1. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Cross-Paradigm Interoperability Implementation Guide for Immunizations (“X Paradigm”) Common Information Model First Cut May 2012

2. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Project Scope “This implementation guide will explore the Service-Aware Interoperability Framework (SAIF) methodology to show how various HL7, IHE and OMG immunization-related artifacts can be deployed to satisfy immunization interoperability use cases. “ This presentation gives work so far on just the Common Information Model section

3. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Project Work Space Wiki http://hssp.wikispaces.com/Cross+Paradigm+I nteroperability+Implementation+Guide+for+Im munization Artefacts  Identified standards documents to use and found links  Download spreadsheet from wiki

4. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Common Information Model First pass  V2  IHE Immunization Content  Consolidated CDA After  Immunization DAM.  EHR FIM  POIZ  …

5. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Version 2 2.3.1 – since early 90s 2.5.1 – recent Very established in the U.S.  Meaningful Use standard Stage I

6. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Background of Immunization Content  First drafts included V2 messaging models  Mapped V2 data elements and NVAC elements to CareRecord and POIZ – see (outdated) wiki workspace  http://wiki.ihe.net/index.php?title=Immunization_Registry_Content &diff=20082&oldid=20081 http://wiki.ihe.net/index.php?title=Immunization_Registry_Content &diff=20082&oldid=20081  Convinced in public comment phase to go with XDS solution only – i.e. CDA model  4 Connectathons/Interoperability Showcases  Voted into Final Text

7. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. IHE Immunization Content Could no longer find our data elements! http://www.ihe.net/Technical_Framework/uploa d/IHE_PCC_Suppl_Immunization_Content_Re v2-2_TI_2011-09-09.pdf

8. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Understanding Templates

9. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Chasing the cascade of template IDs See spreadsheet at: http://hssp.wikispaces.com/Platform+Independ ent+Model+--+Common+Information+Model

10. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Consolidated CDA Formed to resolve many HL7/IHE templates involved in Transfer of Care Out-of-cycle ballot created to include MU Stage II NPRM elements PHER project to add immunization elements

11. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Consolidated CDA Templates  Continuity of Care Document (CCD)  Consultation Notes  Discharge Summary  Imaging Integration, and DICOM Diagnostic Imaging Reports  History and Physical  Operative Note  Progress Note  Procedure Note  Unstructured Documents Immunization Content/PH not included

12. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Templates and data elements See http://hssp.wikispaces.com/Platform+Independ ent+Model+--+Common+Information+Model

13. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Lessons So Far CDA is designed to promote semantic interoperability  ResponsibleParty example Promote inheritance Facilitate integration of patient information Their human-readable forms promote much easier access by non-technical users

14. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Lessons So Far CDA solutions are a very deep technical dive Template IDs are “magic numbers” and not easy to chase Without additional tools, their specifications do not facilitate easy access by non- technical domain expertise

15. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Returning to Common Information Model Need to determine model  RIM? Finish the cross-reference  Based upon templates and not individual data elements? Explore recent efforts  FHIR, Template registry, Green CDA, ??? Vet, vet, vet  Ideas?

16. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Need for implementation guide There a document specifically showing public health or other non-CDA experts how to interpret the immunization CDA-related specs is needed

17. © 2010 Health Level Seven ® International. All Rights Reserved. HL7 and Health Level Seven are registered trademarks of Health Level Seven International. Reg. U.S. TM Office. Discussion Track Patient Care projects and present to PC Track CDA R3 vs R2 Include NVAC data elements in list of artefacts  Old version? Look closely at use cases for what different players such as ACOs want out of them  AIRA functions Map EHR public health functions into EHR functions This project may inform FHIR and/or vice versa