Structured Data Capture (SDC) All Hands Meeting February 28, 2013

Meeting Etiquette 2 Remember: If you are not speaking, please 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 o Hold = Elevator Music = frustrated speakers and participants This meeting is being recorded o Another reason to keep your phone on mute when not speaking Use the “Chat” feature for questions, comments and items you would like the moderator or other participants to know. o Send comments to All Panelists so they can be addressed publically in the chat, or discussed in the meeting (as appropriate). From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute All Panelists

Agenda TopicTime Allotted Welcome and Announcements Meeting Reminders SDC and S&I Get HIMSS SDC Roadmap Reminder: Vote on the Project Charter 5 minutes SDC Use Case & Functional Requirements Kickoff S&I Use Case Development Process SDC Use Case Development Timeline Initiative Concept Diagram & Use Case Approach Use Case Context Diagram Use Case Assumptions Use Case Next Steps 50 minutes Next Steps / Contact Information 3

Welcome and Announcements Structured Data Capture (SDC) Initiative holds weekly community meetings on Thursdays at 3:25 pm EST. –Due to the HIMSS conference, the meeting scheduled for Thursday, March 4 is CANCELLED. –Next meeting is scheduled for March 14, –Please see the SDC Wiki Page for meeting information – 4 Please check the meeting schedule weekly as the meeting link and call in numbers will change.

HIMSS Conference Meet & Greet(s) 1.SDC Get Together –Tuesday, March 5:00 pm –Accenture Booth Meeting Room (Booth #4331) 2.S&I Get Together –Tuesday, March 5:30 pm –Wolfe’s (in the Warehouse Bar at the Marriott, 1 block down from the Convention Center)

Reminder Vote on the SDC Project Charter Consensus voting OPENS on February 22, Consensus voting CLOSES on March 4, Voting form is on the SDC Project Charter Page Voting form is on the SDC Project Charter Page For more information on the S&I Framework Consensus Process, see IMPORTANT Only Committed Members may vote on the Project Charter. Each Organization, no matter the number of Committed Members only receives 1 Vote. If there are multiple committed members from your organization please verify your collective vote with them.

Timelines for Consideration: MU Stage 3, SDO Ballot Cycles Structured Data Capture (SDC) Initiative: S&I Phases Dec ‘12Apr ‘13Jan ‘13Feb ‘13Mar ‘13May ‘13Jun ‘13Jul ‘13Aug ‘13Sept ‘13 Pilots & Testing Pilot site readiness Implementation of solution Test User Stories and Scenarios Monitor Progress & Outcomes Utilize Requirements Traceability Matrix Evaluation Evaluate outcomes against Success Metrics and Criteria Use Case & Functional Requirements Develop, review, and finalize the Use Case and Functional Requirements Pre-Planning Call for Participation Conduct Environmental Scan Success Criteria Stakeholder Engagement Standards & Harmonization Finalize Candidate Standards Standards Gap Analysis Technical & Standards Design Develop Requirements Traceability Matrix Develop Implementation Guide Pre-Discovery Launch initiative Review and Finalize Charter Review initial Candidate Standards 7 Initiative Kick Off: 1/23/13

8 Structured Data Capture (SDC) Initiative: Notional Timeline & Initiative Work steams Pilots & Testing Use Case & Functional Requirements Pre-Discovery Standards & Harmonization Timelines for Consideration: MU Stage 3, SDO Ballot Cycles Dec ‘12Apr ‘13Jan ‘13Feb ‘13May ‘13Jun ‘13Jul ‘13Aug ‘13Sept ‘13 Evaluation Pre-Planning Mar ‘13 Initiative Kick Off: 1/23/13 Technical Work stream Content Work stream SDC All-Hands WG - TBD Lead Use Case WG: API Functionality Technical SWG TBD Lead Common Formats SWG AHRQ Lead PCOR Content SWG NLM Lead Pilots WG Standards & Harmonization WG

S&I Framework Structured Data Capture Initiative Use Case & Functional Requirements Kickoff Meeting 2/28/13 9

Agenda TopicTime Allotted S&I Use Case Development Process20 minutes SDC Use Case Development Timeline7 minutes Initiative Concept Diagram & Use Case Approach7 minutes Use Case Context Diagram7 minutes Use Case Assumptions7 minutes Use Case Next Steps3 minutes 10

