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Health eDecisionsRI/ Pilots
Sub-Workgroup
April 29th, 2013
10/11/2011 1
Agenda• Announcements• Review and Revisit of Goals• Review of RI/Pilot Sub-WG Timeline• “Show and Tell” – Victor Lee and the Vocab and Terminology Work
• CDC• Pilot Updates:
• AllScripts and NewMentor (Million Hearts – MU NQF 68)• IG updates• Vocab Updates
• VA and Wolters Kluwer• IG Updates• Vocab Updates
• CDC and Practice Fusion• IG Updates• Vocab Updates• vMR updates – Aziz and Shu
• Review Support tools• Review Action Items, Next Steps
Announcements
• We will be continuing our work … • Next meeting May 6th, 2013 (plan for a 90 minute meeting)
• Continue to work on pilot activities– Pilot updates– Working Sessions
10/11/2011 3
Pilots
10/11/2011 4
Organization Pilot Lead Email Organization’s Role
Wolters Kluwer Health Sue Johnson/Steve Claypool/Howard Strasberg/Christy May
[email protected]@wolterskluwer.com [email protected] [email protected]
Service Supplier/Artifact Supplier
OpenCDS David Shields [email protected] Service Supplier
Zynx HealthClaude Nanjo (primary)Bernadette MintonVictor Lee
[email protected] (primary) [email protected]@zynx.com Service Supplier/Artifact Supplier
Medexter Healthcare Klaus-Peter AdlassnigKarsten Fehre
[email protected]@medexter.com Service Supplier
newMentor Julie SchererMatt Pfeffer
[email protected] [email protected] Service Supplier/Artifact Supplier
CDC Shu McGarveyLaura Conn
[email protected]@cdc.gov Government /Service Supplier/Artifact Supplier
NextGenDr. Sarah CorleyDr. Jeff FriedlinGary Wietecha
[email protected], [email protected],[email protected] EHR Vendor
Practice Fusion Lauren FifieldMichael Poremba
[email protected] [email protected] EHR Vendor
AllScripts Douglas GentileRobin Williams (primary)
[email protected] [email protected] (primary) EHR Vendor
Design Clinicals Dewy Howell [email protected] EHR Vendor
SuccessEHS Claude Ouimet [email protected] EHR Vendor
Applied Pathways Paul Arnone [email protected] Service Supplier
Support Team• Support Team:
• Pilots Lead: Jamie Parker: [email protected]• Pilot Support: Christina Arenas: [email protected] • Subject Matter Expert: Aziz Boxwala: [email protected]• Subject Matter Expert: Bryn Rhodes: [email protected] • Use Case 1: Dave Shevlin: [email protected] • Implementation Guide: Lynette Elliot: [email protected] • SDO Support: Anna Langhans: [email protected]
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HeD Pilots Goal Goal
The goal of this initiative is to produce, consume and where feasible, execute implementable CDS interventions.1. Event Condition Action Rules (ECA Rules)2. Order Sets3. Documentation Templates
Pilot Scope4. Health eDecisions will apply defined aspects of the Implementation Guide in a
real-world setting.5. Modify the Implementation Guide to ensure it is usable6. Submission of explicit feedback to sub workgroups such as vMR and
vocabulary and terminology to close gaps7. The real-world pilots evaluate not only the technology, standards and model
(VMR), but also provide a test bed to evaluate the interaction of technology, implementation support, and operational infrastructure required to meet Health eDecisions use case 1 objectives at the stakeholder or organization levels.
8. Demonstrate intent of artifact (specifically structures and semantics) are communicated either by direct execution or by translation to native format
9. Ensure Completeness and consumability of artifact
7
Timeline
10/11/2011
Goal & Activities EST. Time
Dates Deliverables
Kickoff /Establish Goals & Partnerships: - Review HeD Initiative Goals - Review Piloting Process & Resources - Define Value Statement - Define HeD Pilot Goals & Success Metrics - Establish & Approve Pilots - Develop Pilot Briefs
4 wks.(reality 5 weeks)
1/07-2/25 (we missed 2 meetings in January pushing our Dates back)
-Wiki Capturing Pilot Deliverables-Established Partnerships-Documented Value Statements and Success Metrics-Documented Pilot Briefs
Pilot Configuration: - Establish Pilot Test Environment & Resources - Establish Pilot Implementation & Testing Process - Develop & Review Pilot Configuration
2 wks.(reality- 4
weeks)
2/25-3/25
-Use Case is Updated with HL7 Comments (3/4)-Approved Pilot Briefs -Committed Pilot Resources-Documented & Reviewed Pilot Configuration Guide-Weekly Feedback on Use-Cases & IG Alignment
Pilot Development : - Setup & Develop Pilot Prototypes - Review prototypes
6 wks. or less
depending on Pilot activity
3/25 – 5/6
-Use Case is Updated with HL7 Comments (3/4)-Weekly Pilot Development Status Updates-Weekly Feedback on Use-Cases & IG Alignment-Updates to Pilot Configuration Guides
Pilot Testing & Showcase : - Complete Testing - Prepare Solution Showcase
2wks 5/6 -5/20 -Weekly Pilot Testing Updates & KPIs-Showcase-Prepare for HL7
Pilot Wrap-up : - Develop Lessons Learned an ONC Feedback - Review Initiative Goal Alignment - Establish Next-Steps
2 wks. 5/20 – 6/3 -Documented ONC Feedback- Next Steps Action Plan
We are Here
Vocabulary and Terminology Show and Tell• Victor Lee – Zynx
• Member of the Vocabulary and Terminology Team
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Vendor Engagement Discussion
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EHR Area of Interest Potential Match
Design Clinicals Order Sets Zynx
AllScripts ECA Rules –NQMF Rule (for Ambulatory Setting)
NewMentor (have catalog for rules in ambulatory setting)
Practice Fusion Anything MU centered
CDC
Success EHS ? ?
