1. Health eDecisions RI/ Pilots Sub-Workgroup February 25th, 2013 10/11/20111

2. Agenda Announcements Review of Goals Review of RI/Pilot Sub-WG Timeline Pilot project presentations Wolters Kluwer ZynxHealth Medexter? Questions and Answers Review Action Items, Next Steps

3. Announcements We will be continuing our work … Next meeting March 11th, 2013 (plan for a 90 minute meeting) We will wrap up presentation of Project Plans The March 4 th meeting is canceled due to HIMSS 10/11/20113

4. Pilots 10/11/20114 OrganizationPilot LeadEmailOrganization’s Role Wolters Kluwer HealthSue Johnson/Steve Claypool/Howard Strasberg/Christy May sjohnson@uptodate.com steve.claypool@wolterskluwer.com howard.strasberg@wolterskluwer.com christy.may@wolterskluwer.com Service Supplier/Artifact Supplier OpenCDSDavid Shieldsdavid.shields@opencds.orgService Supplier Zynx Health Claude Nanjo (primary) Bernadette Minton Victor Lee CNanjo@zynx.comCNanjo@zynx.com (primary) bminton@zynx.com bminton@zynx.com VLee@zynx.com Service Supplier/Artifact Supplier Medexter Healthcare Klaus-Peter Adlassnig Karsten Fehre kpa@medexter.com kf@medexter.com Service Supplier ElsevierJonathan Teichj.teich@elsevier.comService Supplier newMentor Julie Scherer Matt Pfeffer jscherer@newmentor.com mpfeffer@newmentor.com Service Supplier/Artifact Supplier CDC Hilary Wall Kate Shaw Nikolay Lipskiy hwall@cdc.gov kmshaw@cdc.gov dgz1@cdc.gov Government /Service Supplier/Artifact Supplier NextGen Dr. Sarah Corley Dr. Jeff Friedlin Gary Wietecha scorley@nextgen.comscorley@nextgen.com, jfriedlin@nextgen.com, jfriedlin@nextgen.com Gwietecha@nextgen.com EHR Vendor Practice Fusion Lauren Fifield Michael Poremba lfifield@practicefusion.com mporemba@practicefusion.com EHR Vendor AllScripts Douglas Gentile Robin Williams (primary) Douglas.Gentile@allscripts.com Robin.Williams3@allscripts.com Robin.Williams3@allscripts.com (primary) EHR Vendor

5. Support Team Support Team: Pilots Lead: Jamie Parker: jamie.parker@esacinc.comjamie.parker@esacinc.com Pilot Support: Christina Arenas: christina.arenas@esacinc.comchristina.arenas@esacinc.com Subject Matter Expert: Aziz Boxwala: aziz.boxwala@meliorix.comaziz.boxwala@meliorix.com Subject Matter Expert: Bryn Rhodes: bryn@veracitysolutions.combryn@veracitysolutions.com Use Case 1: Dave Shevlin: d.s.shevlin@accenturefederal.comd.s.shevlin@accenturefederal.com Harmonization: Cem Mangir: cmangir@deloitte.comcmangir@deloitte.com SDO Support: Anna Langhans: anna.langhans@accenture.comanna.langhans@accenture.com 10/11/20115

6. HeD Pilots Goal Goal The goal of this initiative is to produce and consume implementable CDS interventions. 1.Event Condition Action Rules (ECA Rules) 2.Order Sets 3.Documentation Templates Pilot Scope 1.Health eDecisions will apply defined aspects of the Implementation Guide in a real-world setting. 2.Modify the Implementation Guide to ensure it is usable 3.The real-world pilots evaluate not only the technology, standards and model (VMR), but also provide a test bed to evaluate the interaction of technology, implementation support, and operational infrastructure required to meet Health eDecisions use case 1 objectives at the stakeholder or organization levels.

7. Timeline 10/11/20117 Goal & Activities WeekDatesDeliverables Kickoff /Establish Goals & Partnerships: - Review HeD Initiative Goals - Review Piloting Process & Resources - Define Value Statement - Define HeD Pilot Goals & Success Metrics - Establish & Approve Pilots - Develop Pilot Briefs 1-2 (4wks) 1/07-2/25 (we missed 2 meetings in January pushing our Dates back) -Wiki Capturing Pilot Deliverables -Established Partnerships -Documented Value Statements and Success Metrics -Documented Pilot Briefs Pilot Configuration: - Establish Pilot Test Environment & Resources - Establish Pilot Implementation & Testing Process - Develop & Review Pilot Configuration 3-4 (2 wks.) 2/25-3/4 -Use Case is Updated with HL7 Comments (3/4) -Approved Pilot Briefs -Committed Pilot Resources -Documented & Reviewed Pilot Configuration Guide -Weekly Feedback on Use-Cases & IG Alignment Pilot Development : - Setup & Develop Pilot Prototypes - Review prototypes 5-10 (6 wks. or less depending on Pilot activity) 3/4 – 4/15 -Use Case is Updated with HL7 Comments (3/4) -Weekly Pilot Development Status Updates -Weekly Feedback on Use-Cases & IG Alignment -Updates to Pilot Configuration Guides Pilot Testing & Showcase : - Complete Testing - Prepare Solution Showcase 11-12 (2wks) 4/15-5/6-Weekly Pilot Testing Updates & KPIs -Showcase -Prepare for HL7 Pilot Wrap-up : - Develop Lessons Learned an ONC Feedback - Review Initiative Goal Alignment - Establish Next-Steps 13-14 (2 wks.) 5/13-5/29-Documented ONC Feedback - Next Steps Action Plan We are Here

