Data Access Framework (DAF) All Community Meeting August 28th, 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 of the Consensus Process (for Project Charter) 5 minutes Use Case Development40 minutes Next Steps/Questions5 Minutes 3

General Announcements We reached Consensus on the Project Charter We are launching the Use Case subwork group starting this Thursday (tomorrow) August 29 th, 2013 from 1-2 pm EST – Meeting details can be found on the DAF wiki homepage: 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 Technology Evaluations Technical Project Outline (11/14) Use Case 1 Consented 10/29 UC 1: Local Data Access : Intra- Organizational Query UC 2: Targeted Data Access : Inter- Organizational Query Discovery Define Use Case & Functional Requirements Implementation Standards Gap Analysis Use Case 2 Consented 11/29 Charter Review & Consensus Today 8/28 6 Local Data Access User Story SWG (8/29)

Project Charter consented!!!! We have successfully reached our first milestone: –Consensus on the Project Charter –Updating Charter with final comments received during consensus voting –Final charter and comments will be posted by August 30 th,

Local Data Access Framework (LDAF) Use Case August 28,

Today’s Agenda : 9 Discussion TopicEstimated Time Review Revised Local Data Access Scenario & Context Diagram 8 minutes Review and Discussion In and Out of Scope Items Assumptions 20 minutes Introduce Sample LDAF User Stories & SWG15 minutes Next Steps2 Minutes

Data Access Framework Local Access via Intra-Organization Query Targeted Access via Inter-Organization Query Multiple Data Source Access via Distributed Query (Query Health) – Completed Initiative Standards based approach to enable access at all levels: Local, Targeted, and Distributed Create and disseminate queries internal to organization Query Structure Layer APIs Receive standardized responses Query Results Layer Create and disseminate queries internal to organization Query Structure Layer APIs Receive standardized responses Query Results Layer Create and disseminate queries to external organization Query Structure Layer Transport Layer Authentication/Authorization Layer Receive standardized responses from external orgs Query Results Layer Create and disseminate queries to external organization Query Structure Layer Transport Layer Authentication/Authorization Layer Receive standardized responses from external orgs Query Results Layer Create and disseminate queries to multiple orgs Governed by a network Receive aggregated or de-identified responses Focus on Information Model for the network and leverage standards from earlier phases. Create and disseminate queries to multiple orgs Governed by a network Receive aggregated or de-identified responses Focus on Information Model for the network and leverage standards from earlier phases. Data Source Data Source Data Source Query Request Query Response Organization X Organization Y 10 DAF Scope – Current focus: Local Data Access Note: An organization can be a hospital that is part of larger organization and can also include HIEs, RIOs, other types of organizations etc.

Generic Scenario Example: A business user uses a query requesting application to access data from a query responding application within the same local Health IT system. The query responding application gathers the appropriate requested data and returns in the requested format to the query requesting application. DAF - Local Data Access Workstream via Intra-Organizational Query Local Data Access Workstream Health Organization Local Health IT System 1. Sends: Data Query 2. Receives: Patient(s) Data or Document Query Requesting Application Query Responding Application 11 Requested information returned LDAF Scope Pre-Step: Local Provider Enters Query API

Proposed Use Case Development Timeline 12 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: Base Flow, Activity Diagram Review: User Stories, Pre/Post Conditions, Base Flow and Activity Diagram 59/11Functional Requirements Finalize: User Stories, Base Flow, Activity Diagram Review: Functional Requirements 69/18 Functional Requirements, Sequence Diagram Review: Functional Requirements, Sequence Diagram 79/25Data Requirements Finalize: Functional Requirements, Sequence Diagram Review: Data Requirements 810/2Data RequirementsFinalize: Data RequirementsReview: Data Requirements 910/9Full Review & Finalize Data RequirementsEnd-to-End Review (10/9-10/16) 1010/16End-to-End Review (10/9-10/16) End-to-End Review comments due 10/ /23Consensus Review (10/17-10/22)Cast consensus vote FINAL CONSENSUS (10/23)

Local Data Access Use Case Section Review Review the Local Data Access Framework: –In Scope (continue review from last week) –Out of Scope –Assumptions 2. Begin discussing Local Data Access draft User Stories 3. Introduce Pre and Post Conditions

SWG Goals & Objectives 14 Goal: 1.The goal of the Local Data Access User Story sub workgroup is to develop and prioritize real world examples best capturing the need for local data access. Objectives: 1.Identify and prioritize user stories to support LDAF 2.Present final and selected user stories to the larger DAF community

Week 1 - Thursday August 29 th, 2013: Review User Story content on DAF Wiki page; potentially identify new user stories Week 2 - Thursday September 5 th, 2013: Review updated/new User Stories and prioritize for inclusion in LDAF Week 3 - –Wednesday September 11 th, 2013: Present recommendations to the larger DAF community during All Hands –Thursday September 12 th, 2013: Incorporate community feedback Week 4 Wednesday September 18 th, 2013: Present final recommendations on select User Stories to the community DAF User Story SWG Schedule 15 Call for Participation sent on 8/27

User Story 1: Analytics Scenario where a primary care physician (PCP) is using Analytics Tool to access data in order to understand severity of illness in patient population within organization A primary care physician has a patient panel with a significant number of patients with cardiovascular disease and diabetes. She would like to use an analytics tool to break down cohorts of patients with mild, moderate, and severe disease, to determine who is missing recommended preventive and disease management services such as lab checks and diabetic foot exams, and highlight within these cohorts who has the most rapidly progressive disease over the past 5 years. She will also use the analytics on patients missing preventive and disease management services and those with the most rapidly progressive disease to allocate high priority clinic appointments. To run her third party software analysis tool (a function that is not currently provided in her EHR or exists but does not sufficiently meet her needs with respect to the types of questions she can design and ask), she needs to identify her diabetic and cardiovascular disease patients over the past 5 years, and retrieve the data that is relevant to the care these patients received. This includes data such as patient age, sex, weight, blood pressure, diagnoses, and dates of lab tests such as Hemoglobin A1c, lipid panels, etc. for each patient during that time period. The primary care physician envisions using DAF to access the required data for all patients using standards so that it enables the use of the third party analytics application. The use of DAF and its related standards will help individual and small practice providers to avoid custom solutions and its related costs. LDAF Sample User Story (Author - Rebecca Coelius, MD) Wiki Page

Next Steps Join us for the Local Data Access User Story Sub Workgroup call tomorrow August 29 th, 2013 from 1:00 PM-2:00 PM (EST) Attend our next session on Wednesday 09/04 at 12:00 PM EST to discuss... Defining Actors and Roles Local Data Access User Stories 17

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 18

Questions 19

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 22

Some Previous and Ongoing S&I Use Cases (not a complete list) 23 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