Control/Query Meeting Minutes (Heading 1)



Working Group Meeting Minutes

Phoenix, Arizona

January 17 – 22, 2010

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Voting Item Summary

1. Commitment to providing R2 in a computable format

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Followup Items

1. Commitment to work on creating R2 in a computable form: Corey Spears

2. Behavioral Health Profile R2 additions: Robert Stegwee

3. Standards knowledge management tool = SKMT: Jim Kretz

4. Continued WIKI development: Pat Van Dyke; Scott Robertson

5. GForge demonstration at Work Group call: Ron Parker

6. Request to move Tuesday calls to 3:00pm Eastern (30 minutes earlier)

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Next Working Group Meeting

The next Working Group Meeting will be held in Rio de Janerio, Brazil, May 16-20, 2010.

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Working Group Meeting Attendance: See attachment immediately below for entire meeting attendance

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Quorum for next trimester: 6 members plus the presiding cochair

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Monday

January 18, 2010

Q1

Introductions

The Minutes of the September, 2009 meeting were accepted.

Overview of Week’s Work

1. Goals

a. Working toward EHR-S Functional Model Release 2

b. Identifying and providing assistance for special needs

2. Reminder to vote: CoChair Elections

a. Pat is re-running, Corey has chosen not to re-run

b. Voting is open until end of day today

c. Both Gary Dickinson and Helen Stevens Love expressed interest in being write in candidates and provided brief bio’s

3. Agenda Review

4. Project List Review

a. Helen volunteered to setup a WIKI for the EHR WG

b. The Payor linked function profile needs to be registered with NIST

c. Jim Kretz announced the availability of the ABT tool as being in the public domain

Monday

January 18, 2010

Q2

Agenda Item #1 ISO and HL7 Process (Audrey Dickerson)

Purpose: The ISO/HL7 process can be very confusing. The Work Group will be balloting R2 later this year as an ISO/HL7 ballot.

ISO/TC 215

HIMSS paid a fee to be the secretary

Chair: Christopher Chute MD

Past Chair: Yun Sik Kwak MD

Secretariat: ANSI

Membership

29 participating members; have voting rights

20 Observing members: no voting or comment submission except through a participating member

ISO Deliverables:

1. Technical Reports

Can be used as a white paper

Can have many uses

2. Technical Specification

Something must be done with it during a 6 year period in order to remain active.

3. Standards

Special Agreement with ISO for the Technical Committee level

1. Partner SDO (IEEE) completely 11073 documents are IEEE with special balloting privileges.

2. Vienna Agreement (ISO and CEN)

3. ISO agreements with SDOs (ASTM and OASIS)

Liaison Agreements

Project Stages (default path)

1. TC secretariat ballot work

2. Preliminary

3. Proposal

4. Preparatory ( is in technical committee ---getting ready for committee draft vote)

5. Committee – committee draft

Enquiry - DIS Ballot

Is a 5 month period

Mandatory German and French translations (France usually wants another 2 months extending to 7 months) France can decide not to translate

Approval - final draft international standard (2 month ballot. ) once something is sent for FDIS, there are no changes. They will correct a typo.

Additional SDO’s

SNOMed

CDISC

GS1 Healthcare (Supply chain; standards on identification and barcoding)

Action Item:

What: Develop the calendar considering ISO and HL7 balloting requirements for R2. Document/get agreement on all steps in the process.

Who: Don Mon, Ron Parker, Lenel James, Gary Dickinson

When: Meeting tonight at 1930 in the Gila Room.

Agenda Item #2 PHR and ISO (John Ritter)

• PHR White Paper: Issues Regarding the Consumer Alteration of Professionally-Sourced Data”

• Policy implications: “Should HL7 make recommendations on the proper use of their standards?”

• Proposed PHR Project Scope Statement: To move PHR-S FM DSTU forward as Normative Standard.

• Proposed PHR Project Scope Statement: To move it forward under the HL7-ISO Pilot Project.

• PHR-EHR Gap Analysis

• Are the Telemedicine / Telehealth use-cases supported?

