Data Provenance Pilots Presentation Presented by: Robert Moerland & Mohammed Islam AUGUST 06, 2015 DRAFT: Not for distribution

Data Provenance Pilots Presentation Agenda Data Provenance Pilots Presentation Opening (MI) Introduction: LPHI, PATH, GNOHIE (RM) PILOT Project Overview (RM) Use Case Scenario (MI) Success Criteria and Value Statement (RM) Timeline and Questions/Needs (MI)

Introduction & Pilot Team Identify the members of your organization who will be supporting this pilot. If possible include the role he/she will play in the pilot and contact information Who we are: LPHI, PATH, GNOHIE Our Pilot Team: Name Role Email Clayton Williams Executive Director (PATH) cwilliams@lphi.org Robert Moerland CIO (LPHI) rmoerland@lphi.org Mohammed Islam Operations Manager (GNOHIE) mislam@lphi.org Kelly Maggiore Huahong Qiang Hang Zhang PM Data Integration Architect HIE Developer kberendt@lphi.org hqiang@lphi.org hzhang@lphi.org

What (Scenario ) portions of the IG are you Piloting? Please use this section to document what parts of the Use Case you are intending to pilot. Please be as specific as possible. This should include any of the examples you intend to pilot (ECA Rules, Documentation Templates, Order Sets) Section of IG Specifics to Pilot Notes 10B.0 Scenario of the DPROV Use Case document Scenario 2: Start Point  Transmitter  End Point Transmission of summary of care document, from hospital to PCP, with provenance information and an indication that the data passed through a transmitter.

Identify the Use Case Actors Involved: A pilot may involve the following participants from the healthcare ecosystem: Start Point -> Transmitter -> End Point Hospitals (System Integrators, EHR Vendors) – Start Point (Out of Scope) GNOHIE - Transmitter Clinics (System Integrators, EHR Vendors) – End Point (Out of Scope) Note: This pilot may not directly involve any start and end point actors

In Scope/Out of Scope In Scope: Use Case Scenario 2 – Transmitter Role If you already know what will be in and out of scope for your pilot (beyond the UC or Functional Requirements) please document it here: In Scope: Use Case Scenario 2 – Transmitter Role Out of Scope: Making Start and End Point interface changes to incorporate or ingest provenance data.

Goal of the Pilot Please include a write up or create a Visio diagram of what you intend to show/prove/support during the pilot process. Make this an actionable statement with specifics. Also include in this description what you hope to gain from this pilot. Use Case Scenario 2 – Discharge Summary (CCD/CCDA) from Hospital to PCP (Clinic) Patient Scenario: Patient is discharged from hospital to the care of a PCP or other care setting and a transition of care (ToC) or Discharge Summary document is generated. The PCP or specialist receives the summary of care with provenance information and an indication that the data passed through a transmitter.

Goal of the Pilot Hospital GNOHIE PCP (Clinic) Provides necessary care Please include a write up or create a Visio diagram of what you intend to show/prove/support during the pilot process. Make this an actionable statement with specifics. Also include in this description what you hope to gain from this pilot. Hospital GNOHIE PCP (Clinic) Provides necessary care Generates a discharge summary and summary of care document Discharge summary sent via GNOHIE to PCP, and/or other care setting Incorporates provenance information Sends discharge summary to PCP and/or other care setting Receives discharge summary document through GNOHIE Takes necessary action

Goal of the Pilot Please include a write up or create a Visio diagram of what you intend to show/prove/support during the pilot process. Make this an actionable statement with specifics. Also include in this description what you hope to gain from this pilot. We would like to better understand and improve the data provenance in GNOHIE by addressing the following questions: What provenance information should be included in export of any healthcare data from a primary source in a clinical setting? How can GNOHIE (or any receiving system) interpret/understand and trust the provenance information? How to maintain data provenance information for each element in a centralized data repository? <<OPTIONAL>> When multi-sourced data is assembled and viewed from a portal (GNOHIE Provider Portal), how do we convey the provenance information of the multiple data sources?

