360Exchange (360X) Project 10/25/12

Reminders / announcements Mission / scope review Workgroup updates Implementation sites 1 Agenda

This meeting is being recorded. If you don’t wish to be recorded, please hang up now. If you’re not speaking, please mute your line. Please don’t put us on hold (though dance breaks are fun). 2 Reminders / Announcements

As quickly as possible using proposed MU Stage 2 standards, enable providers to exchange patient information for referrals from their EHR workflow, regardless of the EHR systems and/or HISP services used (i.e., allowing information to move point-to-point between unaffiliated organizations, differing EHRs, and differing HISPs) and with at least the same quality of workflow integration providers currently experience when referring between homogeneous EHR systems. 3 Mission

It’s not to demonstrate that it’s possible – We already know it’s technically possible It’s to ensure that it’s clinically relevant and useful – It must be ‘good’ for real-world providers It’s to ensure that it’s rapidly and widely deployable – If it’s ‘good’ but unavailable, it’s actually not good Whenever possible reduce friction, add lubricant – Implies applying a high standard for adding ‘requirements’ 4 Mission, cont’d

360X is not a standards-making body 360X is a workgroup for implementing existing standards in combination to advance ‘real-world’ interoperability 360X will not re-litigate conversations around the normative specifications for existing standards in this forum – The existing standards are the standards… 360X’s findings / observations / experimentation may inform other standards-making processes – Help to refine existing standards – Lead to the creation of new standards 5 About standards…

Key issues – Consensus around keeping it simple and then allowing individual pilots to innovate Baseline for everyone in 360X to ensure fundamental interoperability – MUS1 / MUS2 requirements for structured content – Inclusion of additional content types – Inclusion of referral ID – Allow individual groups to try alternative approaches for optional content to gain first-hand experience by experimenting with different approaches – Incorporate lessons learned into subsequent implementation guides – Provide feedback to relevant standards-making bodies 6 360X Content Workgroup

Next steps – Crafting implementation guidance per existing consensus decisions Includes recommendation to use enhanced MDN IG for quality of service – Combining w/ content/payload workgroup Provides for better alignment to address points of intersection / overlap 7 360X Transport Workgroup

Reviewing final draft of implementation guidance for this functionality In 360X, limited PD scope to: – Internal PD query – External PD query – Query for address – Use of HPD+ minimum data set 8 360X Provider Directory Workgroup

Composition of teams – Minimum: 2 providers, 2 EHR vendors, and 1 HISP If one HISP, must demonstrate interop with another community Ideal: >2 providers, >=2 EHR vendors, and >=2 HISPs – Once you assemble a team ……. Let us know: participants (names/role), coordinator Send to – Want to go to the dance but don’t have a partner? Let us know too… we’ll start assembling a list on the wiki and playing matchmaker 9 Forming Pilot Teams Now is the time…….

Baseline (mandatory) as currently proposed: DIRECT-Enabled – Conforming to the Applicability Statement v1.1 HISP/STA to HISP/STA trust certificate exchange EHR workflow/solution enabled for referral process Able to exchange baseline payload (MU1 and MU2) criteria – CCD/CDR or consolidated CDA Ability to view payload – (data consumption is optional) Ready to begin implementation NOW or near term (within next 3 months) 10 Minimum Bar for Participation

11 Are you an Over Achiever? Additional functionality for EXTRA credit Enhanced referral management functions Additional content types Provider directory query C-CDA consumption Automated trust bundle exchange Enhanced Direct MDN functions for QoS