Healthcare Information Technology Stards Panel 2006, 2007 Beyond John D. Halamka MD Chair, HITSP
A public-private Community was established to serve as the focal point for America s health information concerns drive opportunities for increasing interoperability The Certification Commission for Healthcare Information Technology (CCHIT) The Health Information Security Privacy Collaboration (HISPC) American Health Information Community Healthcare Information Technology Stards Panel (HITSP) Nationwide Health Information Network Architecture Projects (NHIN) HITSP includes 249 different member HITSP includes 249 different member organizations is administered by organizations is administered by a Board of Directors a Board of Directors 16 SDOs (6%) 16 SDOs (6%) 197 Non-SDOs (79%) 197 Non-SDOs (79%) 19 Govt. bodies (8%) 19 Govt. bodies (8%) 10 Consumer groups (4%) 10 Consumer groups (4%) 7 Project Team Undeclared (3%) 7 Project Team Undeclared (3%) The The Community Community is is a a federally-chartered federally-chartered commission commission will will provide provide input input recommendations recommendations to to HHS HHS on on how how to to make make health health records records digital digital interoperable, interoperable, assure assure that that the the privacy privacy security security of of those those records records are are protected, protected, in in a a smooth, smooth, marketled marketled way. way. 2
2006 the First Turn of the Crank 4Consumer Empowerment Medications Allergies Demographics Advance Directives 4Electronic Health Records Laboratory including blood banking microbiology Ordering results exchange 4 Biosurveillance Deidentified registrations Labs Radiology text results 3
What did we do in 2006? 4 Established the HITSP Organization its committees 4 Created the stards harmonization process including all coordinating committee subprocesses 4 Harmonized stards for 3 use cases (accepted by Secretary Leavitt) resolved three controversies along the way To resolve CCR v. CDA, the CCD was successfully balloted To resolve the need for Interim stards we accelerated CCD ELINCS an enhanced implementation guide for HL7 2.5.1 will be balloted by HL7 this Summer 4 To align HITSP interoperability specifications with CCHIT functional criteria, the CCHIT/HITSP Joint Working group is establishing a joint timeline for the next 3 years 4
HITSP Organization The Community HHS Secretary Mike Leavitt, Chair HITSP Member Populated Coordination Committees HHS ONCHIT1 PO, Dr. John Loonsk HITSP Dr. John Halamka, Chair Member Populated Board Panel HITSP Member Populated Technical Committees Harmonization Readiness Lynne Gilbertson Business Plan Steve Lieber International Lscape Bill Braithwaite CCHIT JWG Jamie Ferguson Foundations Bob Dolin & Steve Wagner Process Review Lynne Gilbertson & Erik Pupo Program/Project Management Team Executive in Charge, F. Schrotter, ANSI Program Manager, L. Jones GSI Deputy PM, J Corley, ATI Project Manager, Julie Pooley, Booz Allen Panel Secretariat Coordination Technical Committee Management Management Joyce Sensmeier, Michelle Deane, HIMSS ANSI Care Delivery (including Emergency Responder EHR Jamie Ferguson John Madden, MD Steve Wagner Consumer Empowerment Elaine Blechman, PhD Charles Parisot Population Health Floyd Eisenberg, MD, MPH Peter Elkin, MD Shaun Grannis Cross Technical Committee WG Security Privacy WG 5
Work Plan Schedule Overview Stards Harmonization Work Plan Tasks PROCESS I II III IV V VI VII VIII Harmonization Request Requirements Analysis Identification of Cidate Stards Gaps, Duplications Overlaps Resolution Stards Selection Construction of Interoperability Specification Inspection Test Interoperability Specification Release Dissemination IX Program Management TASKS Requirements, Stards Selection, Design Public Review Input 3 weeks Interoperability Specification Construct Development Inspection Test Public Comment Comment Resolution Panel Approval Implementation Support Testing 3 months 3 months 4 weeks 2 months On-going DOCUMENTATION Requirements, Stards Selection, Design Consolidated comments IS Docs V 1.0 Review Draft Summary of comment resolution Consolidated comments IS Docs V 1.0 Summary of comment resolution Annual Updates as Required 6
cd CE Interoperability Specification «interoperability specification» Consumer Empowerment - docid: = IS-03 contains contains contains contains «transaction package» Manage Sharing of Documents + docid: = ISTP-13 «composite stard» IHE XDS + Provide & Register Document Set: ITI-15 + Query Registry: ITI-16 + Register Document Set: ITI-14 + Retrieve Document: ITI-17 implements «base stard» ISO 15000 ebrs 2.1/3.0 «composite stard» CAQH «base stard» LOINC «base stard» X12 270/271 «component» Registration Med History Document(s) Content + docid: = ISC-32 «composite stard» Federal Medication Terminologies references «base stard» NDC RxNorm SPL «base stard» ASTM/HL7 CCD «base stard» NCPDP 8.1 «transaction» Patient ID Cross- Referencing + docid: = IST-22 «composite stard» IHE PIX - PIX Query: ITI-9 implements «transaction» Patient Demographics Query + docid: = ISTP-23 «composite stard» IHE PDQ «base stard» HL7 2.5 Message «base stard» HL7 CDA r2 «base stard» ASTM CCR 2369 7
