1. electronic Long-Term Services & Supports (eLTSS) Initiative All-Hands Workgroup Meeting August 27, 2015 1

2. Meeting Etiquette Remember: If you are not speaking, please keep your phone on mute Do not put your phone on hold. If you need to take a call, hang up and dial in again when finished with your other call o Hold = Elevator Music = frustrated speakers and participants This meeting is being recorded o Another reason to keep your phone on mute when not speaking Use the “Chat” feature for questions, comments and items you would like the moderator or other participants to know. o Send comments to All Panelists so they can be addressed publically in the chat, or discussed in the meeting (as appropriate). o Please DO NOT use the Q&A—only the presenter sees Q&A, not necessarily the person facilitating the discussion From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute All Panelists 2

3. 3 Agenda TopicPresenterTimeframe Welcome Announcements eLTSS Roadmap Lynette Elliott10 mins eLTSS Wiki Updates and Walk-ThroughLynette Elliott10 mins eLTSS Pilot Guidance: Standards 101Grant Kovich40 mins

4. Announcements Accessibility & Usability in Health Information Technology (HIT): User-Driven Research and Actionable Strategies Responsive to People with Disabilities, Older Adults, and Caregivers – What: This two-day event will explore the advancement of the accessible HIT agenda from a compliance-focused paradigm toward one that is user-driven and responsive to human- centered experiences and contributes to improved health and wellness for individual disabilities, older adults, and caregivers. – When: Thursday and Friday, September 17 - 18, 2015 – Where: U.S. Department of Education, Potomac Center Plaza, 10th Floor Auditorium, 550 12th Street SW Washington, D.C. – To register: http://icdr.acl.gov/AHIT/index.htmlhttp://icdr.acl.gov/AHIT/index.html NOTE: Space is limited. Please register right away. 4

5. Announcements, cont’d… National Association of States United for Aging and Disabilities (NASUAD) “National Home and Community Based Services (HCBS) Conference” – What: The conference always sees a strong presence from U.S. Health and Human Services ranging from the Administration for Community Living including AoA, Office of Disability and IADD to CMS, HRSA, SAMHSA, Office of Developmental Disabilities, and other federal agencies. – When: August 31 – September 3, 2015 (Note: eLTSS and S&I specific workshops are Sept. 2 from 4:30-5:30pm ET) – Where: Washington Hilton ~ Washington, D.C. – To register: https://www.hcbsconference.org/ehome/index.php?eventid=1 13072& https://www.hcbsconference.org/ehome/index.php?eventid=1 13072& 5

6. Announcements, cont’d… mHealth Summit – What: The 2015 mHealth Summit explores what is new in mobile, telehealth and connected health—from the impact on healthcare delivery, clinical care and patient/consumer engagement to new technologies, research, investment activities, policy and shifts in the business environment. – When: December 8 – December 11, 2015 – Where: Gaylord National Resort and Convention Center ~ Washington, D.C. – To register: http://www.mhealthsummit.org/registrationhttp://www.mhealthsummit.org/registration 6

7. eLTSS Initiative Timeline 7 Phase 1 Pilots & Testing … Pilot Guide Development Use Case & Functional Requirements Pre-Discovery DEC 14JUNJAN FEBMAYJULAUGSEPOCTNOV Kick Off 11/06/14 Evaluation... Content Work Stream Content Work Stream eLTSS All-Hands Work Group Use Case 1. eLTSS Use Case eLTSS Plan Content SWG 1.eLTSS Plan Domains & Data Elements Pilot Guide Development 1.Candidate Standards & Technologies 2.Three-tiered implementation Approach 3.Functional Requirements Matrix 4.Pilot Guide (Phase 1) MARAPRDEC 15JAN 16 Pilot Execution

8. Goals for the eLTSS Initiative Identify key assessment domains and associated data elements to include in an electronic Long-term Services & Supports (eLTSS) plan Create a structured, longitudinal, person-centered eLTSS plan that can be exchanged electronically across and between community-based information systems, clinical care systems and personal health record systems. 8

9. eLTSS Artifacts Final published Project Charter is located here: http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Charter http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Charter eLTSS Glossary posted here: http://wiki.siframework.org/eLTSS+Glossaryhttp://wiki.siframework.org/eLTSS+Glossary – The eLTSS Glossary is a working document containing eLTSS-relevant terms, abbreviations and definitions as defined by stakeholders – We are looking for your feedback and comments Discussion Thread available Submit any change requests via the Change Request Form located on the wiki Final published Use Case document is located here: – http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Use+Case 9

10. 10

11. eLTSS Wiki: Navigation 11

12. eLTSS Wiki: Navigation, cont’d. 12

13. eLTSS Wiki: Navigation, cont’d. 13

14. eLTSS Wiki: Functional Requirements and Pilot Guide Development Page http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Pilot+Guidance 14

15. eLTSS Wiki: Pilots Page http://wiki.siframework.org/electronic+Long- Term+Services+and+Supports+%28eLTSS%29+Pilots 15

16. 16

17. Pilot Guide Development Workflow Environmental Scan Conduct outreach to LTSS- related projects to research technical solutions in real-world implementations Engage technical resources to assist in development of Pilot Guide Create Candidate Technologies and Standards List Environmental Scan Spreadsheet Candidate Technologies and Standards List Three-Tiered Approach Develop tiered approach with engagement from community for piloting technical solutions Advance tiers progressively Map tiers to Technical framework within FRM Three-Tiered Implementation Approach Functional Requirements Matrix Present requirements via FRM Define details for transactions from user stories within the Use Case Map tiers to Technical framework within FRM Map exemplar technical solutions and standards to functional requirements Map Corresponding Initiative Requirements to functional requirements FRM Activities Output Pilot Guide

