PDMP & HITI Gap Mitigation Analysis Summary May 6 th, 2014

Gap Mitigation Status Matrix Use Case Requirement Category Standards –Gaps Reviewed Standards CategoryInformation InterchangeSystemData Elements HL7 V2.X ADT / Orders / Query Content & Structure  HL7 FHIR Content & Structure  ASAP Content & Structure N/A  PMIX Content & Structure N/A  NCPDP SCRIPT Content & Structure N/A  RxNormTerminology & Code ValuesN/A NDCTerminology & Code ValuesN/A

Standard Reviewed Gap SummaryMitigation Summary Impact on Stakeholders Technical Feasibility Practical Feasibility Remove Standard? Content & Structure Standards HL7 V2.X ADT / Orders / Query Broad query response capabilities; not well defined for PDMP controlled medication history report. Does not address all necessary content. Supports the transmission of information, not the internal processes of creating the query. Does not perform authentication. PDMP-specific query response could be developed with moderate effort. PDMP-specific IG including data attributes would need to be developed. Structure would need to be developed to define standardized format, as well as develop mechanism to perform authentication. 1. PDMP: Moderate to High 2. HIT: Low YNY HL7 FHIR Container could function as request/response, but does not fit the needs for medication history of controlled substances. Portions of the container in query/response transactions would have to be customized to fit the needs of PDMP. New concept and draft process with limited knowledge resource as of now, thus requiring heavy modification and development of entirely new set of resources. 1. PDMP: High 2. HIT: Moderate to High NNY

Standard Reviewed Gap SummaryMitigation Summary Impact on Stakeholders Technical Feasibility Practical Feasibility Remove Standard? Content & Structure Standards ASAP Web Services No gaps identified for generation of query- response and structure of specified formatting, authentication, and packaging. Lacks only a few data elements specific to system or transaction identifiers, and information regarding authorized user – specifically: 1.Requester Routing ID 2.State of request 3.Requestor Location 4.Requested states 5.Authorized user credentials and information 6.Response ID 7.Message ID (response) Add required data elements to request and response categories. 1. PDMP: Low 2. HIT: Low YYN PMIX- NIEM No gaps identified for generation of query- response and structure of specified formatting, authentication, and packaging. Does not support all data elements required in UC within request transactions – specifically: 1.Requestor’s internal patient ID 2.State of Request 3.Requested state(s) 4.Authorized user credentials and information within payload 5.Request/routing ID 6.Summary of Response Modify to include required data elements within payload and/or container (metadata), where appropriate. 1. PDMP: Low 2. HIT: Moderate YYN

Standard Reviewed Gap SummaryMitigation Summary Impact on Stakeholders Technical Feasibility Practical Feasibility Remove Standard? Content & Structure Standards NCPDP SCRIPT No gaps identified for generation of query-response and structure of specified formatting, authentication, and packaging. Does not support all data elements required in UC for general request, authorized user request, and general response categories – specifically: 1.State of Request 2.Requestor’s internal patient ID 3.Requested state(s) 4.State of Response 5.Summary of Response 6.Role of Healthcare Professional Modification to derive requesting state either through SCRIPT or intermediary. Include Role within Authorized User credentials (could be overcome with use of DEA or license # - burden on registration process) Modification to derive responding state and summary through SCRIPT or intermediary. 1.PDMP: Moderate 2. HIT: Low YYN

Standard Reviewed Gap SummaryMitigation Summary Impact on Stakeholders Technical Feasibility Practical Feasibility Remove Standard? Terminology & Code Value Standards RxNorm No gaps identified across information interchange and system requirements. RxNorm required within EHR system – would have to translate NDC codes received by PDMPs or Intermediaries EHRs would have to bear burden of converting NDC codes to RxNorm terminology to present drug information 1. HIT: High 2. PDMP: N/A YYN NDC No gaps identified across information interchange and system requirements. N/A YYN