1. S&I Simplification Use Case Authoring Tool (UCAT) Introduction In collaboration with NIST and AHRQ 19 March 2013

2. S&I Simplification Cross Initiative Effort to… Compile and Distill Components from All S&I Initiatives –For easy reference, organization, comparison –13 Use Cases with 33 Multi-Step Scenarios –Initiatives: TOC, LCC, LRI, LOI, PD, esMD, QH, DS4P, PHRI, HeD Convey Uniform and Integrated Patterns of: –Patient Flow – with Patient as Actor –Provider (Work/Process) Flow – with Provider as Actor –Information Flow – including System as an Actor Show: –Event Steps with Actions taken – by Actors in Roles – to support individual health and provide healthcare –Health record entries resulting from Actions taken Show Commonalties, Patterns of Repetition/Re-Use –Both Current and Potential 19 March 2013Simplification/UCAT Intro2

3. Is it in Common? Is it Re-Usable? Is it Computable? 19 March 2013Simplification/UCAT Intro3 S&I Simplification Component Selection

4. Components selected from S&I Initiative Use Cases Is it…Potentially Computable for… In Common? Re-Usable? Computable? Identity Accountability Permission, Consent Access, Data Use Performance/ Fulfillment Capture, Provenance Content: Struct/Unstruct Coding, Classification Completeness Signature Audit RequirementsYYY Actors, RolesYYY Events, ActionsYYY  As standards-based software services Data Objects, Elements YYY  As standards-based data artifacts, messages, documents… S&I Simplification Component Selection 19 March 2013Simplification/UCAT Intro4

5. (LINK to Core Matrix Spreadsheet v2.4) Status – of S&I Initiative Analysis Key – Contents of All Tabs Assertions – Basis for Initial Requirements *Common Requirements *Common Actors *Scenarios, Events – w/Action examples *Common Actions *Common Data Objects * Re-usable Components 19 March 2013Simplification/UCAT Intro5 S&I Simplification Core Matrix

6. 19 March 2013Simplification/UCAT Intro6

7. (LINK to Progression Spreadsheet) To Date – S&I Simplification + AHRQ –Core Matrix w/USHIK Registry S&I Use Case Requirements Phase with Use Case Authoring Tool (UCAT) S&I Use Case Harmonization Phase with NIST –Standards Selection –Implementation Guide (Tools) –Testing (Tools) 19 March 2013Simplification/UCAT Intro7 S&I Simplification Progression

8. SourceContribution Use Case Authoring Tool (UCAT) Prototype Developed by: Art Griesser Prometheus Computing NIST Cross Industry Perspective, SmartGrid Project (2010) S&I Simplification Consensus Approved Core Simplification Matrix (.xlsx) S&I Use Case Requirements Template (.docx) S&I Lab Results Initiative (LRI) Consensus Approved LRI Use Case Requirements Template (.docx) HL7 EHR WG ISO/HL7 10781/16527, EHR/PHR System Functional Models AHRQ ISO 11179 USHIK Registry of S&I Simplification Components 19 March 2013Simplification/UCAT Intro8 S&I Simplification Ingredients – UCAT Prototype

9. S&I Simplification Use Case Hierarchy GenerallyUCAT Prototype – Example An Initiative…Lab Results Interface (LRI) Initiative Has one or more Use Cases… 1) Lab Results Interface With one or more Scenarios… 1) Send/Receive/View Test Results With one or more Events (Steps)… 1) Send2) Receive3) View With one or more Actions. (Simplification Examples) Identify Patient, Provider, Lab System Originate/Attest/Retain - Lab Results Report Verify - Lab Results Report Set Data Access Permissions  Transmit - Lab Results Report Identify (EHR) System  Receive/Retain - Lab Results Report Identify, Authenticate Provider Check User Data Access Permissions Access/View - Lab Results Report 19 March 2013Simplification/UCAT Intro9

10. S&I Simplification – Demonstration of Concept Use Case Tool Status Current Capabilities Imported Core Matrix Captured use case template structure –Populated completely for LRI Can construct new use cases from reusable components Can create human readable use cases (in UC template) Can curate underlying UC information Can use underlying info programmatically –SQL query Import: CSV –UCAT Native –Simplification Core Matrix –ISO/HL7 10781/16527 EHR/PHR System Functional Models Export: JSON, CSV Ability to clone Additional Capabilities Ability to track status of information –Component Lifecycle Management Next Steps Add remaining 14 S&I Use Cases –One-time manual entry –Resolving differences from template Refine existing master template USHIK integration CEDD integration Evaluate handoff to downstream tools –Implementation Guide, Testing… 19 March 2013Simplification/UCAT Intro10

11. Capture Once, Re-Use Many Times –Component + Standard + Imp Guide + Testing –Each Re-Use Instance = x 1 Savings –Facilitate Cross Agency –Facilitate S&I –Unlocking Value of S&I (maximizes re-use, return) Experience Shows: –AHIC/HITSP: 5 Years, 17 Use Cases (3+/yr) –S&I: 2 Years, 13 Use Cases (6+/yr) –Now w/UCAT: ? 19 March 2013Simplification/UCAT Intro11 S&I Simplification Benefits