Newsletter+-+June+2011

Newsletter available as a .pdf.

**__ Timeline __**
 * June:**
 * //**F2F Meeting**// **//on Jun 13-15//**
 * Prepare documented specifications and handoff to RI/DP
 * Model and XML-Driven Specifications drafted
 * Finalized XML and Model-Driven Spec Handoffs to RI/DP and begin working code development
 * July:**
 * **//Announce to HITSC//**
 * **//Initial Pilot Implementations//**
 * August:**
 * **//Review working code/pilots with UCR/Harmonization (user acceptance)//**
 * September:**
 * “Key Stakeholder” Messaging and Outreach

**__ Provider Directories (NEW) __**
 * Based on feedback from the community, ONC is excited to support development of a mechanism enabling the querying of provider directories to discover electronic addresses.
 * The PD Sprint Team’s initial work would focus on two areas:
 * Digital certificate discovery under directed exchanges when an electronic address is known
 * Electronic address discovery with some basic provider attributes under other exchange frameworks.
 * Both work streams will be conducted in parallel and the Sprint Team will ensure that both efforts are in sync and feed into each other.
 * The second work stream will also address the minimum data elements in a provider directory required to support the discovery of electronic addresses.
 * The sub-workgroup focused on this effort will leverage the work that has been made by the State HIE Community of Practice (CoP).
 * The State HIE Community of Practice (CoP) will be invited to present its work to the Sprint Team and vice versa so that both groups remain in sync.
 * The Sprint Team we will focus on developing both use cases and progress into the standards analysis work during the Friday June 10th 3:00-4:30PM meeting and at the June 15th F2F meeting.
 * The ONC is pleased to host two presentations on the use of provider directories in Canada and Australia. Please see additional information below:

**__ Transition of Care __** Action Items Next Steps
 * Reference Implementation (NEW) **
 * Conducted Workgroup Kick-off meeting on May 31, 2011
 * Workgroup meetings will be scheduled on Tuesdays and Thursdays
 * Met with Open Health Tools representatives on June 3, 2011
 * Review Architecture workgroup documentation (to serve as a baseline for RI activities)
 * Review Open-Source Software Development Process
 * Review communication channels for the workgroup
 * Review the RI Architectural Conceptual Design


 * Virtual Care Planning**
 * Ongoing reconciliation with CIM/Vocab WG
 * A baseline Roadmap has been documented; defining the necessary [structured] document criteria and data elements and their **standards**for Care Planning; eventually realizing interoperability.
 * Presenting to the HITPC Committee in draft format on June 6, 2011
 * Update Roadmap in F2F meetings June 13-15, 2011
 * The Care Planning Standards will be updated with clarity of definitions (referencing NQF)
 * Recommendations of Care Planning Documentation to HITPC Meeting Wednesday, June 8, 2011
 * Reconcile Care Planning Data Elements with Standards Analysis Workgroup at some point in near future

Action Items Next Steps
 * Clinical Information Model/Vocabulary**
 * Defined core data elements (A/B/C) to be captured for care transitions
 * Completed initial iteration of mapping spreadsheet (CIM Mappings) to support the mapping of core, minimum data element groupings for care transitions to each CIM
 * Participants completed additional work on the CIM Mappings and are getting closer to classifying data elements (sub-work groups meeting this week)
 * Draft our first CIM prior to the F2F meeting for review and discussion

**Standards Analysis** Action Items Next Steps **Architecture/Implementation Requirements** Action Items Next Steps
 * Finalize scope of the Content Module Index
 * Coordinated data element discussions with the UCR Simplification group
 * Continuing to draft preliminary recommendations for consensus – to be discussed at the F2F meeting
 * Continue to collaborate across WGs to avoid duplication of efforts
 * Complete revisions to the RI Architecture Overview and begin to provide comments in preparation of final consensus
 * Provide feedback through consensus page on RI Architecture Scope
 * Discuss comments on the RI Architecture Overview
 * Identify the policies, services, and other dependencies that are needed to ensure that a Transitions of Care specification is implementable


 * CDA Harmonization**
 * Reviewed the Amalgamated ballot comments and will provide feedback when consolidation meetings resume next week
 * Reviewed the ballot responses and the reconciliation process and decided to create a spreadsheet to consolidate ballot comments to be posted to the Wiki site
 * Keith introduced a comparison spreadsheet between consolidated IG templates and past implementation guides to be leveraged during the ballot reconciliation process
 * Continued analysis on the change log, immunizations analysis, functional status, encounter, effective time, discharge Disposition code, and priority code
 * CDA Documentation**
 * Provided an update on MDHT and discussed style and artifact configuration and file locations
 * Discussed Keith Boone’s [|Template Meta-Model], which consists of templates, constraints, and value sets. This can be leveraged to develop the Template Exchange Formalism to support exchange of templates between tools