HITSP Named Stards Accredited Stards Committee (ASC) X12 Insurance Subcommittee (X12N) Implementation Guides Version 004010 plus Addenda 004010A1 Accredited Stards Committee (ASC) X12 Stards Release 004010 American Society for Testing Materials (ASTM) Stard Specification for Continuity of Care Record (CCR): # E2369-05 Council for Affordable Quality Health Care (CAQH) Committee on Operating Rules for Information Exchange (CORE) Phase I OperatingRules Federal Medication Terminologies Health Level Seven (HL7) Version 3.0 Continuity of Care Document(CCD) Health Level Seven (HL7) Version 3.0 Clinical Document Architecture (CDA/CDA R2) Health Level Seven (HL7) Version 2.5 Health Level Seven (HL7) EHR System Functional Model Draft Stard for Trial Use (DSTU) Integrating the Healthcare Enterprise (IHE) Laboratory TechnicalFramework Supplement 2006-2007 Revision 1.0 * Integrating the Healthcare Enterprise (IHE) Patient Care Coordination (PCC) Technical Framework Revision 1.0 Logical Observation Identifiers Names Codes (LOINC ) National Council for Prescription Drug Programs (NCPDP) SCRIPT Stard Version 8.1 8
2007 The second turn of the crank 4 Privacy Security stards 4 Emergency Responder 4 Personal Health Records 4 Medication Management 4 Quality 9
Security Stards 4Collect Communicate Security Audit Trails 4 Consistent Time 4 Document Integrity 4 Manage Control Data Access 4Manage Control Privacy Consents 4Manage Entity Identity Credentials 4Non-Repudiation 4Secure Communications Channel 4User Authentication 10
Security timeframe 4 First draft by June 18 4 Second draft share those with other HISTP TCs for written comments June 20-July 8 4Security Privacy TC face to face meeting to finalize the documents July 10-11 4Final documents to prepare for publication public comment period by July 15 4 Inspection Test Public Comment July 20 August 16 4Comment Resolution Panel Approval August 17 October 15 11
Consumer Access to Clinical Information 12
Medications Management 13
Quality 14
HITSP 2007 Timeline Work Plan Schedule Overview 02/05/07 HITSP Board 04/23/07 HITSP Board 07/09/07 HITSP Board 10/09/07 HITSP Board 02/12/07 HITSP Panel 03/19/07 HITSP Panel 05/11/07 HITSP Panel 07/16/07 HITSP Panel 09/07/07 HITSP Panel 10/15/07 HITSP Panel JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 03/06 03/08 TC Face to Face Chicago IL 5/08 5/10 TC Face to Face Arlington VA 6/18 6/20 TC Face to Face San Diego CA 09/04 09/06 TC Face to Face Arlington VA Activity 1 Version 2.0 of Existing EHR, CE, BIO ISs Implementation Support Testing (includes minor document updates) On-going Support EHR, CE BIO v 2.0 Activity 2 On-going Work for Existing EHR, CE, BIO ISs (e.g. Security Privacy) Activity 3 New Emergency Responder EHR Use Case S&P EHR-ER v 1.0, EHR, CE, BIO v M.m Requirements, Stards Selection, Design Public Input 04/13 05/03 IS Construct Development Inspect Test Public Comment Comment Resolution Panel Approval Implementation Support Testing (with annual updates as required) 01/19 04/12 04/13 07/19 07/20 08/16 08/17 10/15 Activity 4 New Use Cases from AHIC Detail Schedule to be Established Upon Review of the Use Cases 15
Overall Timeline 16
Summary 4 Over the past year, HITSP has become an established, trusted organization with a multi-stakeholder, open, transparent process for stards harmonization 4 In 2007, we will complete 4 additional use cases plus security/privacy 4 In 2008, we expect an additional 3-4 use cases 4 Our Foundations Committee will work on the medium to long term alignment of stards organizations their work products in parallel with the Use Case work of the entire panel 17
Contact Information 4 For general HITSP-related questions please contact: Michelle Maas-Deane HITSP Secretariat American National Stards Institute Phone: 212-642.488 email: mmaasdeane@ansi.org 4 For ANSI Document Library related questions please contact: Alison Ziegler Program Administrator, Stards Panels American National Stards Institute Phone: 212-642.4947 email: aziegler@ansi.org 4 For Technical Committee questions: or Joyce Sensmeier MS, RN-BC, CPHIMS, FHIMSS Vice President, Informatics HIMSS Phone: 312-915-9281 email: jsensmeier@himss.org Jessica Kant Coordinator, Stards Harmonization Healthcare Information & Management Systems Society Phone: 312-915-9283 Fax: 312-915-9511 email: jkant@himss.org 18