8rleflna on Pl1 SLandards

CommlLLee
uoua lrldsma CnC
!ohn Palamka Pl1SC vlce Chalr
aenda
Summer Camp cLlvlLles
Meanlnaful use Crosswalk updaLe
1ransporL
ConLenL
vocabularles
Pl1SC Summer Camp ower1eams (1) updaLe
MeLadaLa
aLlenL MaLchlna
erescrlblna
Survelllance lmplemenLaLlon Culde
nwPln
Sl lramework lnlLlaLlves
Cu consolldaLlon
LlecLronlc Lab 8eporLlna (LL8)
1ranslLlons of Care (1oC)
ulrecLorles (new)
ulsLrlbuLed Cuerv (new)
HITSC HonIfh InformnfIon
TochnoIogv Summor Cnmp
Summor Cnmp for HITSC
Analyze the standards implications of HTPC
recommendations
Prepare for Meaningful Use Stage 2
dentify gaps in Standards
Triage Standards Work
Pl1SC rlnclples l
keep lL slmple Lhlnk bla buL sLarL small
recommend sLandards as mlnlmal as posslble Lo supporL Lhe buslness aoal and Lhen
bulld as vou ao
uon'L leL perfecL" be Lhe enemv of aood enouah"
ao for Lhe 80 LhaL evervone can aaree on
aeL evervone Lo send Lhe baslcs (medlcaLlons problem llsL allerales labs) before
focuslna on Lhe more obscure
keep Lhe lmplemenLaLlon cosL as low as posslble
ellmlnaLe anv rovalLles or oLher expenses assoclaLed wlLh Lhe use of sLandards
ueslan for Lhe llLLle auv so LhaL all parLlclpanLs can adopL Lhe sLandard and
noL [usL Lhe besL resourced
uo noL Lrv Lo creaLe a one slze flLs all sLandard lL wlll be Loo heavv for Lhe
slmple use cases
9/28/2011
Cfflce of Lhe naLlonal CoordlnaLor for
PealLh lnformaLlon 1echnoloav
4
Pl1SC rlnclples ll
SeparaLe conLenL sLandards from Lransmlsslon sLandards
le lf CCu ls Lhe hLml whaL ls Lhe hLLps?
CreaLe publlclv avallable conLrolled vocabularles code seLs LhaL are
easllv accesslble / downloadable
Leveraae Lhe web for LransporL whenever posslble Lo decrease complexlLv
Lhe lmplemenLers' learnlna curve (healLh lnLerneL")
oslLlon quallLv measures so LhaL Lhev wlll encouraae adopLlon of
sLandards
CreaLe lmplemenLaLlon Culdes LhaL are human readable have worklna
examples and lnclude LesLlna Lools
9/28/2011
Cfflce of Lhe naLlonal CoordlnaLor for
PealLh lnformaLlon 1echnoloav
3
HITSC AcfIon Ifoms for M!2
Refresh/Reload
Recommend revisions to adopted certification criteria
Recommend new/updated standards/implementation
specifications to associate with adopted certification
criteria
Analyze MU WG draft recommendations
dentify and draft new certification criteria
Associate standards/implementation specifications,
where available
uckofs fo consIdor

8
SufflclenL sLandard and
lmplemenLaLlon aulde
ldenLlfled

erformance
measure onlv no
sLandards needed

LxlsLlna sLandard no
lmplemenLaLlon aulde
ldenLlfled
exlsLlna sLandards/