Next Gen ECA Rule (potential) ?
VA Documentation Template
Wolters Kluwer
Pilot Updates: NewMentor – AllScripts (ECA Rule Million Hearts –NQF 68)
• Team:• Julie Scherer - NewMentor• Bryn Rhodes – Internal Support • Robin Williams – AllScripts
• Notes on the IG• Notes on the Vocab Work
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Pilot Updates: Wolters Kluwer – VA (Documentation Template)• Team:
• Christy May -Wolters Kluwer• ???? – Internal • Ken Kawamoto - VA
• Notes on the IG• Notes on the Vocab and Terminology Work
10/11/2011 11
Pilot Updates: Zynx – DesignClinicals (Order Set- Heart Failure )• Team:
• Claude Nanjo and Victor Lee Zynx• ???? – Internal Support• Dewy Howell – DesignClinicals
• Notes on the IG• Notes on the Vocab and Terminology Work
10/11/2011 12
Pilot Update: CDC – Practice Fusion (ECA Rule)• TEAM:
• Shu McGarvey - CDC• Aziz Boxwala – Internal Support• Jamie Parker– Standing in for Practice Fusion
• Notes on the IG• Notes on the Vocab Work• Updates to the vMR – (based on converting the rule from HQMF
to HeD and the needs of the CDC)• We will be meeting with the CDS WG on Wednesday to
update them on this work
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Pilot Support Tools and Feedback channels Discussion Board: • http://
wiki.siframework.org/HeD+Pilot+Activities#HeD_Pilot_Discussion
Vocabulary and Terminology Feedback:• http://
wiki.siframework.org/HeD+Pilot+Tools
10/11/2011 14
Action Items & Next Steps
• Continue to monitor timeline• Continue pilot work
• Going forward each pilot group will be giving a report out at each meeting
• As needed and necessary we will be discussing issues and challenges during the pilot activities
• Update the IG• Update the Vocabulary and Terminology work• Identify additional support resources if necessary
Meeting Reminder
• Pilots Work stream meets (next meeting: May 6th, 2013) • Every Monday• 1-2:30 pm EDT See Wiki homepage for meeting details: http://
wiki.siframework.org/Health+eDecisions+Homepage
10/11/2011 16
Appendix A: Success Criteria
NOTE: This is a work –in-progress we will need to re-evaluate this after Pilot Project Plans• Discuss Pilot Success Criteria:
• Individual Criteria• Initiative Criteria
• EHR Involvement - DONE• Production (at least one of each artifact and consumption of those artifacts)
– Addressed as part of the Pilot Project Plans (who will be doing which artifacts)• Successful implementation of artifacts
– EHR involvement» Validate artifact – perhaps Pilots focuses on this ?» Execute the artifact
• Cross initiative function» Potential Alignment with eDOC and esMD » SDC
• Alignment with MU 3 objective» 10% knowledge based engine (align 402b)» ACTION ITEM: Review MU3 Criteria» Determine the delivery model we want to pilot
• External (i.e. cloud service)• Assets are portable (can be run locally)
• Discuss this with the group10/11/2011 17
Appendix B
In Scope/Out of Scope
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Scope of Use Case 1
• This Use Case defines the requirements to build a standard for the contents of CDS Knowledge artifacts. The use case focuses on the following artifact types: Event Condition Action (ECA) Rules, Order Sets, and Documentation Templates. To support this purpose the Use Case has one scenario: A CDS Knowledge Artifact Supplier makes computable CDS Knowledge Artifact available to CDS Artifact Integrator (From HeD Use Case: CDS Artifact Sharing)
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In Scope
• Standards to structure medical knowledge in a shareable and executable format for use in CDS
• In Scope Artifact Types (definitions for these artifact types can be found in Appendix A)
– Event Condition Action Rules– Order Sets – Documentation Templates
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Out of Scope• Tools:
– Authoring tools, source “content” management.– Terminology server and mapping tools including management of concept coordination.– Semantic processing of text, including structured string processing and natural language processing.
• System Functions– Messaging Layer– Means of sharing– Security
• Authoring, creation and maintenance of clinical decision support knowledge• Knowledge Repository Design• Search and query mechanisms• Implementation in systems• User presentation, Transport layers• Market factors: regulatory incentive/mandate, liability shield, IP shield (patent/licensing litigation),
certification body, marketplace design, test procedures, FDA rules• Clinical Decision Support Services (this will be covered in Use Case 2 CDS Guidance Services)• CDS Content Development Activities, including the distribution and sharing of artifacts• Context-Aware information retrieval (HL7 Information Button) – This will be covered in UC 2 (CDS
Guidance)
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Pre and Post Conditions• Pre-Conditions
– CDS Artifact Supplier makes CDS artifacts available for search and consumption by CDS Artifact Integrators _ ACTION ITEMS (Clarify this –what is a precondition for this to be useful)
– CDS Artifact integrator has the means to obtain the knowledge artifact from a CDS Repository (e.g. they have either browsed or queried the CDS Repository for available artifacts)
– CDS Artifact Integrator Selects Artifacts of Interest to Use in their CDS System
• Post Conditions– The CDS Knowledge Artifact Supplier has sent the CDS Knowledge Artifact to the
requesting CDS Artifact Integrator– CDS Artifact has been received by CDS Integrator and is available for processing– CDS Artifact is available for mapping, structural transformations and local adaptation– Strategy
10/11/2011
22
Decision: In the pilot activities we will not directly address these as part of our pilot. We will focus the pilot activities on those tasks which occur between the pre and post condition
