1. PDMP & Health IT Integration Use Case & Functional Requirements February 25, 2014 1

2. PDMP & HIT Integration Initiative Proposed Use Case & Functional Requirements Development Timeline Week Target Date (2014) All Hands WG Meeting Tasks Review & Comments from Community via Wiki page due following Monday @ 12 noon 11/7 Use Case Kick-Off & UC Process Overview Introduce: In/Out of Scope, Context Diagram and Scenario Concert Series Presentation: ASAP Review: In/Out of Scope, Assumptions, and Context Diagram 21/14 Review: In/Out of Scope, Context Diagram, Assumptions, Scenario Introduce: User Stories Review: User Stories, In/Out of Scope, Assumptions, and Context Diagram 31/21 Review: In/Out of Scope, Context Diagram, Assumptions, Scenario Introduce: User Stories Review: User Stories, In/Out of Scope, Assumptions, and Context Diagram 41/28 Review: Context Diagram and User Stories Introduce: Pre/Post Conditions, Actor and Roles Concert Series Presentation: OneHealthPort & WADOH Review: Pre/Post Conditions, Actors and Roles, and User Stories 52/4 Review: Context Diagram and User Stories Introduce: Pre/Post Conditions, Actor and Roles Review: Pre/Post Conditions, Actors and Roles, and User Stories 62/11Review: Pre/Post Conditions, Actors and Roles, and User Stories 72/21 Review: User Stories, Post Conditions, Actors and Roles, Activity Diagram and Base Flow Review: Activity Diagram and Base Flow 82/25 Review: Activity Diagrams, Base Flows, Functional Requirements and Sequence Diagrams Review: Functional Requirements and Sequence Diagrams 93/4 Review: Data Requirements and Risks & Issues Begin End-to-End Review End-to-End Review by community 103/11End-to-End Comments Review & dispositionEnd-to-End Review ends 113/18Finalize End-to-End Review Comments & Begin ConsensusBegin casting consensus vote 123/25Consensus Vote*Conclude consensus voting

3. Agenda 3 TopicTime Allotted General Announcements5 minutes 2/21 All Hands Recap5 minutes Finish reviewing Actors & Roles15 minutes Discuss Activity Diagrams, Base Flows, Functional Requirements and Sequence Diagrams 60 minutes Next Steps/Questions5 minutes

4. During our last All Hands Call we reviewed: 1.Use Case Scenarios 2.User Stories 3.Post-Conditions 4.Actors & Roles 2/21 All Hands Recap 4

5. Use Case Scenarios While it is understood that there are various workflows that can take place when a Healthcare Professional queries a PDMP (see full context diagram), for the purposes of this use case, we will be focusing on the transactions originating from the HIT to the next end point, which would be the PDMP, a Hub, or HIE/Pharmacy Intermediary Scenario #1 – HIT to In-State PDMP Scenario #2 – HIT to Hub Scenario #3 – HIT to HIE/Pharmacy Intermediary EHR or Pharmacy System Hub EHR or Pharmacy System HIE/ Pharmacy Intermediary 5

6. Scenario #1 – HIT to In-State PDMP User Story 1.1 – Legally authorized provider queries PDMP before writing a prescription for a PDMP reported controlled substance for a patient User Story 1.2 – Pharmacist queries PDMP prior to dispensing a PDMP reported controlled substance to a patient 6 1. Query is sent to State PDMP to obtain patient history of controlled substances dispensed 2. PDMP sends query response 1. Query is sent to State PDMP to obtain patient history of controlled substances dispensed 2. PDMP sends query response

7. Scenario #2 – HIT to Hub User Story 2.1 – Legally authorized provider queries PDMP through a hub before writing a prescription for a PDMP reported controlled substance for a patient User Story 2.2 – Pharmacist queries PDMP through a Hub prior to dispensing a PDMP reported controlled substance to a patient 7 1. Query is sent to a Hub to obtain patient history of controlled substances dispensed 2. Hub sends query response Hub 1. Query is sent to a Hub to obtain patient history of controlled substances dispensed 2. Hub sends query response Hub

8. Scenario #3 – HIT to HIE/Pharmacy Intermediary User Story 3.1 – Legally authorized provider queries PDMP through an HIE before writing a prescription for a PDMP reported controlled substance for a patient User Story 3.2 – Pharmacist queries PDMP through a Pharmacy Intermediary prior to dispensing a PDMP reported controlled substance to a patient 8 1. Query is sent to an HIE to obtain patient history of controlled substances dispensed 2. HIE sends query response HIE 1. Query is sent to a Pharmacy Intermediary to obtain patient history of controlled substances dispensed 2. Pharmacy Intermediary sends query response Pharmacy Intermediary

9. PDMP & HIT Integration – Pre/Post Conditions Pre-Conditions 1.The necessary access controls and authorization protocols based on State and/or Federal regulations (which could include patient consent or privacy permissions) for any of the systems or users described, are in place o The Health IT system application can provide necessary/required authorization, authentication or privacy information to the PDMP o The Health IT system can apply PDMP authorization requirements to restrict access to PDMP data to authorized users 2.If an intermediary, such as a Hub, is used it provides necessary technology infrastructure to allow PDMP data exchange from the PDMP to the Health IT system 3.Query parameters required to create the query in a standardized format by the Health IT system/Hub are recognized and accepted by the PDMP system 4.The PDMP system can provide a query response in a standardized format which is recognized and accepted by the Hub/Health IT system 5.Health IT System and PDMP have a common understanding of the shared vocabulary that are required to initiate the queries and provide the query results 6.In the event a request is parsed out to other states and the other states respond back, the Health IT system, Hub (if applicable) and PDMP systems will have knowledge about the order of succession to provide the response 7.Health IT System or Hub is able to determine which state PDMP(s) should receive the query 9 Post-Conditions 1.Health IT System has sent a query 2.PDMP system has received the query 3.PDMP system has sent a response to the Health IT system 4.Health IT system has successfully received the query results from the PDMP system 5.Health IT system can display/present query response