lmplemenLaLlon aulde
buL addlLlonal publlc
lnpuL needed
u
no sLandard or
lmplemenLaLlon aulde
ldenLlfled
LxlsLlna sLandard/
lmplemenLaLlon
aulde buL subsLanLlal
publlc lnpuL needed
uckof A Iorformnnco nsod
Monsuros
CCL lab/rad (enLrv process onlv see
below for elecLronlc Lransmlsslon)
lnLeracLlon Checklna
8ecord uemoaraphlcs (enLrv process
onlv)
MalnLaln problem medlcaLlon
allerav llsLs record smoklna vlLals
(see below for elecLronlc
Lransmlsslon)
CuS 8ule
8ecord advanced dlrecLlves
CeneraLe paLlenL llsLs
hvslclan noLes
LlecLronlcallv Lrack medlcaLlon
admlnlsLraLlon
aLlenL educaLlon
aLlenL preference for
communlcaLlon medlum
MedlcaLlon reconclllaLlon (see below
for 1oCbased daLa sources)
8ecord care Leam members
uckof SuffIcIonf Sfnndnrd nnd
ImpIomonfnfIon CuIdo
Measure 5tandard IG
8ecord uemoaraphlcs value SeLs for lCM CaLeaorles
8eporL CCM LlecLronlcallv C8S xML
(hvslclan CuallLv
8eporLlna SvsLem)
noLe mav need Lo move
Lo a new sLandard C8u
level 3 buL sLandard has
noL veL been LesLed
(buckeL C)
CMS lC (lmplemenLaLlon Culde)
urua lormularv Checks nCu LllalblllLv
and 8eneflLs
SubmlL lmmunlzaLlon uaLa PL7 vxu (vacclnaLlon
8ecord updaLe)
CuC lmmunlzaLlon WC worklna on
revlslons Lo lCs
SubmlL LlecLronlc Lab
8eporLlna
PL7 v2 231
(CbservaLlon 8esulL)
LxlsLlna lC wlll be harmonlzed Lo
flnal ambulaLorv lab lC ln 2011
uckof C oods CommunIfv Inpuf
Measure 5tandard IG
lncorporaLe Lab 8esulLs PL7 C8u (Cbv 8esulL)
LClnC 1ransporL?
LClnC subseL
mbulaLorv Sl L8l lnlLlaLlve
rovlde elecLronlc copv Lo
paLlenL (healLh lnformaLlon
dlscharae lnsLrucLlons cllnlcal
summarles)
Sl 1oC explorlna
Cu CC8 areenCu
1ransporL?
vocabularv subseLs
Sl 1oC lnlLlaLlve
rovlde summarv on 1oC Sl 1oC explorlna
Cu CC8 areenCu
1ransporL?
vocabularv subseLs
Sl 1oC lnlLlaLlve
Care plan Sl 1oC explorlna Sl 1oC lnlLlaLlve could be
8uckeL u
Svndromlc Survelllance CuC lC
rlvacv and SecurlLv
ssessmenLs
endlna Pl1C
recommendaLlons (1laer
1eam work ln proaress)
uckof SubsfnnfInI IubIIc
Inpuf !oquIrod
Measure 5tandard IG
CCL lab/rad PL7 v2 messaae Plah prlorlLv buL bevond 2011
(elecLronlc orders of anclllarv
servlces scope)
oods IscussIon
Measure 5tandard IG
1ransporL for Lab
1ranslLlons of Care
ulrecL/nwPln or
erformance 8ased?
ulrecL CerLlflcaLe Sl Work
Send paLlenL remlnders ulrecL/nwPln or
erformance 8ased?
Web orLal 1lmelv
ccess
ulrecL Lo CP8 (ersonallv
ConLrolled PealLh 8ecord) or
erformance 8ased?
Sl 1ranslLlons of Care
(1oc) lnlLlaLlve
Cnllne Secure Messaalna ulrecL or erformance 8ased?
1esL of PlL ulrecL/nwPln or
erformance 8ased?
ulrecLorles Lu? xu? MlcroformaLs?
unS?