8. Materials for Project Plans: Wiki Page: http://wiki.siframework.org/Health+eDecisions+Pilots Process: 1.Register as a “committed member” and attend Pilot Sub-WG calls. 2.Complete Pilot Project Documentation and present it to the Pilots Work Group –Think of this as “what do you intend to pilot” –See Pilots wiki for the document: http://wiki.siframework.org/Health+eDecisions+Pilots 3.Pilot RI/ Pilot implementation – Development, Testing. 4.Provide feedback to ONC and HeD All Hands Community Meeting –Select a community member to represent our work at these meetings.

9. Pilot Project Schedule As a reminder both NewMentor and OpenCDS presented their Pilot Project Plans to the team. (THANK YOU Julie and David) Project plans are viewable on our wiki at: http://wiki.siframework.org/Health+eDecisions+Pilots http://wiki.siframework.org/Health+eDecisions+Pilots February 25 th, 2013 1.Zynx 2.Wolters Kluwer 3.Medexter (?) 4.Anyone, anyone, anyone…. March 11 th meeting will be focused around Vendor engagement and how to best utilize individual project plans with the Vendor community 10/11/20119

10. Action Items & Next Steps Continue developing the Pilots Work Plans If you need help with this activity please contact: Jamie Parker (jamie.parker@esacinc.com)jamie.parker@esacinc.com Christina Arenas:(christina.arenas@esacinc.com )christina.arenas@esacinc.com Begin thinking about ways to connect Vendors, Content Producers and Content Supplier

11. Meeting Reminder Pilots Work stream meets (next meeting: March 11th, 2013) Every Monday 1-2:30 pm EDT See Wiki homepage for meeting details: http://wiki.siframework.org/Health+eDecisions+Homepage http://wiki.siframework.org/Health+eDecisions+Homepage 10/11/201111

12. Appendix A: Success Criteria NOTE: This is a work –in-progress we will need to re-evaluate this after Pilot Project Plans Discuss Pilot Success Criteria: Individual Criteria Initiative Criteria EHR Involvement - DONE Production (at least one of each artifact and consumption of those artifacts) –Addressed as part of the Pilot Project Plans (who will be doing which artifacts) Successful implementation of artifacts –EHR involvement »Validate artifact – perhaps Pilots focuses on this ? »Execute the artifact Cross initiative function »Potential Alignment with eDOC and esMD »SDC Alignment with MU 3 objective »10% knowledge based engine (align 402b) »ACTION ITEM: Review MU3 Criteria »Determine the delivery model we want to pilot External (i.e. cloud service) Assets are portable (can be run locally) Discuss this with the group 10/11/201112

13. Appendix B In Scope/Out of Scope 10/11/201113

14. Scope of Use Case 1 This Use Case defines the requirements to build a standard for the contents of CDS Knowledge artifacts. The use case focuses on the following artifact types: Event Condition Action (ECA) Rules, Order Sets, and Documentation Templates. To support this purpose the Use Case has one scenario: A CDS Knowledge Artifact Supplier makes computable CDS Knowledge Artifact available to CDS Artifact Integrator (From HeD Use Case: CDS Artifact Sharing) 10/11/201114

15. In Scope Standards to structure medical knowledge in a shareable and executable format for use in CDS In Scope Artifact Types (definitions for these artifact types can be found in Appendix A) –Event Condition Action Rules –Order Sets –Documentation Templates 10/11/201115

16. Out of Scope Tools: –Authoring tools, source “content” management. –Terminology server and mapping tools including management of concept coordination. –Semantic processing of text, including structured string processing and natural language processing. System Functions –Messaging Layer –Means of sharing –Security Authoring, creation and maintenance of clinical decision support knowledge Knowledge Repository Design Search and query mechanisms Implementation in systems User presentation, Transport layers Market factors: regulatory incentive/mandate, liability shield, IP shield (patent/licensing litigation), certification body, marketplace design, test procedures, FDA rules Clinical Decision Support Services (this will be covered in Use Case 2 CDS Guidance Services) CDS Content Development Activities, including the distribution and sharing of artifacts Context-Aware information retrieval (HL7 Information Button) – This will be covered in UC 2 (CDS Guidance) 10/11/201116

17. Pre and Post Conditions Pre-Conditions –CDS Artifact Supplier makes CDS artifacts available for search and consumption by CDS Artifact Integrators _ ACTION ITEMS (Clarify this –what is a precondition for this to be useful) –CDS Artifact integrator has the means to obtain the knowledge artifact from a CDS Repository (e.g. they have either browsed or queried the CDS Repository for available artifacts) –CDS Artifact Integrator Selects Artifacts of Interest to Use in their CDS System Post Conditions –The CDS Knowledge Artifact Supplier has sent the CDS Knowledge Artifact to the requesting CDS Artifact Integrator –CDS Artifact has been received by CDS Integrator and is available for processing –CDS Artifact is available for mapping, structural transformations and local adaptation –Strategy 10/11/2011 17 Decision: In the pilot activities we will not directly address these as part of our pilot. We will focus the pilot activities on those tasks which occur between the pre and post condition