Meeting Slides Content Standards Workgroup December 12, 2014 Andy Wiesenthal, chair Rich Elmore, co-chair.

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Presentation transcript:

Meeting Slides Content Standards Workgroup December 12, 2014 Andy Wiesenthal, chair Rich Elmore, co-chair

Consolidated CDA (C-CDA) December 2014 Brett Marquard

Setting the stage Equip WG to: 1.Communicate need and basic use case for Consolidated CDA (C-CDA) 2.Outline C-CDA implementation concerns 3.Locate HL7 support avenues 4.Discuss additional areas for improving interoperability with C-CDA 3© 2014 River Rock Associates, LLC

Presenter Brett Marquard – Principal, River Rock Associates – Extensive EHR experience – Co-Chair of HL7 Structured Documents Work Group (SDWG) Primary author for Consolidated CDA Templates (C-CDA) R1.1/R2 Co-editor of new CDA on FHIR, and Data Access Framework (DAF) initiatives – 4© 2014 River Rock Associates, LLC

The ‘situation’ (C32) © 2014 River Rock Associates, LLC5 C83 C80 HITSP C32 C48 IHE PCC C62 … C84 HL7 CDA HL7 CCD C-CDA

Key Participants © 2014 River Rock Associates, LLC6 Approximately 140 volunteers participating in weekly calls and offline work

HL7 Consolidated CDA IG R1.1 C-CDA July 2012, Draft Standard for Trial Use 9 document templates: 60 document sections 82 entry templates Containment Tree and Used By Tree © 2014 River Rock Associates, LLC7 Continuity of Care Consultation Note Diagnostic Imaging Report Discharge Summary History and Physical (H&P) Note Operative Note Procedure Note Progress Note Unstructured Document

Sweet Spot of Document and Messages Documents enable information exchange across institutions, snapshot in time Messages (V2/V3) enable exchange within an institution © 2014 River Rock Associates, LLC8 Transfer to Long Term Care EHR REG Registration (ADT)

C-CDA R2 by the numbers 12 Documents (+3 over R1.1) +1 new header template 71 Sections (+11) 109 Entries (+27) 8 templates deprecated 108 templates versioned – all marked with V2 1,000+ ballot comments © 2014 River Rock Associates, LLC9

Additions available in C-CDA R2 Document types – Care Plan including Home Health Plan of Care – Referral Note – Transfer Summary Patient Generated Document header template Tighter constraints and new template versioning strategy © 2014 River Rock Associates, LLC10

© 2014 River Rock Associates, LLC11 Where are implementations struggling?

Issues in the field Inconsistent implementation 1 – Structure – Inappropriate terminology – Variability in communicating the same information Appropriate use of document types – ‘Everything’ is a Continuity of Care Document (CCD) – Send me the last 5-years Change is coming (C-CDA R2) 2 … © 2014 River Rock Associates, LLC

Improve C-CDA implementation © 2014 River Rock Associates, LLC13 Make it mandatory that every vendor be capable of displaying any CDA document More examples Test by data domain – Confirm 100% conformance with a set of Problem List scenarios before moving to next domain – C-CDA documents contain an enormous amount of data and it’s easy to get lost coding ‘everything’ – Test against approved examples Publish value sets in a public repository (VSAC – in progress) Provide a public place to collect issues Tighter constraints

HL7 Support HL7 Structured Documents Work Group (SDWG) is responsible for CDA – Meets weekly for current ongoing projectsweekly – Public calls – ~25 participants a week SDWG examples task force – Present your issue and proposal for review – 30+ approved authoritative samplesauthoritative samples Help Desk © 2014 River Rock Associates, LLC14

Measure (score) progress © 2014 River Rock Associates, LLC15 “If you cannot measure it, you cannot improve it.” Lord Kelvin ( ) Feedback loop

© 2014 River Rock Associates, LLC16 Questions Thank you

2014 Q42015 Q12015 Q22015 Q3 OctNovDecJanFebMarAprMayJunJulAugSep Upcoming FACA Milestones 17 Kick-off Federal Milestone Joint HITPC/HITSC Meeting Federal HIT Strategic Plan Posted for Comment Interoperability Roadmap Recs prior to posting for comment FACA HIT Strategic Plan Comments Interoperability Roadmap Posted for Comment and charge WG’s with responding HITPC comments on MU3 NPRM HITSC comments on Certification NPRM All workgroups kicked off FACA Milestone FACA Interoperability Roadmap Comments (estimate)

Content Standards Chair: Andy Wiesenthal Co-chair: Rich Elmore HITSC Workgroups and Chairs 18 Architecture, Services & APIs Chair: David McCallie Co-chair: Arien Malec Transport and Security Standards Chair: Dixie Baker Co-chair: Lisa Gallagher Semantic Standards Co-chair: Jamie Ferguson Co-chair: Becky Kush Health IT Standards Committee Chair: Jon White Vice Chair: John Halamka Implementation, Certification &Testing Co-chair: Liz Johnson Co-chair: Cris Ross Steering Committee Chair: Jon White Co-chair: John Halamka *Task Forces may be formed for specific work assignments

Content Standards Draft Workplan 19 MeetingsTask November 24, 2014, 11:00 ET Consistent implementation of the CCDA to support interoperability EHRA presentation  December 12, 2014, 11:00 ET Consistent implementation of the CCDA to support interoperability January 15, 2015, 11:00 ET Interoperability Roadmap background and context (Tentative) February 4 or 10 (TBD), 2015 – HITSC Meeting Charged by HITSC with responding to the Interoperability Roadmap V.1 Feb 18, 2015, 11:00am EST Overview of Interoperability Roadmap V.1 and prepare to comment February 25, 2015 – HITSC Meeting TBD March 18, 2015 – HITSC Meeting Charged by HITSC with commenting on Certification NPRM March 20, 2015, 2:00pm EST Finalize comments on Interoperability Roadmap V.1 Overview of Certification NPRM and prepare to comment April 22, 2015 – Joint HITPC/HITSC meeting Interoperability Roadmap V.1 comments to the HITSC  Schedule WG meeting for last week in April Comment on Certification NPRM  Schedule WG meeting for 2nd week in May Finalize Certification NPRM comments May 20, 2015 – HITSC Meeting Certification NPRM Comments to the HITSC

Content Standards Draft Workplan 20 HITSC Workplan - Last Updated December 7, TasksStart DateDue DateNovDecJanFebMarAprMayJunJulAugSep Content Standards Workgroup Workgroup Kick-Off10/22/2014 Comment on published version of Interoperability Roadmap TBDTBD - Q1 Comment on Certification NPRM TBDTBD - Q1