ulrecLorles Sl Work mav
be 8uckeL u
ddlLlonal rlorlLles for Lhe PealLh l1
SLandards CommlLLee
aLLrlbuLes for cerLlflcaLlon
1) Source of CuS
2) conflaurable rules
3) rules respond Lo paLlenL daLa
4) conflaurable Llmlna of declslon supporL
3) based on roles
6) lnLearaLed wlLh oLher LP8 funcLlonallLles
eMot aLLrlbuLes for cerLlflcaLlon
1) lerL Lo wrona paLlenL
2) lerL Lo wrona medlcaLlon
3) lu as dose form
4) lu provlder
3) 8ecord Llme medlcaLlon admlnlsLered
vlew and capablllLv Lo download lnformaLlon
1) 1rack number of vlews
2) 1rack number of downloads
3) LlecLronlcallv counLed for compllance and
measuremenL
otv of cote tecotJ/ploo SLaae 2 wlll lnclude addlLlonal daLa elemenLs
Lo be lncluded ln Lhe record/plan
@elv lecttooc Access conslder lncludlna a warnlna messaae before
downloadlna personal healLh lnformaLlon
osptol lobs provlde sLrucLured elecLronlc lab resulLs ln LClnC where avallable
9 ob[ecLlves Conslder a slnale sLandard Lo be used for Lhe submlsslon of all
publlc healLh daLa le Lhree dlfferenL healLh domalns one lmplemenLaLlon Culde
9 ob[ecLlve of submlLLlna reporLable cancer condlLlons osslble use of lPL
cancer reporLlna lmplemenLaLlon aulde
uemoaraphlcsSLaae 2 lncludes expanslon of exlsLlna flelds
rlorlLles for Lhe PealLh l1 SLandards CommlLLee
SLandards for recordlna folv bstotv
aLlenLaeneraLed daLa submlLLed Lo publlc healLh aaencles
dd new flelds ln demoaraphlcs per lCM reporL
CapablllLv Lo reLrleve u from LP8
Mechanlsm for paLlenL enLered daLa
1 Slnale facLor auLhenLlcaLlon (user and password)
for paLlenL onllne accounL
2 udlL Lralls for access Lo paLlenL onllne accounL
3 rovlslons for daLa provenance
4 orLal should have secure download ablllLv (ea
Lo Lransfer Lo P8)
3 lnsLrucLlons Lo sLandards commlLLee abouL
demoaraphlc flelds eLc
6 Slanal SLaae 3 plans abouL nWPln aovernance
Privacy and Security
SLaae 3
rlorlLles for Lhe PealLh l1 SLandards CommlLLee
@e|ne for nI@5 to revew 5tandards
updaLe on Pl1SC Summer Camp
ower 1eams
MeLadaLa
aLlenL MaLchlna
erescrlblna
Survelllance lmplemenLaLlon Culde
nwPln
MeLadaLa ower 1eam
1he Pl1 SLandards CommlLLee puL LoaeLher
recommendaLlons based on Lhe MeLadaLa ower 1eam
analvsls and has submlLLed lL Lo CnC
1he overall sLandard recommended for paLlenL lu
provenance and prlvacv meLadaLa elemenLs was PL7 Cu 82
Wlll need addlLlonal work on plloLs and LesLlna of uLS and
lnLearaLlon wlLh P8s
aLlenL MaLchlna ower 1eam
1he aLlenL MaLchlna ower 1eam meL on !ulv 1 2011
1hev dlscussed Lhe daLa necessarv Lo provlde expllclL auldance on whlch paLlenL aLLrlbuLes Lo requlre" or for
whlch Lo lmprove quallLv
ulscusslon was around Core and Menu lLem MaLchlna llelds whaL consLlLuLes Lhe unlque aLlenL ldenLlfler
whlch was Lhe maln focus of Lhe dlscusslon
Core
name (lasL flrsL mlddle lnlLlal)
8lrLh daLe
Cender (admlnlsLraLlve?)