• BoF (Monday) on “Clinical Genomics and Personalized Medicine”

o Ambassador Briefing of Clinical Genomics

o Family History, pedigree, genetic variation model, genetic makeup of the individual

o Family History

o Surgeon General’s tool

o Obstacles that exist in EHR systems

o CMET

o Lab data interchange

o Drugs tailored for an individual

o Charge: Think about how your country can prepare for Personalize Healthcare / Personalized Medicine

o Question/Invitation: Should we discuss this topic in more depth at the next WGM and at the Plenary?

• BoF (Tuesday) “Lessons Learned on PHR implementation in Arizona, USA”

• “Personal Health Records - Definition, scope, context and global variations of use” (ISO NWIP by Dipak Kalra and Gora Datta)

o Definition of PHRs

o Describe a pragmatic multi-axial classification of PHRs.

o Describes the possible ways in which the inclusion and engagement of individuals in managing their health and health care impacts on the potential roles of the PHR, including scenarios for collaborative care between individuals and healthcare organizations.

o Expose the landscape, rather than lock down the market.

Monday

January 18, 2010

Q3

Agenda Item #1 R2 Development (Don Mon)

Options to continue:

1. Continue on in weekly calls

2. Break off into groups and have this brought back to the group after an overview/update of what has happened up to now

Monday

January 18, 2010

Q4

Agenda Item #1: Tooling (Corey Spears)

Why do we need tooling:

1. Validate the standard (syntactically)

a. We have rules in place for conformance of our standard

2. Assist in authorship

a. Collaboration

b. Evaluation

3. Assist in publishing

a. Release of final standard

4. Assist in use of the standards (e.g. profiling)

a. Authorship, publishing, validation

b. Allow balloters to easily review ballot ( what is being proposed)

c. Review changes made since previous ballots/standards

d. Profiling - Allow user to create conformant profiles.

Discussion – what does the workgroup perceive as the needs:

1. Authorship

o To be able to access existing knowledge as one authors

o Validation is critical

o Add/delete/deprecate

o Add conformance criteria and functions

o Delete

o Version control

o Repository for access

o Synchronization of versions : centralized vs decentralized repository

2. Balloting

o Turning out a better balloting tools is needed for the membership

3. Publishing

o Concern that we don’t get too close to HL7 publishing

o Helen: concern that there is a disconnect between

the needs of this committee and publishing. This has not been well defined.

4. Profiling

o Hetty reports using the ABT software

o What does this tool allow?

Review list

Can vote, modify, propose changes to the criteria

Does it support validation?

Do you have to do data entry?

Metadata would be beneficial to have

o Also having the historical reference/decisions made at the time and why?

o Can put some reasons for changes into the Overview – not all are appropriate for the Overview –

o Richard: Institutional suffers amnesia

o Apart from the user interface too, is there a way to release our standard so that tools can be built on top of it?

Corey’s Prototype - demonstration

o R.1.1 is in XML and rendered etc

o Uses links to get to other parts of the record

o Statistics: errors. functions that do not match

o The demonstrated tool will work with the PHRS and EHRS FM as long as we keep the structures of the 2 models harmonized

o Would be helpful to show the base model, show what was extracted, keep the historical versioning from all previous e.g. R1 vs R 1.0 vs R1.1

o Review of tools readily available

o Can we reference other standards or profiles?

o Helen – would like both of the tools and the biggest downside is that the 2 tools function on different platforms.

o Lenel: XML work could be exported to ABT

o Helen: If ABT could import and export XML, that would make it a rigorous tool.

o Would ABT be willing to work with us on these features? Would HL7 pay for it?

***VOTING ITEM***

Motion was made to commit to creating R2 in a computable form such as

XML and release as part of the ballot with a schema

Motion was seconded.

Discussion:

The models/profiles would continue to be published in PDF and Word formats as well.

The time to put this into XML is about 20 human hours

Vote: Abstentions : 0

Opposed: 0

Passes: Unanimously

Volunteers to work on this: Helen, Lenel, Corey, Hetty

Timeframe and Next Steps

Timeline – be ready for R2 and will need to build this into our publishing time.