Minimum Configuration What is your current set up? What will you be using to conduct the pilot? Who are your potential partners? Etc. EMR Data Source Mirth Appliances Mirth Connect Channels Mirth Results (Web interface, and API) Clinics EMR interfaces Mirth Match ORU Msg CCD/CCDA Msg ADT msg CDR Channels Mirth Mail EMR Vendors Msg listener HIE Vendor – Mirth EMR Vendors – Epic, Cerner, Allscripts, Greenway, eCW, Aprima, Athenahealth, etc.

Standards Under Consideration For content/ system requirements we are using the following standard(s): HL7 Version 2.x Messaging Standard HL7 Clinical Document Architecture (CDA), based on HL7 Version 3 HL7 Clinical Documentation Architecture Release 2 (CDA R2) For transport/Information Interchange we are using the following standard(s): DIRECT Simple Object Access Protocol (SOAP) Cross Enterprise Document-Sharing (XDS) HL7 V3 Minimal Lower Layer Protocol (MLLP) Do you belong to the SDO that maintains the standards in consideration? If yes which SDOs?: No

Success Criteria What will you/your organization use to determine the success of this pilot? This needs to be quantitative and not subjective in as much as possible. (For example: Successfully implement 1 Use Case Scenario showing successful execution from the EHR system) Successfully developing a plan for incorporating data provenance information in Scenario 2 Successfully incorporate provenance data to at lease one message type from a single start point Successfully send at least one message type with provenance data to an end point

Value Statement: hope to gain Please include a write up or create a Visio diagram of what you intend to show/prove/support during the pilot process. Make this an actionable statement with specifics. Also include in this description what you hope to gain from this pilot. Value Statement: hope to gain Focusing on understanding data provenance in our network will help users better trust the data that is coming from outside of their own organization. When users trust the information coming from GNOHIE, it will help in improving transitions of care and continuity of care for the patients. Learn from experiences of others throughout the country and be part of the community of volunteers that support ONC’s goals of promoting interoperability and meaningful health information exchange.

Timeline Milestone Target Date (Tentative) Responsible Party Discovery What is your proposed timeline? (see Appendix A for more detailed timeline and activities) Month: Kick off and Logistics Month: Start Pilots Month: Conclude Pilots Milestone Target Date (Tentative) Responsible Party Discovery August, 2015 Encoding Message October, 2015 Testing December, 2015 Conclude February, 2016

Questions/Needs Please include those items you wish to consider and questions you have or hope the pilot addresses. Additionally, please include those items you need in order to succeed (we will try to accommodate as many of these needs as possible within the scope of ONC, S&I and DPROV) Support for reconstructing or incorporating the provenance data into the incoming messages such as CCDA, HL7 ADT, ORU messages etc. Collaborating with other piloting teams Support from any (participating) major EMR vendors

Helpful References Use Case and Functional Requirements can be found on the DPROV Pilots Wiki Page: http://wiki.siframework.org/Data+Provenance+Pilots

Appendix A: timeline details (example) XX Pilot Team Estimated Completion Complete Sprints, Update Requirements Traceability Matrix, and Write Test Cases - February 22, 2016 Prepare for HIMSS 2016 - March 2, 2016 HIMSS Demonstration and Inspection of test results - March 3 - 7, 2016 (at HIMSS) Lessons Learned Update RTM with test result evidence and artifacts Provide feedback to improve the DPROV IG and Use Cases - March 22, 2016 Complete Sprints Update Requirements Traceability Matrix   Scenarios 1 and 3 implemented Prepare to demonstration to DPROV community -  January 15, 2016 Continue updates to Requirements Traceability Matrix XX pilot team prepares a Lessons Learned          document -   January 31, 2016 Address Test Procedures and Validation   -   February 28, 2016