Menu (some requlred Lo successfullv maLch)
ddress lncludlna zlp (currenL and pasL)
Soclal securlLv number
Malden name
lull mlddle name
PealLhcare provlder (lndlvldual or lnsLlLuLlonal)
vlslL lnformaLlon
llow oLher asslaned ldenLlflers Lo supporL evoluLlon
SpeclflclLv more crlLlcal Lhan senslLlvlLv (need pollcv declslon abouL Lhe raLe of false poslLlves LhaL can be
LoleraLed)
1he nexL call wlll revlslL CS1 reporL Lo Lallv up Lhe meLadaLa needed for paLlenL maLchlna
erescrlblna ower 1eam
1he ower 1eam flrsL convened on !une 24
wlLh !amle lerauson as Lead
ulscussed Lhe charae scope and prlorlLles of
Lhe ower 1eam
ulscussed whaL exLenL sLandards exlsL
prlorlLles for addresslna Lhe scope of whaL ls
ln Leam's purvlew
1he nexL call wlll be held on !ulv 27
Survelllance lmplemenLaLlon Culde ower 1eam
1he ower 1eam flrsL convened on !une 28 2011wlLh Chrls
ChuLe as Lhe lead
ulscussed Lhe charae scope and prlorlLles of Lhe power Leam
ulscussed whaL exLenL sLandards exlsL focused on CuC's
Svndromlc Survelllance Messaalna Culde
1he nexL meeLlna wlll be held on !ulv 22 2011
nwPln ower 1eam
CnC presenLed a drafL approach Lo Lhe nwPln ower 1eam
on !une 30
Lh
2011 on how Lo choose speclflcaLlons LhaL wlll
ao Lhrouah Modular SpeclflcaLlon process Mav noL lnclude
[usL nwPln and ulrecL specs
1he nwPln ower 1eam aareed LhaL Lhe process and
approach proposed bv CnC are aood for Lhe purpose
lnLended
CnC ls maklna ad[usLmenLs Lo Lhe crlLerla based on ower
1eam recommendaLlons and updaLlna Lhe arld
ken 1arkoff (8elav PealLh) wlll lead a small aroup LhaL wlll
ldenLlfv oLher mechanlsms LhaL are belna wldelv used for
healLhcare exchanae such as Lhose used for erescrlblna
admlnlsLraLlve LransacLlons and lab reporLlna
Sl lramework lnlLlaLlves
9/28/2011
Cfflce of Lhe naLlonal CoordlnaLor for
PealLh lnformaLlon 1echnoloav
23
8la 1enL" lnfrasLrucLure
ulrecL ro[ecL updaLe
8ased on Pl1C nwPln Workaroup auldance Lo expand scope of nwPln Lo broadlv
accommodaLe lndlvldual provlders ln supporL of Mu wlLh a nearLerm focus on dlrecLed
exchanae
8apld focused efforL Lo develop and plloL LesL sLandards and speclflcaLlons
nnounced March 2010 klcked off laLe March/earlv prll
90 davs Lo specs and worklna proof of concepL 90 more Lo worklna reference
lmplemenLaLlon less Lhan a vear Lo flrsL ln producLlon usaae
8ased on pollcv sandbox" provlded bv Pl1C recommendaLlons and Lechnoloav
prlnclples provlded bv Pl1SC creaLed approach for dlrecLed exchanae LhaL
llows for exchanae wlLh exposlna Pl Lo lnLermedlarles (whlle preservlna ablllLv
for provlders Lo work wlLh 8s lf needed)
rovldes for hlah assurance LhaL onlv Lhe recelver or deleaaLes can access Pl
rovldes for hlah assurance ln oraanlzaLlonal ldenLlLv of sender and recelver
llows for unlversal addresslna and LransporL" Lo enable anv sender Lo send Lo
anv recelver (LhaL shares a common deflnlLlon of ldenLlLv and LrusL)
ls slmple Lo lmplemenL and adopL
9/28/2011 23
lloL Lxperlence
ulrecL ls ln producLlon boLh wlLh commerclallv released producL and wlLh
a seL of plloL lmplemenLaLlons ln aeoaraphles wlLh exlsLlna volume of care
LranslLlons
redomlnaLe usaae ls Lo supporL transtons of care and consuer
engageent
1ranslLlons of Care plloLs demonsLraLlna use for closed loop referral
Lu and hosplLal dlscharae acuLe Lo L1C