**__ Laboratory Results Interfaces __**
 * //Critical Issues for LRI//**
 * Extensibility to Public Health scenarios
 * Working to ensure that Public Health recommendations are aligned to Implementation Guide Analysis
 * Identifiers and OIDs
 * Defining what the policy and technology issues with OIDs are and beginning discussion on possible solutions
 * Units of Measure
 * Review of specific UCUM issues and implementation roadmap moving forward – scanning for usage of UCUM by laboratories
 * Allowable vocabularies
 * Review of SNOMED as a possible vocabulary for in-scope tests

Action Items Next Steps
 * Reference Implementation (NEW) **
 * Monitoring progress in LRI Architecture Workgroup
 * Gauging progress to determine if the ToC RI Architecture Conceptual Design will also support LRI RI
 * Schedule LRI RI Workgroup Kick-Off Meeting
 * Depends on Architecture Workgroup progress


 * Success Metrics**
 * **PURPOSE:** To identify appropriate methodology and baseline data to use as a metric for measuring success of the Lab Result Interface Initiative and recommend to the full WG.
 * Reviewed cost and time data points from 45 lab interface informational interviews
 * **//Achievement://** Successfully established the methodology and identified baseline cost and time data pertaining to the development of a new lab results interface.
 * Used a statistical approach to arrive at a baseline for cost and time
 * Baseline Time to develop a new results only laboratory interface: **4.17 Months**
 * Baseline Cost to develop a new results only laboratory interface: **$12, 015**
 * Currently have data to identify baseline cost and time data pertaining to the development of a new __bi-directional__ interface.
 * Approach and best practices of LRI Success Metrics SWG will be leveraged for the newly developed ToC Success Metrics SWG

Action Items Next Steps
 * Implementation Guide Analysis**
 * Working through message structure
 * Discuss and come to consensus on Conformance Verbs and Conformance Usage documents
 * Mitigate challenges and path forward for OIDs
 * IG Analysis will review the data elements created by the use case group for message structure discussion
 * Also will review high-level requirements analysis and start to formulate provisional consensus statement/strategy

Action Items Next Steps
 * Architecture/Implementation Requirements**
 * Arch/IR has come to consensus on the LRI deployment models and the abstract models
 * Working with the RI Workgroup to coordinate what an LRI Reference Implementation looks like
 * Continue coordination with the RI Workgroup on LRI Reference Implementation to determine next steps for possible pilots

Action Items Next Steps
 * Clinical Information Model/Vocabulary**
 * Discussed issues with UCUM implementation
 * Conducted informal discussion/scanning on usage of UCUM by labs and other healthcare organizations
 * CIM/Vocab will continue to discuss UCUM this week and begin to document the way forward


 * Public Health Lab Results**
 * **PURPOSE:** Immediate responsibility of the Public Health WG (i.e., not inclusive of the long-term goals or roadmap) is to ensure that Public Health Laboratory reporting requirements are taken into account during the selection of the LRI IG.
 * In order to meet the short term goal the group decided to pull out the data elements from the ELR guide. The data elements from the ELR guide were documented as part of the Public Health Reportable Lab Results Abbreviated Use Case.
 * The abbreviated Use Case outlines the requirements for Public Health Laboratory Reporting for the consideration in the selection of the Laboratory Results Interface Initiative Implementation Guide. In order to adhere to the requirements for Public Health Laboratory Reporting by inpatient electronic health record systems outlined in the Meaningful Use criteria the HL7 Version 2.5.1 Implementation Guide: Electronic Laboratory Reporting to Public Health, was utilized to develop and validate the contents of this document.
 * The abbreviated Use Case includes; an User Story, Actors and Roles, Use Case Diagram, Activity Diagram, Sequence Diagram an Functional requirements and will be used to provide the groups recommendation to be considered for the harmonization efforts.
 * As a next step, the Public Health Lab Results WG has been asked to review and provide comments on the abbreviated Use Case.
 * The group’s goal is to reach consensus on the Abbreviated Use Case & Required Data Elements by COB June 10th to ensure our recommendations are taken into account as part of the harmonization efforts.

**__ Cross Initiative Updates __** Data Element Set SWG
 * Use Case Simplification**
 * UC Simplification Matrix and Vision Document “package” posted to the Wiki for a comment period (June 6th, 2011) and then a final round of consensus at F2F meetings
 * CDA Mapping Reconciliation; Diagnostic Results
 * Future Consideration of **__ISO 21090__** document to be used as a boundary as mapping of data elements continues
 * There is a need to formulate business rules around data elements (fixed, reusable)
 * Collaboration with WGs (including SA) at F2F meetings
 * Correlation of Data Elements (cross-span) with HITSP C154
 * Mapping of LRI Data Elements to V2.0 IG
 * Reconciliation with other WG’s efforts at F2F

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