Working Meeting Data Provenance Task Force Lisa Gallagher, Chair January 16, 2015

Agenda Opening Remarks: Lisa Gallagher, Chair – Agenda Review – Meeting Objectives for Today Task Force Discussion – Review Specific Charge of the Task Force – Discuss TF Members’ input on Supporting Questions – Discussion on Use Case Scenarios Panel Discussion Scoping Straw Recommendations and Next Steps 1

Meeting Objectives for Today 1.Task Force discussion on Use Case scenarios 2.Panel Discussion 3.Agree on a theme or scope for the straw recommendations 2

Task Force Discussion 3

Task Force Charge Specific Question from ONC: Given the community-developed S&I Data Provenance Use Case, what first step in the area of data provenance standardization would be the most broadly applicable and immediately useful to the industry? 4

5 Supporting Questions 1)Do the 3 scenarios in the Use Case, and the Use Case’s identified scope, address key data provenance areas, or is something missing? a) Yes, the scenarios address key provenance areas b) No, some key data provenance areas are missing 2)The Use Case is broad and spans a lot of challenges. Where in the Use Case should the Initiative start in terms of evaluating standards to meet Use Case requirements? a)At the point of data creation in a Patient Controlled Device (PCD) or PHR? b)At the point of origin/data creation in an EHR or HIE? c)With the transfer of data from a PCD/PHR to an EHR system? d)With exchange of data between EHRs? 3)Are there any architecture or technology specific issues for the community to consider? a)Content: Refining provenance capabilities for CDA/C-CDA while supporting FHIR? b)Exchange: Push (e.g. DIRECT), Pull (SOAP and REST-based query responses)? c)Others?

Data Provenance Initiative Use Case Summary 6 Scenario 1: Start Point -> End Point. Describes simple provenance requirements when transferring healthcare data from a Start Point (sending system) to an End Point (Receiving System). Scenario 2: Start Point -> Transmitter -> End Point. Includes use of a third party as a conduit/transmitter to transfer information from Start Point to End Point. There may be use cases where it is important to know how the information was routed, as well as who originated it and who sent it. Scenario 3: Start Point ->Assembler / Composer -> End Point. Uses a third party system to aggregate or combine information from multiple sources, either in whole or in part, to produce new healthcare artifacts. The new artifacts may contain information previously obtained from multiple sources, as well as new information created locally.

Panel Discussion Presentation from CMS and esMD Perspective – Robert Dieterle, CMS Panelists – Reed D. Gelzer, HL7 Records Management- Evidentiary Support Workgroup – Gary Dickenson, CentriHealth – Adrian Groper, Patient Privacy Rights – Lenel James, Blue Cross Blue Shield 7

Scoping Straw Recommendations Agree on a “theme” or “scope” for the straw recommendations, making sure that the three supporting questions are answered. 8

Next Steps Assignment #2: Build on straw recommendations from today’s meeting and be prepared to review/discuss/approve final recommendations at next meeting 9

Backup Slides 10

Task Force Members Member NameOrganization Lisa Gallagher, ChairHIMSS Rebecca D. KushCDISC John MoehrkeGE Floyd Eisenberg, MDiParsimony, LLC Aaron Seib National Association for Trusted Exchange (NATE) Mike Davis (Workgroup Federal Ex Officio) US Department of Veterans Affairs 11

Example Recommendations: Ideal recommendations might suggest priorities for the Initiative’s future harmonization work. The following is an example only - the Task Force may choose a different approach. Task Force recommends the following priorities for the S&I Data Provenance Initiative: 1) Define the minimum dataset for provenance for health information at point of creation, and at rest in the following: (produce a list in priority order) EHR systems, Patient Generated Data in PHRs, Medical Devices, HIEs, Etc… 2)Select/recommend standards to define common system behavior for provenance metadata pertaining to the following information interchanges: (list in order) PHR to EHR, EHR to EHR, Medical Device to PHR, Etc… 3)Focus on technology / architecture drivers according to the following priorities: (list in order) FHIR, SOAP/SAML, DIRECT (push), Etc. 12

13 Data Provenance Initiative Use Case Summary