10. Agenda 10 TopicTime Allotted General Announcements5 minutes 2/21 All Hands Recap5 minutes Finish reviewing Actors & Roles15 minutes Discuss Activity Diagrams, Base Flows, Functional Requirements and Sequence Diagrams 60 minutes Next Steps/Questions5 minutes

11. Note- Below sections will be reviewed within the separate Use Case word document: Discuss and review the following sections: 1.Actors & Roles 2.Activity Diagrams and Base Flows 3.Functional Requirements 4.Sequence Diagrams Section Review 11 Click the icon to open the Word Document

12. Agenda 12 TopicTime Allotted General Announcements5 minutes 2/21 All Hands Recap5 minutes Finish reviewing Actors & Roles15 minutes Discuss Activity Diagrams, Base Flows, Functional Requirements and Sequence Diagrams 60 minutes Next Steps/Questions5 minutes

13. 1.0 Preface and Introduction 2.0 Initiative Overview –2.1 Initiative Challenge Statement** 3.0 Use Case Scope –3.1 Background** –3.2 In Scope –3.2 Out of Scope –3.3 Communities of Interest (Stakeholders)** 4.0 Value Statement** 5.0 Use Case Assumptions 6.0 Pre-Conditions 7.0 Post Conditions 8.0 Actors and Roles 9.0 Use Case Diagram Use Case Outline Tailored for each Initiative 10.0 Scenario: Workflow –10.1 User Story 1, 2, x, … –10.2 Activity Diagram o 10.2.1 Base Flow o 10.2.2 Alternate Flow (if needed) –10.3 Functional Requirements o 10.3.1 Information Interchange Requirements o 10.3.2 System Requirements –10.4 Sequence Diagram 11.0 Dataset Requirements 12.0 Risks, Issues and Obstacles Appendices –Privacy and Security Considerations –Related Use Cases –Previous Work Efforts –References ** Leverage content from Charter 13

14. Review of Key Use Case Sections Activity Diagram An Activity Diagram is a special form of a state transition diagram in which all or most of the states are activity states or action states The Activity Diagram illustrates the Use Case flows graphically, and represents the flow of events and information between the actors –It also displays the main events/actions that are required for the data exchange and the role of each system in supporting the change 14

15. Review of Key Use Case Sections Functional Requirements Functional Requirements identify the capabilities a system in a role must have in order to enable interoperable exchange of the healthcare data of interest –They provide a detailed breakdown of the requirements in terms of the intended functional behaviors of the application The Functional Requirements include: –Information Interchange Requirements –System Requirements The Information Interchange Requirements define the system’s name and role. They also specify the actions associated with the actual transport of content from the sending system to the receiving system System Requirements include the requirements internal to the system necessary to participate successfully in the transaction. System requirements may also detail a required workflow that is essential to the Use Case 15

16. A Sequence Diagram is primarily used to show the interactions between objects in the sequential order that they occur –This representation can make it easy to communicate how the exchange works by displaying how the different components interact –The primary use of the diagram is in the transition from requirements expressed as use cases to the next and more formal level of refinement Note: Horizontal lines are used to identify the specific activity between the systems Review of Key Use Case Sections Sequence Diagram 16

17. Agenda 17 TopicTime Allotted General Announcements5 minutes 2/21 All Hands Recap5 minutes Finish reviewing Actors & Roles15 minutes Discuss Activity Diagrams, Base Flows, Functional Requirements and Sequence Diagrams 60 minutes Next Steps/Questions5 minutes

18. Next Steps Review: Functional Requirements and Sequence Diagrams Next Meeting is March 4, 2014 from 12:00pm - 1:30pm EST Reminder: All PDMP & HIT Integration Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Use Case, Project Charter and general information will be posted on the PDMP Wiki page – http://wiki.siframework.org/PDMP+%26+Health+IT+Integration +Homepage http://wiki.siframework.org/PDMP+%26+Health+IT+Integration +Homepage 18

19. Contact Information For questions, please feel free to contact your support leads: – Initiative Coordinators: Johnathan Coleman jc@securityrs.comjc@securityrs.com Sherry Green sgreen@namsdl.orgsgreen@namsdl.org – ONC Leads: Mera Choi mera.choi@hhs.govmera.choi@hhs.gov Jennifer Frazier Jennifer.Frazier@hhs.govJennifer.Frazier@hhs.gov Helen Caton-Peters Helen.Caton-Peters@hhs.govHelen.Caton-Peters@hhs.gov – SAMHSA Leads Jinhee Lee Jinhee.Lee@samhsa.hhs.govJinhee.Lee@samhsa.hhs.gov Kate Tipping Kate.Tipping@samhsa.hhs.govKate.Tipping@samhsa.hhs.gov – Support Team: Project Management: – Jamie Parker jamie.parker@esacinc.comjamie.parker@esacinc.com – Ali Khan Ali.Khan@esacinc.com (Support)Ali.Khan@esacinc.com Use Case Development: – Ahsin Azim Ahsin.Azim@accenturefederal.comAhsin.Azim@accenturefederal.com – Presha Patel presha.patel@accenture.compresha.patel@accenture.com Vocabulary and Terminology Subject Matter Expert: – Mark Roche mrochemd@gmail.commrochemd@gmail.com 19