Use Case Development in the S&I Framework 11 Federal Responsibility Private Sector Joint Efforts NwHIN Exchange Operations NwHIN Exchange Operations S&I Pilots S&I Framework ATCBs and Testing Infrastructure NWHIN Implementation & Pre-Certification Testing Standards Development Use Cases Harmonization S&I Framework eHealth Exchange

Use Case Development Objectives Engage Stakeholders as Committed Members, Invited Experts, or Interested Parties in the creation of a Use Case Identify a Use Case and User Stories that address real-world problems Keep it simple Create a finalized Use Case that demonstrates value and supports the proposed goals and success criteria for the Initiative Publish a finalized Use Case that contains necessary content, supported by artifacts, to enable Harmonization and subsequent S&I Framework efforts to occur Establish the Use Case and supporting artifacts in a reusable fashion to support future health information interchange Initiatives 12

1.0 Preface and Introduction** 2.0 Initiative Overview –2.1 Initiative Challenge Statement** 3.0 Use Case Scope –3.1 Background** –3.2 In Scope –3.2 Out of Scope –3.3 Stakeholders** 4.0 Value Statement** 5.0 Use Case Assumptions 6.0 Pre-Conditions 7.0 Post Conditions 8.0 Actors and Roles 9.0 Use Case Diagram Use Case Outline Tailored for each Initiative 10.0 Scenario: Generic Provider Workflow –10.1 User Story 1, 2, x, … –10.2 Activity Diagram o Base Flow o Alternate Flow –10.3 Functional Requirements o Information Interchange Requirements o System Requirements –10.4 Sequence Diagram 11.0 Dataset Requirements 12.0 Risks, Issues and Obstacles Appendices –Related Use Cases –Previous Work Efforts –References 13 ** Leverage content from Charter

Use Case Development Process 14

Review of Key Use Case Sections Defining the Actors This section of the Use Case outlines the business actors that are participants in the information exchange requirements for each scenario. A business actor is a person or organization that directly participates in a scenario. Thus, as a person or organization, the actor can (and should) be a stakeholder. The business actor must use a system to perform the functions and to participate in the information interchange. The system or system actor has roles (send, receive, publish, subscribe or in some cases display) and actions which involve exchanging content. Please see the table below for an example of these designations. NOTE: A Business Actor may be a Stakeholder and also can have more than one role. ActorSystemRole PCPEHR SystemSender SpecialistEHR SystemReceiver PatientPHR SystemReceiver Example 15

Review of Key Use Case Sections Use Case Diagrams The Use Case and Context Diagrams conceptually represents the Business Actors interacting with the Use Case and the User Stories –These diagrams characterize the types of interactions that an actor has with a specific system –The section can include a Use Case Diagram and, if applicable, a Context Diagram (examples are shown below) The Use Case diagram shows the association and interaction between the business actors and the Use Case –It provides an overview of the actors (users or external systems), Use Cases, and the interactions between them The context diagram uses inputs and outputs to provide a pictorial representation of the environment, both internal and external, where the exchange takes place As the UML associated with the diagrams proceeds through the different S&I Framework functions (i.e., Harmonization, Reference Implementation), it is defined at a more granular level closer to the coding (implementation). Example of Use Case Diagram 16

Transitions of Care – Use Case Diagram 17

Transitions of Care – Context Diagram Actors & Roles Context Diagram ActorSystemRole Provider (Person)Electronic Health Record (EHR) SystemSender/Receiver or Source/Destination HISPHealth Information Service Provider The “wire” across which the health information is sent from the sender to the receiver PatientPersonal Health Record (PHR) SystemSender/Receiver or Source/Destination Provider OrganizationElectronic Health Record (EHR) SystemSender/Receiver or Source/Destination CaregiversPersonal Health Record (PHR) SystemSender/Receiver or Source/Destination 18

Review of Key Use Case Sections Scenarios The scenario is a comprehensive description of the actors, interactions, activities, and requirements associated with the information exchange It is a prototypical sequence of interactions in a business collaboration or the application context Scenarios pertain to supporting the health information exchange and, describing key flows, and are supplemented by User Stories 19

Review of Key Use Case Sections User Story User Stories summarize the interaction between the actors of the Use Case, and specify what information is exchanged from a contextual perspective Furthermore, the User Stories describe the real world application as an example of the Scenario These interactions are further described in subsequent sections. Historically, user stories have been utilized to provide clinical context. 20