When we have a stable version of R2, then add that into the tool

The additional work on the XML tool could possibly the accomplished by middle of February

Pull the small group together right after this session

Agenda Item #2: Behavioral health Profile – The Netherlands Update for R2

Robert Stegwee provided an update on the progress of the Behavioral Health Profile. He will summarize key changes to the model that have proved important to their work.

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Decided to use the EHR-S FM as the reference model for Behavioral Health to deliver:

o Reference Model

o Strategy

o Communication plan

Tuesday

January 19, 2010

Q1

EHR Co-chair elections:

• Gary Dickinson: newly-elected co-chair

• Pat Van Dyke: re-elected

Agenda Item #1: Update on ISO Project from Q5 Monday (Lenel James)

• NWIP must be submitted soon. EHR-S FM Release 2 for 2011. EHR WG targets Out of cycle committee-level ballot June 2010, in time for 5-month DIS (Draft International Standard), plus HL7 Membership, ballot for October 2010, in time for January 2011 ballot cycle.

• The EHR WG will outreach aggressively to International HL7 Affiliates to gather input into EHR WG ballot Release 2.

Agenda Item #2: Interoperability Global Update (Gary Dickinson)

Review of the EHR Interoperability Wiki site. Artifacts are located at:



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• Global Interoperability Standards Projects:

▪ Joint Interoperability Council

▪ ISO TC215 – “Standards Convergence” Work Item

▪ ANSI HITSP – Simplification, Convergence of Capabilities

• EHR / PHR & System Level Interoperability

▪ EHRS Functional Model Release 2 – Incorporate Interoperability and Lifecycle Models

▪ Record Synchrony

▪ Records Management/Evidentiary Support

▪ Record Meta-Data

▪ HL7 Clinical Document Architecture Release 3

• Implementation Projects:

▪ HL7 Services-Aware Enterprise Architectural Framework (SAEAF)

Quality Reporting – 2011

Joint Initiative Council

• Submitted “Standards Convergence to Promote EHR Interoperability” as ISO TC215 New Work Item Proposal (NWIP) in October 2009 on recommendation from JIC co-chairs Don Newsham and Melvin Reynolds.

• Target: ISO Technical Specification (1st Stage Normative)

• Status:

▪ Presented to Work Groups 1 (Data Content) and 8 (EHR Requirements) at TC215 Meeting, 18-21 October, Durham, NC

▪ Accepted as Preliminary Work Item by full TC215 Plenary, per WG1 recommendation

The ANSI Health Information Standards Panel (HITSP) contract expires in January 2010, resulting in uncertainty regarding subsequent activities.

In Kyoto (May 2009) EHR WG agreed to incorporate EHR Interoperability and EHR Lifecycle Models into EHR System Functional Model Release 2.

HL7 EHR-S FM R2 Record Synchrony project (leads: Wes Knox, Pat Van Dyke)

RM-ES Profile to EHRS FM R2 project:

• Incorporate Records Management – Evidentiary Support Functional Profile into EHR-S Functional Model Release 2 (RM-ES Leads: Michelle Dougherty, Harry Rhodes, Reed Gelzer, MD)

Agenda Item #3: Interoperability & LifeCycle Modesl/R2 (Gary Dickinson)

It is suggested that chapters on interoperability be added to the R2 ‘Front Matter’ for reader understanding. Also reference the models as additional columns in the Function Chapters

Tuesday

January 19, 2010

Q2

Agenda Item #1: RMES Update and R2 (Michelle Dougherty)

• Update on the ONC-NPRM and CMS-IFR related to the RM-ES Functional Profile

The two goals of this project:

• Identify talking point for organizations to use in their response to the rules and also for HL7 policy committee to consider in their response.

• Identify gaps in the EHR-S FM Release 2 and current RM-ES profile and recommend how to address the gaps in functionality and conformance criteria

Agenda Item #2: R2 Development

Don Mon

• Don met with the Child Health Work Group (CHWG) this morning.

• The CHWG cannot wait until 2011 for the Joint ISO DIS and the HL7 ballot to finish.

• The CHWG would like to schedule a joint EHR WG (with PVD) conference call to offer CH Functional Profile insights.

