1. S&I PUBLIC HEALTH REPORTING INITIATIVE: DEVELOPING OF A TEAMING APPROACH S&I Public Health Reporting Initiative Nikolay Lipskiy, MD, DrPH, Co-Lead September, 21 st, 2011

2. Background Goal of the initiative The goal of the S&I Public Health Reporting Initiative is to harmonize HIT standards and implementation guides for bi-directional interoperable communication between clinical care and public health entities for selected use cases. Approach I. Approach the creation of the implementation guide(s) so as to minimize unnecessary modification of EHRs and their certification by harmonizing with other ONC-certification criteria and other S&I Framework activities like the Transfer of Care (TOC) Initiative and others. II. Approach the creation of the implementation guide(s) in a way to maximize its future extensibility and re-usability to other public health reporting use cases. III. Minimize unnecessary impact on established MU Stage 1 public health reporting objectives while potentially simplifying such reporting in the future. IV. Enable bi-directional communication as needed for public health reporting use cases. V. Approach the creation of the implementation guide(s) so as to account for the needs of subsequent inter-jurisdictional communication (e.g. transfer of cases between jurisdictions and national notification requirements) and population-level reporting. VI. Facilitate future certification of public health information systems that are interoperable with ONC-certified EHRs.

3. Background. Examples of S&I Framework Teaming and Descriptions of Workgroups at Wiki

4. Purpose The LRI Pilots Workgroup will support the LIS and EHR community in integrating and demonstrating the toolset provided by the LRI Validation Suite to (1) validate the ability of LIS and EHR systems to send and receive LRI-compliant lab test messages and (2) to determine the extent of EHR compliance with the CLIA requirements. Scope The scope of the LRI Pilots will be to demonstrate at a production level the transport of LRI-compliant laboratory results from LISs to ambulatory EHRs. Objectives Short-Term1. Pilot testing of the LISs and EHRs that have agreed to implement the LRI IG specifications. 2. Pilot LIS and EHR systems may use the LRI Validation Suite 3. Build a list of potential Pilot participants 4. Capture best practices from existing Lab Pilots Long-Term1. Support ONC NHIN as they draft the MU Stage 2 requirements Background. Examples of S&I Framework Teaming and Descriptions of Workgroups at Wiki

5. Public Health Reporting * Adapted from the ONC S&I Standards Development Support page at: http://wiki.siframework.org/Standards+Development+Supporthttp://wiki.siframework.org/Standards+Development+Support S&I Public Health Reporting Activity: Team Engagement Concept* The diagram above depicts the inter-relationships of the S&I Framework functions, from a teaming perspective. This diagram is developed based on the results of harmonization of standards across all steps in the S&I Framework, in parallel with the development of the implementation specifications.

6. The Information Exchange Package Documentation (IEPD) Artifacts* IEPDs contain both required and recommended artifacts Required : Bold Recommended : Italic Note: Best practices for most organizations include many of the optional artifacts listed here Business Process Use Cases Sequence Diagrams Business Rules Business Requirements Exchange Content Model Mapping Document Subset Schema Exchange Schema XML Wantlist Constraint Schema Extension Schema Main Document IEPD Catalog IEPD Metadata Sample XML Instances XML Stylesheets Scenario Planning Analyze Requirements Map & Model Build & Validate Assemble & Document Publish & Implement No required artifacts. Publish the IEPD to a repository and implement the exchange *Source: Doug Fridsma, at: http://www.google.com/url?sa=t&source=web&cd=1&sqi=2&ved=0CB8QFjAA&url=http%3A%2F%2Fhealthit.hhs.gov%2Fportal%2Fserver.pt%2Fdocument%2F947907 %2Fapplication_vnd_ms-powerpoint&rct=j&q=S%26I%20Governance&ei=oN94Tsf5C5TogQfI05nXDQ&usg=AFQjCNH-cviEuaqg4- bzMgPBD2r8mb02CQ&sig2=nQmnYGZ-Qf3jI8TqwmQNag

7. S&I Process for Documenting Workflow and Artifact Development (Artifacts, Roles and Controls)* Core artifacts are versioned and controlled Artifacts are “packaged” and released Each artifacts has a responsible role Artifacts and releases have prioritization and approval points, or “controls” * Source: Doug Fridsma, 09-28-10, at: http://www.google.com/url?sa=t&source=web&cd=3&sqi=2&ved=0CCoQFjAC&url=http%3A%2F%2Fhealthit.hhs.gov%2Fportal%2Fserver.pt%2Fgateway%2FPTARGS_0_0_7660_3080_20704_43%2F http%253B%2Fwci- pubcontent%2Fpublish%2Fonc%2Fpublic_communities%2F_content%2Ffiles%2Ffridsmapresentation_092810.ppt&rct=j&q=S%26I%20governance&ei=StZ4Tt2IO8nOgAfuvpHkDQ&usg=AFQjCNFCpiT 1b5mo5V_x9JzPLtOYey-iZQ&sig2=WDmEgWGygzCWlKNW3CKAng

8. Data Drill-Down Process* * Adopted from the ONC S&I Case Simplification Supplement at: http://wiki.siframework.org/file/view/ONC-SI-UC-Simplification-V1- Cover-20110715-Consensus.pdf PH Reporting Use Cases

9. Action Drill-Down Process* * Adopted from the ONC S&I Case Simplification Supplement at: http://wiki.siframework.org/file/view/ONC-SI-UC-Simplification-V1- Cover-20110715-Consensus.pdf PH Reporting Use Cases

10. Recent Public Health Reporting Documents (Examples)

11. Use Case Development & Functional Requirements Implementation Specifications Standards Development and Support Harmonization of Core Concepts Certification and Testing Pilot Demonstration Projects Reference Implementation Tools and Services (Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository, Testing Scripts, etc.) Architecture Refinement and Management 1. Use cases and functional requirements harmonization (UCR) 1. Use cases and functional requirements harmonization (UCR) Public Health reporting WGs 2. Vocabulary and Terminology harmonization (VT) 3. Reference Implementation /Architecture (RI&A) 4. Certification 5. S&I Knowledgebase (S&I KB) / S&I KB Portal 6. Policy/ Deployment (P&D) 6. Policy/ Deployment (P&D) Governance Body Potential S&I Public Health Reporting Activity Workgroups

12. Categories of Potential DeliverablesPotential Workgroups/Activities 1. Landscape of existing PH reporting scenarios, terminology and business process 1. Use cases and functional requirements harmonization 2.Vocabulary and terminology harmonization 5. S&I Knowledgebase/Tools (PHIN) 6. Policy/Deployment 2. An implementation guide for most important use cases and reference implementation (potential testing process, validation tools, etc.). 2.Vocabulary and terminology harmonization 3. Reference Implementation (Testing)/Architecture, 5. S&I Knowledgebase (S&I KB)/ S&I KB Portal 6.Policy/Deployment 3. Vision on a certification of public health systems (purpose, criteria, potential certification entities and process, validation tools, etc.) 4. Certification, 5. S&I Knowledgebase (S&I KB)/ S&I KB Portal 6. Policy/Deployment Matrix of Potential Deliverables/Workgroups

13. Workgroup Name PurposeScopeObjectives 1. Use cases and functional requirements harmonization (UCR) 2. Vocabulary and terminology harmonization 3. Reference Implementation (Testing)/Architecture 4. Certification 5. S&I Knowledgebase (S&I KB)/ S&I KB Portal 6. Policy/Deployment Workgroups: Purpose, Scope and Objectives

14. Call for Participation Please, submit your participation information through the S&I Public Health Reporting activity website at: http://wiki.siframework.org/Public+Health+Reporting+Initiative