1. Laboratory Pilots/Deployment June 26, 2012 1

2. Participants Coordination of Effort Validation Suite Vocabulary Group Implementation Guide Analysis LRI/LOI/eDOS Workgroups Support Team 2 Pilot I Project Participants Atlas Development CAP Halfpenny Technologies KHIE LabLynx Pilot II Project Participants Conversations Lab System and EHR Vendor (2) Lab System Vendor (2) EHR Vendor (3) Commercial Laboratories (2) Provider Based Commercial Labs (3) Production/Deployment Project Participants Allscripts (EHR) Athenahealth (EHR) Cerner (EHR/LIS/HIE) OPTUMInsight (HIE/EHR) RML (LIS) LabCorp (LIS) Halfpenny Technologies (Integrator)

3. Agenda Updates on Laboratory Activity 1.LRI – DSTU comment review 2.LOI – Status 3.eDOS – Status 4.Validation Suite update 5.Vocabulary Workgroup update 6.Next Steps 3

4. LRI Finishing response to DSTU comments Expected completion next couple of weeks Need feedback from Pilots WG regarding: –length/conformance length –1.7.3 re “snapshot” –TQ1/TQ2 RE/O 4

5. LOI / eDOS Status 5 LOI Charter complete Use Case Consensus Review Alignment in process Vocabulary work in process eDOS Charter / Use Case status

6. Laboratory Pilots Community Options for Piloting 6 Option One: Individual Initiative Pilots aka Pilots I Point of Contact: Bob Dieterle Details: Participants will pilot LRI LRI LOI eDOS LRI LOI eDOS Option Three: eDOS Only Pilots Point of Contact: Freida Hall Details: Participants will pilot eDOS eDOS Option Two: “Pilots II” Point of Contact: Bob Dieterle & Freida Hall Details: Participants will pilot LRI AND LOI with the option to additionally pilot eDOS LRI LOI

7. Validation Suite LRI DSTU update to be completed by July 7 th. LRI to be published to Federal Register by July 15 th Validation Suite Incorporation of updated DSTU LRI by end of July Coordination of effort with Public Health Initial meeting TBD Review LRI validation suite and applicable test list Solicit help from participants 7

8. NIST Validation Suite Considerations Reporting Scenarios 1)Preliminary Report 2)Partial Report 3)Final Report 4)Cumulative Report (for recurring draws?) 5)Corrected Report / Amended Report 6)Cancel due to ………….. (e.g. specimen quality) 7)Error conditions (e.g. R, RE, C,CE misuse invalid syntax) 8)Reflex Testing 9)Add-on Tests/results 10)Addenda Report (is this a valid HL7 report type/status? 8 Test Types 1)Single numeric result with reference rangeA1 2) Single alpha result from limited response list (e.g. Positive, Negative, …)A2 3)Panel testing with combinations of 1) and 2)A1&A2 4)Textual ResultsA4 5)PDF as payloadA4 6)Textual with tabular dataA4 7)Combinations of 1) and 2) e.g. susceptibility MIC and InterpA3 Errata 1)NTE 2)PID text 3)Multiple OBR 4)Addon 5)Multiple OBR 6)Additional OBX 7)Reflex testing 8)Multiple OBR 9)Additional OBX 10)Add OBX for specific result types from order (e.g. total urine volume) 11)Multiple testing locations 12)Non-standard abnormal flags

9. Interaction between Pilots and S&I Provide feedback on any implementation, deployment, support issues with IGs Provide feedback on any implementation, deployment, support suggestions to improve adoption/use of the IG by other entities. Provide feedback on any Validation Suite gaps, issues and additional requirements During initial production deployment, participants are strongly encouraged to report scope of use of IG compliant interfaces (e.g. options supported, tests, LOINC codes utilized, SNOMED CT codes used, UCUM used 9

10. Needed from all participants Testers and feedback for current version of Validation Suite tool http://lri.sipilotdevelopment.org/lri-dstu/ Volunteers for 1-on-1 WebEx testing –Especially EHR systems –Validation Suite for reconciled DSTU version to be ready end of July 2012

11. Ecosystem  Each participant will propose a complete ecosystem for reference implementation purposes  The recommended ecosystem should consist of a laboratory, LIS/interface vendor (may be in-house effort), provider organization, and EHR vendor  To the extent third parties integrators are required to create and/or support the reference implementation, they will be considered part of the proposed ecosystem  If participants are unable to assemble the entire ecosystem, Laboratory Pilot/Deployment leadership will assist in making introductions where possible 11

12. Laboratory Results Interface (LRI)  Each participant shall develop/implement and test a production or pre-production interface compliant with the Draft Standard for Trial Use (DSTU) version of the LRI IG for the exchange of laboratory results between the LIS and EHR.  Utilize the online validation suite to test all supported use cases applicable to the specific ecosystem.  Each laboratory/LIS and EHR should participate in an S&I Laboratory Pilot coordinated virtual interoperability forum to be established among the Laboratory Pilot II participants.  The resulting pre-productions LRI implementations are expected to be taken to production use by the end of 2012 and where possible rolled out to additional implementations in early 2013. 12

13. Next Steps / Questions Next Steps Continue recruiting Production/Deployment participants Work with Public Health on expanded scenarios for validation suite Establish ecosystems for production/deployment Ask for help if need partner Schedule Calls for coordination every other week at same time next call 7/10 Continue work with Validation Suite Continue participation in LOI and compendium effort based on LOI calendar For questions, please feel free to contact Bob Dieterle: rdieterle@enablecare.usrdieterle@enablecare.us 13