• The CHWG would like to schedule a joint call with the Vital Records Work Group to offer CH Functional Profile insights.

• Roel Barelds volunteered to examine the Child Health Functional Profile and provide insights from Finland. Don Mon gave Roel CH WG contacts.

• CH is hoping to use the CH Functional Profile to pursue a HITECH Grant to help standardize CH in the USA.

Tuesday

January 19, 2010

Q3

Joint Meeting: EHR, SOA, PHER and Government Services

Agenda Item #1 Healthcare SOA Reference Architecture (aka EHR System Design Reference Model EHR-SD RM)

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Steve presented the DOD use of the EHRS- FM as a foundation for systems and as a part of a long range planning component.

HL7 “EHR SD RM” Project

“EHR System Design Reference Model”: Constructing a Future State EHR Reference Architecture from HL7 and HITSP Artifacts

• EHR Way Ahead Business Architecture

• Healthcare SOA Reference Architecture

• Enterprise Information Model

PROJECT DESCRIPTION: HL7 EHR System Design Reference Model (EHR SD RM) This project will mature the April 2008 Healthcare Services Oriented Reference Architecture (H-SOA-RA) version 1.0 into H-SOA-RA Version 2.0, for HL7 Architecture Review Board (ArB) consideration, and then integrate it into an EHR System Design Reference Model (EHR-SD RM), using the HL7 SOA-Aware Enterprise Architecture Framework (SAEAF), HITSP Multi-Enterprise Architecture of Networked Services Standards (MEANS), EHR System Functional Model (EHR-S FM). Emphasis will be placed on maintaining AHIC, HITSP, NHIN and CCHIT conformance by maintaining Information Exchange Requirements (IERs) and Data Requirements (DRs) traceability. Mapping and analysis of the HL7 product portfolio against the EHR-S FM will be used to integrate the reference architecture with HL7 product lines and initially mature the resulting model as a technical white papers, then an informative reference model and finally a standard reference model. An HSSP based prototype case study architectural specification will be built to validate the effort.

OBJECTIVE: A system agnostic Future State EHR Business Architecture (BA) specified with a lexicon, based upon HITSP’s data architecture, HL7’s System Functional Model (EHR-S FM) and HL7’s Reference Information Model (RIM).

• A Health IT EHR BA can be modeled as clinical stakeholder requirements and their workflow-orchestration of

▪ HL7 RIM compliant HITSP data modules manipulated by

▪ HL7 EHR-S FM functions.

• An EHR Information Model, for a project or enterprise, can be constructed from the HITSP data models managed by the EHR Functions used within the EHR BA, categorized using the HL7 RIM Entity, Role and Action foundation classes.

Value Proposition of Standards Based Approach:

• Analysis Pre-Done: Analysts from throughout industry have vetted and contributed to the development of thorough specifications

• Less Customization: COTS vendors are already building applications to meet these specifications.

• Comprehensive View: Standards provide a way to ensure that requirements and design address all of the necessary issues

• Lack of unexpected dependencies late in project: All functions and specifications have been pre-analyzed and defined

• Better Interoperability: Standards based approaches will ensure development between all stakeholders are able to communicate at the project and technical level

• Across Project Visibility: Normalized requirements and design would allow for “apples to apples” comparison across the portfolio

Cost Effectiveness Proposition:

• Target cost function of healthcare IT connectivity:

▪ # of service consumers * # of services

Point to Point Messaging Economics:

• Approximately 75 U.S. Immunization Information Systems (IISs)

• Completely connected point-to-point IIS network: 74 * 75 / 2 = 2775 connections

• Assume 200 regional provider EHRs per IIS:

200 * 75 = 15,000 connections

• Each connection costs $10K-$30K per side

• $40K each * 17,775 =$711,000,000

How to Solve? How about using:

• Bus architecture

• Plug-and-play connections

• Common information model

• 75 IISs each accessing one service

• 15,000 EHRs, 500 products @ 30 installations ea = 500 connections

• Cost @$20K is per service consumer only

• $20K * (500 + 75) =$11,500,000

+ cost of carrier

• Drive down the $20K

HL7 EHR-S Functional Architecture /Services Analysis

63 Lines of Business were identified (e.g., “Primary Care”)

Tuesday

January 19, 2010

Q4

Agenda Item #1 Ambulatory Oncology Profile (Helen Stevens Love/Charlie Mead)

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caEHR Project Background

National Cancer Institute (NCI) is developing an EHR for use in the ambulatory oncology environment (caEHR).