Consumer LnaaaemenL plloLs demonsLraLlna ablllLv Lo send from anv
LP8 Lo anv P8
lso plloLs demonsLraLlna usaae for ub|c hea|th reortng and
e|ectronc |aboratory resu|ts
lloLs have demonsLraLed Lhe need for common and conslsLenL deflnlLlons
and levels of assurance for ldenLlLv assurance and auLhenLlcaLlon
9/28/2011 26
lnlLlaLlves updaLe
9/28/2011
Sl lnlLlaLlves
@ranston of are
SupporLs quallLv aoals and Meanlnaful use SLaae 1 and
foreseen SLaae 2 requlremenLs bv sLandardlzlna
cllnlcallv meanlnaful core daLa supporLlna hlah quallLv
LranslLlons of care
CurrenL SLaLus
ueflnlna cllnlcallv meanlnaful core daLa for LranslLlons of
care
Parmonlzlna daLa Lo exlsLlna sLandards Lo supporL
lmplemenLers
lannlna reference lmplemenLaLlons and plloLs
LxpecLed Llmellne lloL 1esLlna compleLe bv
SepLember 2011 updaLe SLandards CerLlflcaLlon
n8M bv lall/WlnLer 2011
28
Sl lnlLlaLlves
ab kesu|ts Interface
locuses on ldenLlfvlna Lhe requlremenLs speclflcaLlons and
sLandards and on provldlna Lhe lmplemenLaLlon auldance for
elecLronlc reporLlna of ambulaLorv care laboraLorv LesL resulLs ln
Lhe uS 8ealm
SupporLs Meanlnaful use SLaae 1 requlremenLs for exchanae of
daLa for declslon supporL quallLv reporLlna and LranslLlons of
care bv enabllna lncorporaLlon of lab resulLs lnLo an LP8 as
sLrucLured daLa
chleve cosL and Llme savlnas Lo develop new lab resulLs
lnLerfaces Lhrouah Lhe developmenL of one sLandard
lmplemenLaLlon aulde enabllna cerLlflcaLlon of LP8s
CurrenL SLaLus
Parmonlzlna messaae sLrucLure and vocabularles bulldlna
on exlsLlna PL7 lmplemenLaLlon auldes
CuLllnlna harmonlzaLlon plan for ubllc PealLh 8eporLlna
roposed Llmellne lloL 1esLlna compleLe bv CcLober 2011
updaLed SLandards and CerLlflcaLlon n8M bv lall/WlnLer 2011
29
Sl lnlLlaLlves
ertfcate Interoerab|ty
SupporLs naLlonwlde exchanae of healLh lnformaLlon whlch requlres a fabrlc of LrusL LhaL
enables secure daLa Lransfer and ldenLlLv assurance amona provlders PlLs and oLher
healLhcare lndusLrv parLlclpanLs
nalvzlna lssues relaLed Lo complvlna wlLh dlalLal cerLlflcaLe requlremenLs for exchanalna
daLa wlLh lederal aaencles
ssessmenL Lo conslder cosL complexlLv and feaslblllLv of provlders acqulrlna manaalna and
uslna dlalLal cerLlflcaLes LhaL are crosscerLlfled wlLh Lhe lederal 8rldae
CollaboraLlna wlLh Lhe CerLlflcaLe uLhorlLv 1askforce under Lhe Pl1 ollcv CommlLLee rlvacv
and SecurlLv 1laer 1eam Lo conducL research and lnLervlews wlLh broad base of sLakeholders
CollaboraLlna wlLh Lhe Pl1 SLandards CommlLLee and Lhe rlvacv and SecurlLv Workaroup Lo
lnvesLlaaLe archlLecLural and operaLlonal alLernaLlves for crosscerLlfvlna ulrecL Cs wlLh Lhe lederal
8rldae C
roposed 1lmellne nalvsls compleLed bv !ulv 2011 Lo enable revlslon Lo n8M of
SLandards 8equlremenLs
30
Sl lnlLlaLlves
9rovder Drectores
laclllLaLes secure exchanae of healLh daLa bv enabllna senders Lo ldenLlfv desLlnaLlon s
and obLaln Lhelr dlalLal cerLlflcaLes
ocus rea #1 SLandards for dlscoverv of dlalLal cerLlflcaLes ln dlrecLed exchanae
roposed Llmellne use Case and SLandards nalvsls bv !ulv/uausL 2011 lloL LesLlna
bv CcLober 2011 Lo enable revlslon Lo n8M of SLandards 8equlremenLs
ocus rea #2 SLandards and daLa model for quervlna provlder dlrecLorles Lo dlscover
elecLronlc addresses
1lmellne 18u focus on broad aareemenL amona lmplemenLers raLher Lhan
lnfluenclna n8M
31