Data Access Framework (DAF) All Community Meeting October 23rd, 2013

Meeting Etiquette Remember: If you are not speaking keep your phone on mute Do not put your phone on hold – if you need to take a call, hang up and dial in again when finished with your other call – Hold = Elevator Music = very frustrated speakers and participants This meeting, like all of our meeting is being recorded – Another reason to keep your phone on mute when not speaking Feel free to use the “Chat” feature for questions, comments or any items you would like the moderator or participants to know. NOTE: This meeting is being recorded and will be posted on the Meeting Minutes Wiki page after the meeting From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute 2

Agenda TopicTime Allotted General Announcements5 minutes Timeline discussion5 minutes Review IHE Submission of DAF project5 minutes Review what we have accomplished and what we need to do 5 minutes Discuss Patient Portability User Story10 minutes Continue Discussion of User Stories25 minutes Next Steps/Questions5 minutes 3

General Announcements We are resuming our DAF meetings as planned going forward – We meet every Wednesday from 12:00 -1:00 pm ET For meeting details see the DAF wiki page at: All DAF Materials are posted on the DAF (video of meetings, materials, reference materials from the meeting) – 4

S&I Framework Phases & Data Access Framework Activities 5 We are Here

Notional Project Timeline Kick-off (7/16) Pre-Discovery, Call for Participation Jan 2014 Nov Discovery S&I Lifecycle (Discovery  Pilot & Evaluation) 6 July 2013Sept Implementation Define Use Case & Functional Requirements Standards Gap Analysis Harmonized Specifications Use Case 1 Consented 11/20 UC 1: Local Data Access : Intra- Organizational Query UC 2: Targeted Data Access: Inter- Organizational Query Discovery Define Use Case & Functional Requirements Charter Review & Consensus Today 10/23 6 User Story SWG (8/29) Meetings cancelled due to HL7 and Govt. Shutdown

Local Data Access Framework Use Case 7 October 23 rd, 2013

Today’s Agenda : 8 Discussion TopicEstimated Time Timeline Check1 minute Update on Standards Development Organization Engagement – HL7 & IHE 5 minutes Initiative and Use Case Recap (as of 9/18 meeting)10 minutes Inclusion of User Story 3 – Patient Portability10 minutes Continue Use Case Discussion 20 minutes Next Steps4 minutes

Proposed Use Case Development Timeline 9 Week Target Date All Hands WG Meeting Tasks Review & Comments due Monday COB 18/14Use Case Kick-Off & UC Process Overview Review: In/Out of Scope and Assumptions sections 28/21 Review: In/Out of Scope and Assumptions Review: In/Out of Scope and Assumptions Sections, User Stories 38/28 Review: In/Out of Scope and Assumptions, Context Diagram, User Stories Finalize: In/Out of Scope and Assumptions, Context Diagram Review: Pre/Post Conditions Review: User Stories, Context Diagram, Pre/Post Conditions Note- Separate User Story SWG will launch on 8/29 49/4 Review: Pre/Post Conditions, Actor and Roles Review: Pre and Post Conditions and Actors & Roles Review: User Stories, Pre/Post Conditions, Base Flow and Activity Diagram 59/11 Review: Activity Diagram and Base Flow Review: Base Flow, Activity Diagram Finalize: Pre and Post Conditions and Actors & Roles Review: Activity Diagram, Base Flow and Functional Requirements 69/18 Functional Requirements, Sequence Diagram Finalize: User Stories Review: Functional Requirements, Sequence Diagram 9/25- 10/16 Meetings cancelled due to HL7 WGM & Govt. Shutdown 710/23 Use Case Recap, Review of editorial updates, Data Requirements Finalize: Functional Requirements, Sequence Diagram Review: Data Requirements 810/30Data RequirementsFinalize: Data RequirementsReview: Data Requirements 911/6Full Review & Finalize Data RequirementsEnd-to-End Review (11/6-11/12) 1011/13End-to-End Comments ReviewEnd-to-End Review comments due 11/ /20Consensus Voting 11/20– 11/27Cast consensus vote FINAL CONSENSUS completed prior to 11/27 (Thanksgiving )