Review of Key Use Case Sections Activity Diagram An Activity Diagram is a special form of a state transition diagram in which all or most of the states are activity states or action states –An action state represents the fulfillment of associated responsibilities in response to the communication received from the previous step –Most transitions are triggered by completion of activities in the source states The Activity Diagram illustrates the Use Case flows graphically, and represents the flow of events and information between the actors –It also displays the main events/actions that are required for the data exchange and the role of each system in supporting the change Example of Activity Diagram 21

ToC Activity Diagram 22

Review of Key Use Case Sections Sequence Diagram A Sequence Diagram is primarily used to show the interactions between objects in the sequential order that they occur –This representation can make it easy to communicate how the exchange works by displaying how the different components interact –The primary use of the diagram is in the transition from requirements expressed as use cases to the next and more formal level of refinement Note: Horizontal lines are used to identify the specific activity between the systems Example of ToC Sequence Diagram on next slide 23

ToC Sequence Diagram 24

Review of Key Use Case Sections Functional Requirements Functional Requirements identify the capabilities a system in a role must have in order to enable interoperable exchange of the healthcare data of interest –They provide a detailed breakdown of the requirements in terms of the intended functional behaviors of the application The Functional Requirements include: –Information Interchange Requirements –System Requirements –Dataset Requirements Detailed descriptions of requirement types on next slides 25

The Information Interchange Requirements define the system’s name and role. They also specify the actions associated with the actual transport of content from the sending system to the receiving system System Requirements include the requirements internal to the system necessary to participate successfully in the transaction. System requirements may also detail a required workflow that is essential to the Use Case Dataset Requirements –Include the data elements and data element sets that will be available within the message or document. Each data element included is necessary for some aspect of the Use Case; however, the requirements do not specify exactly how they may be used together. All data element sets may contain multiple data elements unless otherwise stated. –The identification of data elements forms the foundation for harmonization activities. The data elements identified in the Use Case set constraints on the contents of documents and messages. –NOTE: This content of this section will vary per Initiative as the references are contingent upon the specific list of Functional Requirements that is developed by the Workgroup. The Use Case Simplification Workgroup is tasked with creating a structure for this section that will eventually be applied to all Use Cases. Data element sets are defined for reuse within the Use Case Simplification Workgroup 26 Review of Key Use Case Sections Functional Requirements

S&I Community Enabling Toolkit (CET) Use Case Overview 27

Previous and Ongoing S&I Use Cases 28 Use Case TitleStatus 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 2In progress Structured Data CaptureIn progress Longitudinal Coordination of CareComplete Public Health ReportingComplete Automate Blue Button InitiativeIn progress Prescription Drug Monitoring ProgramIn progress esMD – Author of Record Level 2In progress

Agenda TopicTime Allotted S&I Use Case Development Process20 minutes SDC Use Case Development Timeline7 minutes Initiative Concept Diagram & Use Case Approach7 minutes Use Case Context Diagram7 minutes Use Case Assumptions7 minutes Use Case Next Steps3 minutes 29

Week Target Date All Hands WG Meeting Tasks Homework due Tuesday COB 12/28 Use Case Kick-Off & UC Process Overview Introduce: Context Diagram, Assumptions Review: Charter content, Context Diagram, Assumptions -3/7Cancelled for HIMSS 23/14 User Stories, Pre/Post Conditions Finalize: Context Diagram, Assumptions Draft: User Stories Review: Actors & Roles, Pre/Post Conditions 33/21User Stories, Actors & Roles Review: User Stories Finalize: Actors/Roles, Pre/Post Conditions Review: User Stories 43/28Base Flow, Activity DiagramFinalize: User StoriesReview: Base Flow, Activity Diagram 54/4Functional Requirements Finalize: Base Flow, Activity Diagram Review: Functional Requirements 64/11 Functional Requirements, Sequence Diagram Review: Functional Requirements, Sequence Diagram 74/18Data Requirements Finalize: Functional Requirements, Sequence Diagram Review: Data Requirements, Risks, Issues, & Obstacles 84/25 Data Requirements, Risks, Issues, & Obstacles Review: Data Requirements, Risks, Issues, & Obstacles 95/2Finalize: Data Requirements, Risks, Issues, & ObstaclesNone 105/9Full ReviewEnd-to-End Review (5/10-5/20) 115/16End-to-End Review (5/10-5/20)End-to-End Review due 5/20 125/23Consensus (5/24-5/29)Cast consensus vote FINAL CONSENSUS Structured Data Capture Initiative Proposed Use Case & Functional Requirements Development Timeline 30 12/28 Use Case Kick-Off & UC Process Overview Introduce: Context Diagram, Assumptions Review: Charter content, Context Diagram, Assumptions

