S&I Public Health

*We will start the meeting 3 min after the hour

October 7th, 2014

Housekeeping

This meeting is being recorded and un-paused and will be available via the wiki

*Please mute your phone when not speaking to assist with background noise.

Today’s Agenda

– Announcements– Updates– Provenance – Next steps

Announcements

• New Listserv – Lab Results Interface (LRI) Initiative– wiki.siframework.org/LRI+Implementation+Guides+Analysis+WG

– LRI - Purpose and Goals– Meaningful Use Alignment: Incorporate lab 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.

Updates

• Nationwide Interoperability Roadmap Community Home (comments closed but viewable)

– http://confluence.siframework.org/display/NIRCH/Nationwide+Interoperability+Roadmap+Community+Home

– http://www.healthit.gov/sites/default/files/ONC10yearInteroperabilityConceptPaper.pdf

Provenance – PHTT Next Steps

• The term “provenance” in the context of Health IT refers to evidence and attributes describing the origin of health information as it is captured in a health system.

• Use cases and comments are published here:– http://wiki.siframework.org/Data+Provenance+Use+Case+Consensus– Source for content in this presentation

Provenance – Questions addressed

• When healthcare data is first created, what is the provenance information that should be captured (previously created provenance information or newly created provenance information), retained, and conveyed?

• Can a receiving system understand and trust that provenance information?• Do we need to know who touched it along the way? If so, how do we know?• When the receiving system combines this information with data received from

third parties, how do we persist the provenance from multiple sources?• When multi-sourced data is assembled and sent to another system, how do we

convey the provenance of the multiple data sources as well as for the system doing the assembly?

– Is this considered new data?– What if the assembling system “cherry picks” from multiple sources, or adds some new

health information of its own?

Provenance – In scope

• To identify and define guidance on use of standards to facilitate provenance capabilities by specifying the following: ***– Standards for the provenance (e.g. origin, source, custodian(s), FHIR

resources, CDA, etc.) – Supportive standards (e.g. integrity, non-repudiation, and privacy & security

with respect to provenance )– Vocabulary standard metadata tags for data provenance

• Variance in granularity of data to which provenance is applied, the way provenance is encoded, and how data and its provenance are conveyed to consuming systems and users

• To define system requirements that describe how applications capture, retain and convey data provenance and maintain association with the data

• To ensure sufficient granularity to support chain of custody

Provenance – Out of scope

• Patient identity matching***• Third party mechanisms for checking patient consent

and the relative merits of existing policies or regulations (such as privacy policies or jurisdictional considerations)***

• Policy-based decisions (such as records management based policies on record retention)

• Non-clinical data (such as environmental data)• Mechanisms to verify the validity of the original

source data

Provenance – The ActorsActor System Role

*Start Point (e.g., patient, provider/provider organizations, labs)

Data Capture System (e.g., EHR, PHR)

Create DataSend Data

Transmitter (e.g., State HIEs)

Intermediary System (e.g., HIE, HISP)

Receive DataSend Data

Assembler (e.g., provider/provider organizations, State HIEs)

Data Integration System (e.g., EHR, HIE, PHR)

Receive DataConsolidate DataSend Data

End Point Data Storage System (e.g., EHR, HIE, PHR)

Receive Data

Composer Data Integration Composer System

Receive DataConsolidate Selected DataSend Data

Provenance – The Use Cases

Questions for PHTT

• Does PH use data provenance today and if so, how and to what end?

Questions for PHTT

• Are there other scenarios where PH could use health data provenance? To start the discussion:– When getting the data from a primary source, e.g.

directly from a hospital ED?– When getting data from a secondary source, e.g.

using clinical data from an HIE, or then combining that with claims data?

Questions for PHTT

• Does PH use data provenance today and if so, how and to what end?

S&I Public Health Contact Information

ONC Public Health Lead: Daniel Chaput (daniel.chaput@hhs.gov) CDC Public Health Lead: John M. Saindon (uzn0@cdc.gov)

PHTT Wiki Page: http://wiki.siframework.org/Public+Health+Tiger+Team SDC Wiki Page: http://wiki.siframework.org/Structured+Data+Capture+InitiativeDAF Wiki Page: http://wiki.siframework.org/Data+Access+Framework+HomepageCQF Wiki http://wiki.siframework.org/Clinical+Quality+Framework+Initiative PHRi Archived Wiki http://wiki.siframework.org/Public+Health+Reporting+Initiative

Weekly PHTT Meeting Info (Tuesdays):• Time: 2:00pm - 3:00pm Eastern• URL: https://siframework1.webex.com/• Dial-In Number: 1-650-479-3208• Access Code: 665 131 907