This is the highest trajectory project in at the NCI right now.

90-95% of people who have cancer and are treated in the USA are treated through NCI.





NCI Goals of the caEHR Project

1. Utilize all relevant content from the HL7 EHR-S FM 1.1 and Release 2

a. Validate by caEHR stakeholders

2. Utilize all relevant content for HL7 EHR Interoperability Model

3. Contribute additional requirements to EHR WG for consideration in EHR-S FM R2 (including abstraction from ambulatory oncology context to more general EHR context).

4. Conformance criteria that are testable within the profile. Tighten this profile up beyond that seen in any other profile.

Some of the EHR-S FM requirements met the needs of ambulatory oncology, but needed more commentary.

Agenda Item #2 R2 Development (all)

Continued R2 discussion/development.

Wednesday

January 20, 2010

Q1

Joint Meeting with Security, Structured Documents and EHR

Agenda Item #1: Vocabulary Alignment (Heather Grain)

The EHR WG continues to identify terms or terms that infer additional terms. Where do these fit in the broader scheme of things especially as we move into the international space. Thank you to Richard Dixon-Hughes for arranging this presentation.

Heather describes the Standards knowledge management tool and how it came about.

cred.ca/skmt_glossary

Standards knowledge management tool = SKMT

Includes all of the definitions of documents of several different standards bodies

ISO

CEN

CDISC

HL7 Green glossary

HL7 Publishing Committee (V3 glossary)

Trial community in HL7

Patient Care has volunteered to be one of the communities.

o Does EHR want to be part of this? Yes and our Volunteer is Jim Kretz

How it works

o When new work begins – that work is put into the glossary with the status of pending.

o Don’t want to have to change things at ballot

o Check the online glossary

o Mark as a term you want to watch

o The words electronic health record has 34 terms – 7 different concepts

o Can accept /rationalize the definition

o Can declare the context

o Can search by terms or documents

o Candidate means it has been published in a balloted standards document.

o Standard: the only term or the agreed way

o Terminology ----words may be weighted eg. By IHTSDO

o Source is the reference point – not necessarily the document that contained the work

Using the tool

o Must register to use the tool

o Documenters (a couple of EHR folks)

o Can get reports that allow you to say -----all terms by HL7 or by the EHR working group etc.

o Can get statistics

o Anyone can use the watch facility

o Administrators roles

o Organizations

o Committees

o Document status

o Publication Types

o User guide is available on the website

o ISO instructions are in there

o HL7 process is being defined and will be placed in here

o Fits into SAEAF, information models, artifacts, ontology.

o Learn about ontology.

Agenda Item #2: Joint WG: Security, Structured Documents, EHR

The need for Security as a foundation as we move forward in connecting/appending structured documents into an EHR

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o Bernd – the architectural framework for trustworthy health information systems

o Role of policies

o Provides the bridge to the SAEAF projects

o Architecture of components

o Risk assessment

o RBAC is the starting point to the ontology?

o The HL7 vocabulary is not an ontology

o Richard – must embrace this technology

o What planning is in place to move the Bernd models into the RIM?

o Architecture approach of future systems

o Current is messages based on need

o The RIM does not comply with current ontologies

o EHR as it stands today is not formalized; the interrelationships are not formalized. This would need to occur to have a policy basis.

o Suggestion of a joint project between Structured Documents, Security and EHR for the Security Risk Assessment

Wednesday

January 20, 2010

Q2

Joint Meeting with PHER, Patient Care and EHR

Agenda Item #1: Public Health and EHR (Anna Orlova)

Reevaluation of HL7 EHR-S FM V1.1 from Public Health Perspectives: Proposed Methodology

