Certification Commission for Healthcare Information Technology Validation of Laika Usage Scenarios Dennis Wilson – Certification Technology Director, CCHIT December 12, 2007

© 2007 | Slide 2 | 12 Dec Interoperability Criteria Criteria testable with Laika: 7002: Admission into Inpatient Care Setting – Registration Summary 7003: Admission into Inpatient Care Setting - Medication History 7005: Admission into Inpatient Care Setting - Allergy Information 7025: Discharge from Inpatient Care Setting or Transfer to Other Health Care Facility - Medications and Allergies ?7033: Receive and store general laboratory results ?7034: Receive and store microbiology laboratory results 7051: Receive, Display and Send Allergy content information via HITSP C32 document 7066: Import, Display and Send Registration Summary information via HITSP C32 document 7067: Receive, Display and Send Medication History information via a HITSP C32 Document

© 2007 | Slide 3 | 12 Dec 2007 CCD/C32 Sections

© 2007 | Slide 4 | 12 Dec 2007 Objectives of Laika 1.0 Initial scope targets a subset of interoperability criteria: Exchanging CCD/C32 Clinical Documents –Validate CCD/C32 exported/imported by EHR –(Provisional) test transport via XDS/XDM/XDR –(Possible) round trip test of CCD/C32 registration subset Create a modular, automated, framework, expandable for coverage of other test areas

© 2007 | Slide 5 | 12 Dec 2007 Test Environment Overview

© 2007 | Slide 6 | 12 Dec 2007 Laika v1 Scenarios Import + Export CCD (“Round Trip”) Import HL7 2.4/2.5 Lab Results

© 2007 | Slide 7 | 12 Dec 2007 Scenario: Import + Export CCD Demonstrate EHR can import a properly formed Continuity of Care Document (CCD) as constrained by HITSP/IS03 Demonstrate EHR can export a properly formed Continuity of Care Document (CCD) as constrained by HITSP/IS03 Syntax, structure and data encoding of the exported CCD are validated by Laika and presented to Jurors to make a final judgment of pass/fail on the test.

© 2007 | Slide 8 | 12 Dec 2007 Scenario: Import/Export CCD 1.Define CCD export test case a)CCHIT Proctor logs into Laika b)Initializes test case (or resumes previous test case) Vendor ID Vendor Name (?) Inspection Identifier ( AMB-2007) Re-Test (yes/no) Date of Inspection Test Identifier c)Setup of Juror logins (or confirm existing) d)Confirm parameters for generation of CCD to create Registration info Clinical info Retrieval (transport) method

© 2007 | Slide 9 | 12 Dec 2007 Scenario: Import/Export CCD 2.Generate CCD and make available for import a)CCHIT Proctor uses Laika to create a CCD for import by vendor EHR. This is accomplished by either: Selecting from a set of pre-built CCD test cases Or dynamically generated CCD from parameters pre-defined as test cases b)Instructions are generated for vendor to: Retrieve the CCD by either: –File transfer by , FTP, or HTTP –XDS.b transactions (future) Modify an element of the patient registration (after importing CCD to the EHR) Send the CCD back by either: –File transfer by , FTP, or HTTP –XDS.b transactions (future)

© 2007 | Slide 10 | 12 Dec 2007 Scenario: Import/Export CCD 3.Generate inspection checklists for Jurors  Identical to all Jurors  Describes CCD content to look for in vendor EHR (matches content of CCD generated) 4.Vendor imports CCD into EHR: a)Proctor starts GoToMeeting session (Jurors observe Vendor EHR) b)Vendor retrieves and imports CCD by agreed method c)Vendor creates new chart from CCD registration information d)Vendor stores CCD as text document in new chart (not required to import structured data) e)Jurors confirm CCD imported by observation

© 2007 | Slide 11 | 12 Dec 2007 Scenario: Import/Export CCD 5.Alter Patient registration info a)Within newly created patient registration, Vendor updates a registration element as per given instructions 6.Create and export CCD: a)Vendor exports CCD for the chart of updated patient b)Vendor transports resulting CCD by agreed method 7.Validate CCD a)Laika validates: CDA R2 structure CCD structure CCD/C32 structure Coding and correctness of information b)Display of results to Proctor, Jurors (and Vendor?) c)Report results for required, optional, and provisional elements

© 2007 | Slide 12 | 12 Dec 2007 Scenario: Import CCD 8.Collect Juror scores and record test results a)Jurors enter scores into Laika Correlates to checklist (previous) Correlates to CCD/C32 structure? b)Proctor reviews Juror scores and test results c)Proctor declares test results valid (or invalid) 9.Test results posted to MS Excel spreadsheets 10.Test results posted to Certification Mgmt System a)Proctor initiates “push” of test results to SFDC XML encoding of test results interpreted by SFDC Inspection record created, test details uploaded b)Proctor reviews test result records in SFDC