18. What is a Standard? 18 A standard is a technical “building block” that enables the construction and use of resources within information technology Standards help to establish and enable products and assist in the development of services and markets Standards are necessary to advance technical interactions and enable interoperability of data across various systems Standards are vetted through a Standards Development Organization (SDO) – Responsible for developing, coordinating, producing and publishing technical standards to address the needs of developers and adopters ONC has provided best available standards and implementation specifications through the 2015 Standards Interoperability Advisory http://www.healthit.gov/standards-advisory

19. Categories of Standards 19 Standards can be broken down into five distinct categories based on their purpose and proposed use:

20. Applicability to Functional Requirements Matrix Purpose: Identify whether technical solutions and standards support specific eLTSS functional requirements – Not a comprehensive list of all available technical solutions/standards Two categories of exemplar technical solutions and standards will be provided to the eLTSS Community via the eLTSS Pilot Guide – Concert Series Presentations: Products and associated technical frameworks/standards that were publically shared with the eLTSS Community as part of a Concert Series Presentation – Environmental Scan: Products and associated technical frameworks/standards found through independent research and vendor engagement through partnerships and industry conferences 20

21. Concert Series Presentations Purpose: organizations were invited to present on an existing project or initiative that is related to the eLTSS scope of work – Presentations provided technical guidance and potential solutions to inform the eLTSS Initiative functional requirements 21 Solution NameContact NameContact EmailPresentation Link FEi Systems (State of Maryland)Nish ThakkerNish.thakker@feisystems.comFEi Systems Concert Series Slides The Imagine ProjectDebra AlbertDebra.albert@dodd.ohio.govThe Imagine Project Concert Series Slides PeerPlaceEric Freyefrey@peerplace.comPeerPlace Concert Series Slides Care At HandDr. Andrey OstrovskyAndrey@careathand.comCare At Hand Concert Series Slides CORHIOKelly WilsonKelly.Wilson@state.co.usCORHIO Concert Series Slides Kno2Dane Meulerdmeuler@inofile.comKno2 Concert Series Slides Harmony Information SystemsJohn Byerjbyer@harmonyis.comHarmony Concert Series Slides Right Care NowDr. Susan Abendsabend@rightcarenowproject.orgRight Care Now Concert Series Slides

22. Environmental Scan 22 Candidate Technologies and Standards List Prior S&I Candidate Standards Lists Engagement with LTSS Providers and Vendors at Conferences Concert Series Presenters Purpose: Engage LTSS-based solution providers to understand technical framework and best practices for solution planning Casting very wide net; some products may be full-fledged or have a single LTSS element Extract technical framework, standards, and data models from solutions for Tiered Approach and Pilot Guide Vendors engaged include 3M, Accenture, The Advisory Board Company, and NTT Data among others

23. Functional Requirements Matrix Example 23 Use Case Activity Tier Exemplar Technical Solutions/Frameworks Exemplar Standards/Technologies Relevant SDOs/Vendors Vocab & Code Set Content & Structure Transport & Security Cross Category Create PlanTier II Kno2C-CDA; HL7v2.0 Direct; Equifax Level 3 Assurance; Two-Factor Authentication; SSL Microsoft AzureHL7; IETF; Microsoft (MS) 3M ClinTrac Care Planning Manager ICD-10; ISO 639-2; SNOMED-CT; CPT; HCPCS; CVX; LOINC; RxNorm SAP Crystal Reports; InterQual CDC; ISO; IHTSDO; CPT-4; CMS; LOINC; NIH; SAP; McKesson Example Activity and Exemplar Technical Solutions/Frameworks from FRM :

24. Next Steps Over the next few weeks, the eLTSS Internal Team will introduce the Exemplar Technical Solutions/Frameworks and associated Exemplar Standards These presentations will help to assist in the “matchmaking process” between committed vendors and TEFT states in preparation for the Pilots Phase If you are interested in piloting, please express your interest using the Pilot Interest Survey form: – http://wiki.siframework.org/electronic+Long+Term +Services+and+Supports+Pilot+Interest+Survey http://wiki.siframework.org/electronic+Long+Term +Services+and+Supports+Pilot+Interest+Survey 24

25. Comments/Discussion 25

26. eLTSS Initiative: Project Team Leads ONC Leadership – Mera Choi (mera.choi@hhs.gov)mera.choi@hhs.gov – Elizabeth Palena-Hall (elizabeth.palenahall@hhs.gov)elizabeth.palenahall@hhs.gov – Patricia Greim (Patricia.Greim@hhs.gov)Patricia.Greim@hhs.gov CMS Leadership – Kerry Lida (Kerry.Lida@cms.hhs.gov)Kerry.Lida@cms.hhs.gov Community Leadership – Andrey Ostrovsky (andrey@careathand.com)andrey@careathand.com – Mary Sowers (msowers@nasddds.org)msowers@nasddds.org – Terry O’Malley (tomalley@mgh.harvard.edu)tomalley@mgh.harvard.edu Initiative Coordinator – Evelyn Gallego-Haag (evelyn.gallego@siframework.org)evelyn.gallego@siframework.org Project Management – Lynette Elliott (lynette.elliott@esacinc.com)lynette.elliott@esacinc.com Use Case & Functional Requirements Development – Becky Angeles (becky.angeles@esacinc.com)becky.angeles@esacinc.com Pilot Guide Development – Grant Kovich (grant.kovich@accenture.com)grant.kovich@accenture.com – Atanu Sen (atanu.sen@accenture.com)atanu.sen@accenture.com Pilots Management – Jamie Parker (jamie.parker@esacinc.com)jamie.parker@esacinc.com Standards and Technologies Identification – Angelique Cortez (angelique.j.cortez@accenture.com)angelique.j.cortez@accenture.com 26