NEED PRESENTATION

o Public Health has established links with HL7

o The 3 domains that have had involvement already include: Communicable Disease, Biosurveillance, Immunizations. (were included in AHIC and HITSP) These, plus others will be included in the evaluation.

o Now meaningful use is requiring the electronic reporting from EHRS to Public Health entities ‘ unless the entitiy does not have the capability to receive it. ‘

o Update of the EHR-S FM is underway. Call for participation was made in December 2009 - 87 participants have signed up for the PH TaskForce

o Project outcomes

o Extensions to EHRS FM

o Development of public health FM

o Development of an independent Public Health FM consisting of nonclinical functions e.g. monitoring immunization developers.

o 6 conference calls scheduled in January through April

o Feedback 3/30 with agreement on revisions/ 4/15

o Re-evaluation challenges

o Making sure that all domains participate

o Chronic Disease, Maternal/Child Health are not in meaningful use

o Level of evaluation: high vs specific

o PH are focused on 3 functions (assessment, policy development and assurance and 10 essential services

o Using a consensus based approach

o Should they document a variety of EHR PH opinions/ challenges for information exchange from the participants, then prioritize and then build a roadmap for addressing them in the EHR and build a roadmap for addressing them in the ehrs-fm?

o Jim – include a CCD within the EHR. What do you need besides CCD that have been de-identified?

o Paradigm shift within Public Health to look to the EHR for information. The capability of an EHR to enhance what the public health receives is a shift.

Wednesday

January 20, 2010

Q2

Agenda Item #2 Diabetes Data Strategy (Crystal Kallen)

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Discussion of comparing this with the DCM’s William Goossen (Patient Care ) is developing.

William: Methodology

DCM – a unique structure

Metadata repository

Bron : FDA working with CDISC to launch new projects in 2010

Launch to publication of standard to be no more than 12 months.

What are we (DDS) learning and how can we synchronize the projects?

What can we learn about the process and methodology in order to do quick reliable, repeatable projects?

This process could possibly be used as a model for public health

Don: Discussed the need to Tool requirements to support a repeatable process rather than the current spreadsheet process

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Governance: needs to be developed

Technical: who gets to harmonize and what goes into the reference value set?

Value Sets exist in many locations:

HITSP

HL7

There has been discussion at ISO as well.

Anna: good work, but concerned that not all organizations/ individuals are involved that could be ---or that might be affected

EHR IHE new profile on XDS (formerly THIN VADS)

Suggesting discussion with Clem McDonald.

Don suggested that the slide presented is not comprehensive of participating parties.

Jim: LOINC, ICD10 and SNOMED are going to be the standards data sets in HITECH

Don expressed that getting into data was always an interest of the WG

Concern that you can focus too closely on an issue and miss other data that could influence the actual data need. The comparative effectiveness efforts devolve into collecting CCD type information for all representative encounters.

Bron: What is the central mechanism for projects to come together as they could come in from research, patient safety and quality, clinical decision support, public & population health, business operations/ administration ?

Wednesday

January 20, 2010

Q3

Agenda Item #1: Board of Directors Update (Don Mon)

Agenda Item #2 Vital Records Profile – Issues discussion/resolution and building toward R2 (Hetty Khan and Michelle Williamson)

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After discussion, it was suggested to:

a. Resubmit the scope statement for the US Realm Vital Records Profile with the restrictions imposed.

b. Submit a new universal project scope statement as much of the work that will not be in the US Realm profile could be of value to the international community.

Wednesday

January 20, 2010

Q4

Agenda Item #1 R2 Development (all)

Thursday

January 21, 2010

Q1

Agenda Item #1 R2 Development

Added new columns to Release 2 spreadsheet:

• Security Considerations (from Bernd Blobel)

• HITSP Use Case: Remote Monitoring

• HITSP Use Case: Bio-surveillance

• HITSP Use Case: Quality Reporting

• HITSP Use Case: Consumer Empowerment

• HITSP Use Case: Lab Results Reporting

• CEN 13606 (Ask Dipak Kalra for assistance; Ron Parker can help; need to raise this topic at ISO)

• 18308 (Ask Dipak Kalra for assistance; Ron Parker can help; need to raise this topic at ISO)

• (Eventually) Ambultory Oncology Functional Profile (see Helen Stevens)

• (Eventually) Blueprint 2015, Canada (see Ron Parker)

• (Eventually) Alignment of ONC-IFR standards, certification results with EHR-S FM Release 2

• (Eventually) Profiler-Enforcer Organizations (what is their role?)

