2. GCPR - Modeling Discussion September 1999 HL7 Meeting Atlanta, Georgia

3. Discussion Group Dr. Mike Lincoln - VA Dr. Tim Mayhew - IHS Dr. Terry Clark - VA Dr. Steve Brown - VA Mr. Steve Wagner - VA Mr. Marco Johnson - DoD Ms. Nancy Orvis - DoD Mr. Ken Rubin - VA/EDS Mr. John Leslie - Litton/PRC Capt Jim McCain - IHS

4. WHAT IS THE GCPR FRAMEWORK?

5. Materiau rudiments une, deaux, trois Request for Information Requisition de rancard Data elements 1, 2, 3, 5, 6, 7 Entropie Anforderung Datei funf, sechs, sieben GCPR Utility Service Concept

6. High-level Architecture Model

7. Data Management Model

8. Security Component zEnsure client/population information is available to authorized users only zGuiding legislation yFederal Privacy Act yHealth Insurance Portability and Accountability Act, 1996

9. Common Information Model/Data Representation zIdentify and model common data elements zMaximize use of established data standards zFacilitate collaborative development of additional standards by academic, industry and government agencies

10. Phase I - Development zDevelop and maintain Reference Information Model (RIM) for clinical information domains. y(ongoing activity) zDevelop heritage/legacy system interfaces y(agency unique activity, ongoing). zEstablish security standards and authorities. zDesign and develop the technical environment. zProof-of-Concept Testing. zPrototype Demonstration.

11. Phase I - Government Tasks/Responsibilities zModel Selection ySelect baseline information models yDocument adopted terminology models zModel Development yIdentify trigger/events and data elements by domain expert focus groups yProduce electronic format of model for hand-off zModel Maintenance yOngoing maintenance of information and terminology models zHeritage/Legacy System Interfaces zEstablish Common Security Standards yIdentify and document common policies and methods. yEnsure compliance with key regulations/laws.

12. 5 Months 7 Months Nov 99 - Mar 00 Apr 00 - Oct 00 6 Months Nov 00 - Mar 01 Apr 01 ………………………………… Model (4 Likely Partitions) Outpatient Encounter Notes Narrative Summaries Physical Exams Consult Tracking Framework Version 2 Build & Alpha V 2 Refine & Beta V 2 Deploy V 2 … May 00 - Oct 00 6 Months 5 Months Nov 00 - Mar 01 Apr 01 - Aug 01Sep 01... EXPECTED GCPR FRAMEWORK TIMELINE Model (6 Partitions ) Problem Lists Medication Profiles Allergies Imaging Results Immunizations Vital Signs Model (5 Partitions ) Person (MPI) Laboratory Patient Record Architecture Security Continuity of Care Framework Version 1 Build & Alpha V 1 Refine & Beta V 1 Deploy V 1 ……………… Draft for Discussion Only

13. GCPR Modeling Discussion

14. GCPR GRM zGRM Goals zBrief History zRole of HL7 zRole of other Standards Models zWhere we are

15. GCPR GRM -- The Present zStatus of the GRM zGaps in the model zIdentified collaboration opportunities with HL7

16. GRM -- The Future zGRM = Domain Model + Computational zCornerstone Deliverables yGRM Product Description Document yGRM Modeling Approach Document yGRM Utilization Guide(s) yHL7 Rules of Engagement Approach

17. GRM and HL7: Open Questions 1) When should we engage HL7? 2) How should we engage HL7? 3) What should be done informally vs formally? 4) Whom should be engaged? 5) When does the Govt SIG become involved?

18. GRM and HL7: Current CONOPS zRefine and extend the model ySecurity Example (RIM) yLanguage Example (RTM) zForward and backward harmonization zPropose extensions but continue working (e.g., cannot risk HL7 interdependency with project timelines) zRole of GRM Team and HL7

19. Symbiotic Outcomes (for GCPR) yAbility to leverage significant existing work (Utilization of RIM 3.0) yField-test HL7 Clinical Templates yTap into existing expertise and knowledgebase (for HL7) yRefine and contribute to areas of the RIM 3.0 model (i.e. security) yGained experience in applying the model both to large provider environment and via current technology yTerminology refinement and detail definition yCreation of HL7 Clinical Templates yGreater involvement in SIGS and Technical Committees Others?

20. Next Steps...