SDO Engagement 10 1.HL7 Workgroup Meeting - September 23 rd -27 th Informative presentations about DAF to various workgroups to spread awareness of this initiative 2.IHE Planning Meetings – October 8 th – 9 th DAF was presented as a project at IHE Planning committee Proposal accepted by Patient Care Coordination (PCC) committee to develop a white paper that provides guidance on the DAF Framework. Further collaboration with IHE will be conducted to determine next steps 3.Conduct additional outreach and engagement with SDOs

Local Data Access Use Case Quick Recap 11 As of the 9/18 meeting, the following sections had been reviewed Generic Scenario* Generic Assumptions Generic Pre & Post conditions* User Stories – Finalized 2 User Stories for inclusion – Patient Level Document Metadata based access A Provider accesses clinical summary documents on an ad hoc basis for a new diabetic patient with documented poor glucose control – Patient Level - Data Element based access Physician referral to Endocrinologist within the same organization using different EHRs with system alerts for patient protected information Activity diagram & Base flow* Began initial discussions on the Functional Requirements Note* – Sections noted with an asterisk above have been updated with feedback and will be reviewed today

Local Data Access Use Case Quick Recap (cont.) 12 Sections to be further discussed in the next few weeks New User Story ( Patient Portability) Draft Functional Requirements – Information Interchange, System Requirements, & Sequence Diagram Draft Data Requirements for the following – Document Metadata based access – Querying for document metadata – Data Element based access – Querying for specific clinical value(s)

Patient Portability User Story (#3) 13 A provider needs to access information for one of his patients’ who recently moved to a new state and that has a new care team. A patient is moving from Michigan to Florida for retirement. The patient has diabetes and has also undergone multiple open heart surgeries to correct irregular heartbeats and other ailments related to the heart. His new care team in Florida is preparing for an initial visit and has requested the patient to retrieve his medical history from as many sources as possible. The patient approaches the Michigan hospital, the PCP and the cardiologist office who are part of the current care team and where he has received treatment before. He requests each one to provide his medical records (clinical documents) to date. The providers query each of their local EHR systems to obtain the clinical documents, requested by the patient. Now that the patient has all necessary records, he can carry them with him on his initial visit to a new care team in Florida.

Use Case Discussion 14 Refer to Use Case document for discussion

Next Steps Attend our next All Hands call on Wednesday 10/30 12:00 PM EST to continue our discussion from today with Functional and Data Requirements The latest Use Case document will be posted to the wiki by COB Thursday for your reviews

Initiative Support Leads For questions, please feel free to contact your support leads: – Initiative Coordinator: John Feikema – ONC Sponsors: Mera Choi – Support Team: Project Management: – Jamie Parker Technical Support: – Dragon (Nagesh) Bashyam Use Case Development: – Presha Patel Vocabulary and Terminology Subject Matter Expert: – Mark Roche Project Support – Gayathri Jayawardena 16

Data Access Framework (DAF) Resources DAF Wiki Homepage – Become a Community Member – tive tive DAF Charter – embers embers Standards and Interoperability(S&I) Framework – S & I Calendar of Events –

Appendix B: Additional Use Case Reference Material

S&I Community Enabling Toolkit (CET) Use Case Overview 19

Some Previous and Ongoing S&I Use Cases (not a complete list) 20 Use Case Name (including links)Status Data Access FrameworkIn Progress Transitions of CareComplete Lab Results InterfaceComplete Provider Directory - Certificate DiscoveryComplete Provider Directory - Electronic Service Information DiscoveryComplete Query HealthComplete Data Segmentation for PrivacyComplete esMD - PPA Provider Registration (UC 1)Complete esMD - Secure sending and Structure of eMDR (UC 2)Complete esMD - Author of Record Level 1Complete Lab Orders InterfaceComplete Lab Orders Interface - eDOSComplete Health eDecisions CDS Artifact Sharing UC 1Complete Health eDecisions CDS Guidance Service UC 2Complete Structured Data CaptureComplete Longitudinal Coordination of CareComplete Public Health ReportingComplete Automate Blue Button InitiativeComplete Prescription Drug Monitoring ProgramComplete esMD – Author of Record Level 2Complete