• (Eventually) EuroREC QRec

Clarified an existing column as:

• R 1.1 Comments from ISO that must be considered for inclusion in Release 2

The analysis approach of the existing input into EHR-S FM Release 2 is unsupportable. We need to divide the work among subteams, and have the subteams offer the results to the full EHR WG for review. An elegant tooling solution is required. The ARB is analyzing the process of receiving (and managing) requirements from the industry.

AR (co-chairs): Motion to accept “Suggested R2 format v1_1a.docx” as the new publication format for EHR-S FM Release 2.

Proposed method for proceeding with the EHR-S FM Release 2 analysis:

1. Assign a given section (permanently, so to speak) to a Section-Master. (A Section-Master should gather a semi-permanent team who will become experts on that given section.) Thus, any new material that arrives that pertains to a given section will be analyzed by the Section-Master. A Section-Master will “own” a given section.

2. The Section-Master will report to the plenary EHR WG from time to time for approval of items updated by the Section-Master’s team.

Can Sue Mitchell serve as the Process-Master for the following Section-Masters??

|Section-Master |Owns Section |Team Members |xxxxxxx |

|Helen Stevens |DC.1 |Christine Bester |yyyyyy |

|(Lenel James??) |DC.2 | | |

|Kim Salamone |DC.3 | | |

| |SP.1 | | |

| |SP.2 | | |

| |IN.1 | | |

|xx |xxx |xx |Xx |

| | | | |

|General Purpose Reviewers (available for any team) |

|Roel Barelds | | | |

| | | | |

| | | | |

| | | | |

| | | | |

General Purpose review

Sasha recommends the use of a (named) version-control product (being used by the Canadians).

SharePoint is a powerful tool that can help control versions of documents.

GForge is already being used by HL7 to provide version control, is easy to learn, and is integrated.

Ron Parker volunteers to demonstrate GForge during an upcoming EHR WG conference call.

Thursday

January 21, 2010

Q2

Agenda Item #1: R2 Development

Discussion of how to organize in order to ensure that R.1.1 is reviewed – all sections—

We would like to get a committee level ballot out no later than the summer ballot cycle. We would like synchronize with the expected ISO ballot. Right now our ballot will be final about the end of the ISO ballot cycle.

Assigned Primary Analysts will lead the review of the of each section of the FM. The review will be of the horizontal rows of the Comparison Spreadsheet. The work of the sub teams will be brought back to the full WG for review and approval. Focus of work will be on review and harmonization of Direct Care and Supportive by the sub-group. The infrastructure will continue to be reviewed and harmonized in the weekly EHRS WG call.

A call with go out for volunteers to work on the Direct Care sections.

The metadata issues have yet to be addressed. Maybe an option to roll CDA metadata work model

Scott Robertson and Pat Van Dyke volunteered to help populate and normalize the new EHR Wiki site. Certain outdated documents needs to be posted to an “Archive” section.



It would be good to note that “Normative materials are available in the HL7 Members section” on the front page of the EHR Wiki.

The EHR WG thanks Kaiser-Permanente (and specifically, Scott Robertson) for providing a WebEx service for the EHR-S Functional Model Release 2 effort during the EHR WG’s weekly conference calls.

Booze-Allen recently received a contract to develop a minimal function list (i.e., of the functions that ought to be included in certifying EHR systems that meet CMS-NPRM “Meaningful Use” requirements).

The EHR WG will designate certain quarters as “open” for networking, relationship building, and brainstorming about EHR-related topics.

Direct Care 1, Direct Care 2 and Direct Care 3 will be assigned and developed by smaller groups with review coming back to the primary workgroup for discussion and voting.

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