Agenda TopicTime Allotted S&I Use Case Development Process20 minutes SDC Use Case Development Timeline7 minutes Initiative Concept Diagram & Use Case Approach7 minutes Use Case Context Diagram7 minutes Use Case Assumptions7 minutes Use Case Next Steps3 minutes 31

SDC Initiative Conceptual Workflow Word document 32

SDC Use Case Approach The full diagram below highlights an overall picture of the full SDC workflow The SDC Use Case itself will only focus on generic functionality outlined below and the exchanges in scope for standardization 33 Use Case Scope

Agenda TopicTime Allotted S&I Use Case Development Process20 minutes SDC Use Case Development Timeline7 minutes Initiative Concept Diagram & Use Case Approach7 minutes Use Case Context Diagram7 minutes Use Case Assumptions7 minutes Use Case Next Steps3 minutes 34

SDC Use Case Context Diagram Word document 35

Agenda TopicTime Allotted S&I Use Case Development Process20 minutes SDC Use Case Development Timeline7 minutes Initiative Concept Diagram & Use Case Approach7 minutes Use Case Context Diagram7 minutes Use Case Assumptions7 minutes Use Case Next Steps3 minutes 36

SDC Use Case Assumptions Word document 37

Agenda TopicTime Allotted S&I Use Case Development Process20 minutes SDC Use Case Development Timeline7 minutes Initiative Concept Diagram & Use Case Approach7 minutes Use Case Context Diagram7 minutes Use Case Assumptions7 minutes Use Case Next Steps3 minutes 38

Next Steps for SDC Use Case...! Next week is cancelled for HIMSS –  SDC Initiative Meet and Greet on Tuesday 3/5/13  Accenture Booth Meeting Room (Booth #4331) from 5:00 – 5:30 pm  S&I Framework Wide Meet & Greet Tuesday 3/5/13  Wolfe's in the Warehouse Bar at the Marriott a block down from the Convention Center starting at 5:30 Review content & submit comments by Tuesday 3/12 COB  Context Diagram  Assumptions  Wiki link: Attend our next session on Thursday 3/14 to discuss...  Pre & Post Conditions  User Stories 39

Week Target Date All Hands WG Meeting Tasks Homework due Tuesday COB 12/28 Use Case Kick-Off & UC Process Overview Introduce: Assumptions, Pre/Post Conditions Review: Charter content, Context Diagram, Assumptions -3/7Cancelled for HIMSS 23/14 User Stories, Pre/Post Conditions Finalize: Context Diagram, Assumptions Draft: User Stories Review: Actors & Roles, Pre/Post Conditions 33/21User Stories, Actors & Roles Review: User Stories Finalize: Actors/Roles, Pre/Post Conditions Review: User Stories 43/28Base Flow, Activity DiagramFinalize: User StoriesReview: Base Flow, Activity Diagram 54/4Functional Requirements Finalize: Base Flow, Activity Diagram Review: Functional Requirements 64/11 Functional Requirements, Sequence Diagram Review: Functional Requirements, Sequence Diagram 74/18Data Requirements Finalize: Functional Requirements, Sequence Diagram Review: Data Requirements, Risks, Issues, & Obstacles 84/25 Data Requirements, Risks, Issues, & Obstacles Review: Data Requirements, Risks, Issues, & Obstacles 95/2Finalize: Data Requirements, Risks, Issues, & ObstaclesNone 105/9Full ReviewEnd-to-End Review (5/10-5/20) 115/16End-to-End Review (5/10-5/20)End-to-End Review due 5/20 125/23Consensus (5/24-5/29)Cast consensus vote FINAL CONSENSUS Structured Data Capture Initiative Proposed Use Case & Functional Requirements Development Timeline 40

Next Steps HOMEWORK: Committed Members VOTE on the Project Charter: – nd+Membershttp://wiki.siframework.org/Structured+Data+Capture+Charter+a nd+Members Next Work Group Meeting March 7, 2013 Meeting is CANCELLED Next Meeting is Thursday, March 14, 2013 from 3:30pm - 4:30pm Eastern – Reminder: All SDC Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Use Case, Project Charter and general information will be posted on the SDC Wiki page –

Contact Information For questions, please contact your support leads –Initiative Coordinator: Evelyn Gallego –Project Manager: Jenny Brush –PM Support: Zachary May –Use Case/Requirements Lead: Jennifer Sisto –Standards Development Lead: Caryn Just