PDMP & Health IT Integration All-Hands Meeting April 29 th, 2014

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 Artifacts 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 PDMP & HITI Standards and Harmonization Finalize UCR-Standards Crosswalk outcomes Introduce Gap Mitigation Plan 80 minutes Next Steps/Questions5 minutes

General Announcements… The Privacy Appendix has been added to the Use Case and has been posted to the wiki. – +Use+Cases 4

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PDMP & Health IT Integration Standards and Harmonization April 29 th, 2014

PDMP Harmonization Timeline MarchAprilMayJuneJuly 3/25 Harmonization Kick-off Standards Evaluation Candidate Standards List UCR-Standards Mapping Gap Mitigation Plan HITSC Evaluation Solution Planning IG Development Solution Plan Create IG Template IG Development End-to-end Review & Community Consensus (Today) 7/29 Harmonization Close

Harmonization Weekly Timeline Week Target Date (2014) All Hands WG Meeting Tasks Review & Comments from Community via Wiki page due following 12 noon 13/25 Harmonization Kick-Off & Process Overview Introduce: Overview of UCR-Standards Mapping Review: N/A 24/1Introduce: Candidate Standards List & UCR-Standards MappingReview: Candidate Standards List 34/8 Finalize: Candidate Standards List Review: UCR-Standards Mapping 44/15Review: UCR-Standards Mapping -4/22 Cancelled for National Rx Summit 54/29 Finalize: Outcome of UCR-Standards Mapping Introduce: Gap Mitigation Plan Review: Gap Mitigation Plan 65/6 Finalize: Gap Mitigation Plan Introduce: HITSC Evaluation Review: HITSC Evaluation 75/13 Finalize: Full Review of HITSC Evaluation, Total Ratings, List of Final Standards for Solution Plan Introduce: Solution Plan Review: Solution Plan 85/20Review: Solution Plan 95/27 Finalize: Solution Plan Introduce: Implementation Guide (IG) Template Review: Implementation Guide Template /3 – 7/8Review: Implementation Guide /15 – 7/22End-to-End Community Review of Implementation GuideEnd-to-End Review of Implementation Guide 187/29Consensus Vote

Summary of UCR-Crosswalk Outcomes The following slides provide a summary of the UCR-Crosswalk standards evaluations stemming from the 4/8 and 4/15 All Hands in addition to ad hoc working sessions held on 4/11, 4/14, 4/16, and 4/17. Partial (‘P’), No (‘N’), and Not Applicable (‘NA’) evaluations across all use case requirement sections were totaled for each standard to quantify identified gaps. Standards receiving a combination of more than 50% ‘NA’, ‘N’ or ’P’ ratings have been eliminated from the next phase of standards evaluation Standards receiving less than 33% ‘NA’, ‘N’ or ’P’ ratings have been deemed as strong candidates to carry forward for further analysis Standards receiving greater than 75% ‘P’ ratings have been deemed as “Partial” candidates to carry forward for further consideration. PDMP UCR Crosswalk Outcomes Legend Strong CandidateStandard meets majority of PDMP Use Case requirements and requires little to no modification. Partial CandidateStandard partially meets the majority of PDMP Use Case requirements but would require significant modification. Weak CandidateStandard does not meet the majority of PDMP Use Case requirements and/or is not applicable across many requirement categories. Requires excessive modifications and/or adaptations to fit the needs of the Use Case requirements.

Standard ReviewedOutcomeGap(s) [# of P's, N's, & N/A's] Keep (Y/N) HITSP/HL7 C32C32 is a medical summary document that supports some aspects but is not a broad solution for PDMP & HITI. 23 N NCPDP Telecommunications E.5Standard does not support transactions that would query and return back medication history but could be an excellent trigger to identify real-time medication being dispensed. 24 N ASAP Web ServicesStandard was developed specifically for the purpose of integrating PDMPs with Health IT systems and uses new Web service technology which is widely used and available. Further confirmation on authorized user component of the data elements needed. 3- localized to Data Elements requirements Y PMIX-NIEMPMIX is generally used for the PDMP-Hub or PDMP-PDMP transactions but could be extended. Further confirmation on authorized user component of the data elements needed. 3- localized to Data Elements requirements Y Consolidated CDA R2 - Clinical NotesCDA R2 Clinical Notes defines document templates with section and entry templates and contains required standard format for receiving patient summaries. However, there is no defined template for medication history or with detailed dispense info. C-CDA would require document management infrastructure such as IHE XCA and additions to data elements to address PDMP reporting values. Would require formation of a new document template and changes to PDMP systems. 23 N NCPDP ScriptSupports query-response for medication history within a standardized package format. Lacks some data elements across General, Authorized User, and Prescription Information categories. 4 - All specific to data elements Y ISO :2008 PDF 1.7PDF standard provides standard document framework but would require a completely new specification focused on PDMP. Does not provide for query-response transactions N/A or N ratings across all requirements N

Standard ReviewedOutcomeGap(s) [# of P's, N's, & N/A's] Keep (Y/N) HL7 V2.X ADT/Orders/QueryIncludes query/response mechanism that could be utilized to fit the need of the PDMP transactions. Orders can be used to send medications dispensed information and ADT enables information flow for discharge or treatment information for a POI. Authentication is not support and data elements would need to be vetted in detail to support the requirements. A specific implementation guide would need to be formalized to meet the full requirements N/A or P ratings across all requirements Y FHIRSet of flexible, RESTful resources that could be leverage for PDMP transactions. FHIR Containers specifications could be used for query and response but would have to be customized. Does not provide for authentication or transformation capabilities. Would require building data sets from scratch N/A or P ratings across all requirements Y RxNORMProvides broader code value identification procedure. Does not provide manufacturer information. Focus on drug and dosage. 8 - N/A or P ratings localized to Data Element requirements Y NDCNDC Code set widely used within pharmacy systems to identify detailed prescription information 8 - N/A or P ratings localized to Data Element requirements Y SNOMED CTFocused on providing code values for clinical documentation and not useful for conveying patient/prescriber-specific information N/A or P ratings across all requirements N ASAP Reporting Standard 4.2Reporting standard used by PMPs that carries all the data elements available in the response to a query. Not defined as a typical code value or terminology set; rather, a data elements set which defines necessary reporting values. 19 N/A ratings N Federal Medication TerminologiesCoordinated effort by federal government agencies to consolidate a set of terminology specific to various domains. 24 N/A ratings. N

Gap Mitigation Plan Review Note- Below artifact will be reviewed within the separate Gap Mitigation Plan document: I.Introduce Gap Mitigation Plan: 1.Review gaps and recommendations to close gaps for each standard 2.Determine feasibility of recommendations Click the icon to open the Excel file

Next Steps Review: Gap Mitigation Plan Next Meeting is Tuesday, May 6 from 12:00pm - 1:30pm ET Reminder: All PDMP & HIT Integration Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Harmonization materials, Use Case, Project Charter and general information will be posted on the PDMP Wiki page – +Homepage +Homepage

Contact Information – Initiative Coordinators: Johnathan Coleman Sherry Green – ONC Leads: Mera Choi Jennifer Frazier Helen Caton-Peters Helen.Caton- – SAMHSA Leads Jinhee Lee Kate Tipping – Support Team: Project Management: Jamie Parker Ali Khan Use Case Development: Ahsin Azim Presha Patel Standards Development Support Alex Lowitt Harmonization Support Divya Raghavachari Atanu Sen Vocabulary and Terminology Subject Matter Expert: Mark Roche For questions, please feel free to contact your support leads: