Blue Button Plus Push Workgroup Meeting July 15, 2013

Meeting Etiquette 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 2

Agenda TopicTime Allotted Announcements, Meeting & Event Reminders5 minutes Push WG Where We Are & Where We’re Going 20 minutes Push Implementation Guidance Discussion V/D/T vs. BlueButton Change / Triggers 30 minutes Next Steps5 minutes 3

Push WG Direction First Blue Button Plus Developer Forum – July 12, 2013 – At Autodesk in San Francisco, CA – Over 100 developers in attendance – Hands-on- Tutorial for Blue Button Plus

Push WG Direction Where We Are – Published Implementation Guide – – Reference Implementations – C#, Java, and Java Quickstart – Tools – C-CDA Scorecard – Direct Connect-A-Thons – Blue Button CoDesign Challenge – Blue Button Developer Forums – San Francisco and New York Where We’re Going 1.Helping the community get it right 2.Helping address issues not covered in the implementation guide

Push IG Discussion Areas of Concern (What we are hearing…) – Helping the community meet V/D/T, so they can meet BB+ Attaching file to message vs. packaging it as a ZIP Including the request.txt Not pulling the Blue Button Anchor Bundle – Triggers & Automation Identifying data holders who are implementing automation

Discussion Question (Ryan): Are people pulling the bundle properly? Or are we not there yet? – Response (Adrian): We are not doing enough. I’m the volunteer lead for clarifying existing policies, but other than the folks who volunteered at the meeting, I’m unclear what we are supposed to do next. We are looking for guidance on how to make progress in that direction and have something prepared for the Sept 16 th meeting on this topic. Key questions include what is it going to take to get data holders comfortable with releasing real patient data through the automation & BB. – Response (Chris B): We have incomplete data; (Sean N.) we point them at the bundle when folks request information on how to connect with Direct. It would be useful to have clarity around guidance from ONC to the extent that there is the capability to do that; that yes, this is okay for us to do. – Comment (Ryan): We have good individual examples of organizations pulling/using the bundle, but not sure everyone is. Recommend pointing anyone at ‘pulling the bundle’. – Comment (Adrian): Patient bundle does not necessarily have governance and is a temporary (?) / technical construct. We would like to figure out how to get people to discuss the issues around pateint bundles, and guidance, etc. so that we can identify / generate guidance that is clear. – Comment (Chris): EMR vendors can only go so far if their clients make the switch. If Cerner is going BB+ direction, that’s great – but a key next step would be a major hospital system following suit.

Discussion Comment (Greg): Cerner is using the IG as the guidline for pulling the patient bundle and support one-way transport of the patient information. This was also an issue identified at the Patient Access Summit in June. Outcome was that policy will be revisited around the patient bundle; community still waiting for result of that meeting. – ACTION: Ryan / Nayan will have an update on the Patient Summit action items for the next Push meeting on July 29. Recommend waiting for data holders input before updating the automation section of the Push IG. – ACTION: Plan for 4 – 6 weeks, to put a plan together [Greg M & Team] for an achievable ask to the community. Comment (Patrick): WEDI is advisor to Sec of HHS. They are very interested in achieving the things we (BB+) are working on; however, do not necessarily have the technical expertise. There is a WEDI patient engagement meeting this Wednesday, July 12:00 Central / 1:00 pm Eastern. Benefit: user community who would be ready adopters of BB+ Push. – ACTION: Patrick forward the information; Nayan attend the call.

Next Steps & Announcements Continue Bi-weekly Push WG calls, with a focus on helping adopters / implementers with the bundle (will send out a new invite / placeholder) New BlueButton Plus Leads! – Initiative Coordinator: Rebecca Mitchell – Presidential Innovation Fellow: Nayan Jain Announcements – BB+ Developer Day: July 22, 2013 in NYC (see wiki for link to register) – Direct: Connect-a-thon this week 10:30 am Eastern) – Direct: New version of the Java RI (see the wiki for info) Next Push WG Meeting is July 29!

Chat Log Host: If you're interested in attending the BB+ Developer Day in NY (or seeing the results of the July 12) you can find more information here: Host: BlueButton Push Implementation Guide Link: Greg Meyer: GUI installer for Java RI as well! install.html Josh Mandel: Re: sitplatform Q&A, contact is: "Bill Dyer" Greg Meyer: There will a demo of the sitplatform at this week's Direct connet-a-thon Host: Josh Mandel: NYC BB+ Forum on 7/22: (Registration Link)

BlueButton+ Push Implementation Guidance (IG)

Contact Information 12 Contact Information – Initiative Coordinator: Rebecca Mitchell – Presidential Innovation Fellow: Nayan Jain – Project Manager: Jennifer Brush