Cross-Paradigm Interoperability Implementation Guide for Immunizations (“X Paradigm”)

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Cross-Paradigm Interoperability

Implementation Guide for Immunizations(“X Paradigm”)

Common Information Model

First Cut

May 2012


Project Scope

“This implementation guide will explore the Service-Aware Interoperability Framework (SAIF) methodology to show how various HL7, IHE and OMG immunization-related artifacts can be deployed to satisfy immunization interoperability use cases. “

This presentation gives work so far on just the Common Information Model section


Project Work Space

Wiki

http://hssp.wikispaces.com/Cross+Paradigm+Interoperability+Implementation+Guide+for+Immunization

Artefacts Identified standards documents to use and found

links Download spreadsheet from wiki


Common Information Model

First pass V2 IHE Immunization Content Consolidated CDA

After Immunization DAM. EHR FIM POIZ …


Version 2

2.3.1 – since early 90s 2.5.1 – recent Very established in the U.S.

Meaningful Use standard Stage I


Background of Immunization Content

Background of Immunization Content First drafts included V2 messaging models Mapped V2 data elements and NVAC elements to

CareRecord and POIZ – see (outdated) wiki workspace

http://wiki.ihe.net/index.php?title=Immunization_Registry_Content&diff=20082&oldid=20081

Convinced in public comment phase to go with XDS solution only – i.e. CDA model

4 Connectathons/Interoperability Showcases Voted into Final Text


IHE Immunization Content

Could no longer find our data elements!

http://www.ihe.net/Technical_Framework/upload/

IHE_PCC_Suppl_Immunization_Content_Rev2-2_TI_2011-09-09.pdf


Understanding Templates


Chasing the cascade of template IDs

See spreadsheet at:

http://hssp.wikispaces.com/Platform+Independent+Model+--+Common+Information+Model


Consolidated CDA

Formed to resolve many HL7/IHE templates involved in Transfer of Care

Out-of-cycle ballot created to include MU Stage II NPRM elements

PHER project to add immunization elements


Consolidated CDA Templates Continuity of Care Document (CCD) Consultation Notes Discharge Summary Imaging Integration, and DICOM Diagnostic Imaging

Reports History and Physical Operative Note Progress Note Procedure Note Unstructured Documents

Immunization Content/PH not included


Templates and data elements

See

http://hssp.wikispaces.com/Platform+Independent+Model+--+Common+Information+Model


Lessons So Far

CDA is designed to promote semantic interoperability ResponsibleParty example

Promote inheritance Facilitate integration of patient information Their human-readable forms promote much

easier access by non-technical users


Lessons So Far

CDA solutions are a very deep technical dive Template IDs are “magic numbers” and not

easy to chase Without additional tools, their specifications

do not facilitate easy access by non-technical domain expertise


Returning to Common Information Model

Need to determine model RIM?

Finish the cross-reference Based upon templates and not individual data

elements?

Explore recent efforts FHIR, Template registry, Green CDA, ???

Vet, vet, vet Ideas?


Need for implementation guide

There a document specifically showing public health or other non-CDA experts how to interpret the immunization CDA-related specs is needed


Discussion

Track Patient Care projects and present to PC Track CDA R3 vs R2 Include NVAC data elements in list of artefacts

Old version?

Look closely at use cases for what different players such as ACOs want out of them AIRA functions

Map EHR public health functions into EHR functions This project may inform FHIR and/or vice versa