI Initiative Charter
 * If you have any questions or concerns feel free to reach out to John Feikema at john.feikema@siframework.org ||

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