Laboratory Orders Interface (LOI) Initiative Kickoff 3/30/2012

Agenda for Pre-Discovery Prep Introductions S&I Framework Overview LOI Introduction Initiative Summary Background Target Goals & Outcomes Scope Timeline F2F Overview Next Steps 2

Standards & Interoperability (S&I) Framework The Standards and Interoperability (S&I) Framework is an open and transparent forum sponsored by the Office of Standards & Interoperability (OSI) to fulfill its charge of enabling harmonized specifications in support of national healthcare priorities. These efforts are carried out in the form of targeted Initiatives based on the healthcare priorities set forth by OSI to achieve lasting results and delivery improvements.

LOI Initiative Summary The Laboratory Orders Interface (LOI) Initiative is focused on the creation of an Implementation Guide (IG) that builds on the architecture and design of the California HealthCare Foundation’s (CHCF) ELINCS Laboratory Orders and the Health Level Seven (HL7) Version Implementation Guide: Laboratory Results Interface for US Realm, Release 1 (LRI IG). The goal of the initiative is an IG for electronic ordering of laboratory tests in an ambulatory setting that can serve as a foundation for eventual use in in-patient and public health settings. Further, the design will incorporate vocabulary consistent with the above mentioned guides as well as support for use of the Electronic Directory of Service (eDOS) IG.

Background & Tiger Team The LOI Initiative will leverage existing California HealthCare Foundation (CHCF) work to develop an ambulatory laboratory order Implementation Guide (IG) CHCF and the Office of the National Coordinator for Health IT (ONC) have discussed how to align the CHCF ELINCS Orders effort with the Standards & Interoperability (S&I) Framework goal of producing a Health Level Seven (HL7) balloted IG that would complement the Laboratory Results Interface (LRI) IG Through the formation of a Tiger Team, key stakeholders have taken several initial steps to queue up this Initiative –The Tiger Team consists of Corey Spears, Glen Moy, Walter Sujansky, Bob Dieterle, Ken McCaslin, Bob Yencha, Hans Buitendijk, Austin Kreisler and Sam Faus

Background & Tiger Team The Tiger Team met on January 25 – January 26 to discuss the overall approach, key activities, requirements & supported needed for an HL7 DSTU process, workgroup structure/leadership and timelines to develop the LOI work products within the S&I Framework. –Several follow up meetings have occurred to prepare for the launch of the Initiative The Tiger Team will continue to meet over the next several weeks to help prepare the work products for the larger community’s review and approval As part of these efforts, the Tiger Team will conduct an initial analysis and produce the following initial work products: –Use Case Translation/Validation –Draft LOI IG Aligning ELINCs Orders and the LRI IG –Vocabulary Review Once the initial analysis is complete the Tiger Team will no longer meet on a regular basis

LOI Target Goals & Outcome Goal: To develop an IG that, when broadly adopted by clinical laboratories and ambulatory EHR systems, will obviate the requirement to define a new specification each time an EHR system- LIS orders interface is implemented. Stretch Goal/Consideration: To pursue an approach that enables expansion to consistently support laboratory orders for the acute care and Public Health settings. Note that in the future multiple message structures may be required to support this. This guide does not intend to define the complete framework in the first phase. Outcome: A laboratory orders interface IG designed to serve as a companion document to the LRI IG.

LOI Scope Develop an IG to support electronic laboratory ordering between an EHR System and a LIS in an ambulatory care setting. In Scope –Development of an Orders IG that aligns with the LRI IG and ELINCS Laboratory Orders IG –Incorporation of support for the adoption and use of the Test Compendium Framework, i.e., eDOS Out of Scope –Non-US laboratory ordering use cases –Referral orders placed between laboratories –Laboratory orders in the acute setting (EHR System to LIS all within the hospital)

S&I Framework Phases & LOI Activities 9 PhasePlanned Activities Pre-Discovery  Development of Initiative Synopsis  Development of Initiative Charter  Definition of Goals & Initiative Outcomes Discovery  Creation/Validation of Use Cases, User Stories & Functional Requirements  Identification of interoperability gaps, barriers, obstacles and costs  Review of Vocabulary Implementation  Creation of aligned specification  Documentation of relevant specifications and reference implementations such as guides, design documents, etc.  Validation of Vocabulary  Development of testing tools and reference implementation tools Pilot  Validation of aligned specifications, testing tools, and reference implementation tools  Revision of documentation and tools Evaluation  Measurement of initiative success against goals and outcomes  Identification of best practices and lessons learned from pilots for wider scale deployment  Identification of hard and soft policy tools that could be considered for wider scale deployments

LOI Timeline Key Kick-off (3/30) Discovery F2F (4/11 – 4/13) Today (3/30) Implementation Vocabulary Review Pilot Testing Reference Implementation & Validation Assessment of RI and Pilot Outcomes Mar Apr MayJun Jul Aug SepOct IG Ready for Ballot 8/31 Creation/Validation Use Case & FR Initial LOI – LRI Alignment/ Development of DRAFT LOI IG Vocabulary Validation LOI Validation Tiger Team/Support Activities Community Activities HL7 Activities CHCF/ELINCS Orders Pilot Participants eDOS Sub Workgroup Tiger Team/Support Activities Community Activities HL7 Activities CHCF/ELINCS Orders Pilot Participants eDOS Sub Workgroup HL7 Ballot Cycle Pilot & Evaluation Documentation & Incorporation ELINCS Orders Lessons Learned/Key Findings from Pilot Participants eDOS Alignment Aligned Specification Testing & RI Tool Development Pre Discovery LOI Timeline

LOI Upcoming Activities April 2012 Achieve consensus on Initiative Charter (Community) F2F Meeting (Community & Tiger Team) Validate preliminary Use Case and Vocabulary work products (Tiger Team) Achieve consensus on the Use Case and Vocabulary work products (Community) Develop initial LOI IG draft based on the ELINCS Orders v 1.0 (Tiger Team)

F2F Basic Information Dates: Wednesday, April 11– Friday, April 13 Alexandria Westin: – Address: 400 Courthouse Square, Alexandria, VA, – Phone: – Website: – Public Transportation: King Street Metro (Blue/Yellow Lines) – 3 Blocks Ronald Reagan Airport (DCA) – 6 miles Booking Accommodations: –See F2F Logistics page on wiki for detailsF2F Logistics – Phone: – Rate: $169/night (excluding tax) This rate is only available through 5pm ET on April 2 Group rate includes free wireless in all guest rooms 12

F2F LOI Meeting Agenda

F2F Next Steps for Community Members Reserve guest rooms at Westin and make travel plans –On Wednesday, April 11 Workgroup Leads Meeting starts at 9:00am, All- Hands Kickoff Session starts at 1:00pm –Event concludes at 3:00pm on Friday, April 13 –Information on booking the hotel is available on the Logistics pageLogistics page F2F Registration is now open –Use the Registration page to indicate whether you are attending or notRegistration page –Registration form allows you to select which specific workgroup sessions you will attend F2F is entirely in person – no phones or WebExs will be provided. Notes will be taken during breakout sessions and posted to the wiki as soon as possible after sessions are over. You must register for the meeting sessions and book your room at the Westin by 5pm ET on Monday, April 2 14 For more information, visit the F2F Wiki or the F2F planning committee at Wiki

Next Steps Review Initiative Charter prior to 4/6 Work Group meeting (link)link Sign up for the S& Framework F2F by 4/2 (link)link The next LOI Work Group meeting will be held on April 6 from 1:00 – 2:00 PM EST 15