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PDMP & Health IT Integration Standards and Harmonization

PDMP & Health IT Integration Standards and Harmonization. June 3 rd , 2014. PDMP Harmonization Timeline. (Today). 3/25 Harmonization Kick-off. 7/29 Harmonization Close. Candidate Standards List. End-to-end Review & Community Consensus. Standards Evaluation. Solution Plan.

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PDMP & Health IT Integration Standards and Harmonization

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  1. PDMP & Health IT IntegrationStandards and Harmonization June 3rd, 2014

  2. PDMP Harmonization Timeline (Today) 3/25 Harmonization Kick-off 7/29 Harmonization Close Candidate Standards List End-to-end Review & Community Consensus Standards Evaluation Solution Plan UCR-Standards Mapping Gap Mitigation Plan Create IG Template IG Development HITSC Evaluation* Solution Planning IG Development

  3. Harmonization Weekly Timeline

  4. Review: Solution Planning Workgroup Session 5/29Current-State Transaction: Standards Landscape

  5. HIE/Pharmacy Intermediary 2 5 2 7 4 Out of State PDMP In-State PDMP EHR or Pharmacy System Hub 1 8 8 3 7 6 3 Hub PMP/HITI User Stories with Alternate Workflows EHR or Ph. to In-State PMP: 1a: EHR to In-state PMP 1b: Ph. to In-state PMP 2a: EHR to In-state PMP via HIE 2b: Ph. to In-State PMP via HIE 3a: EHR to In-state PMP via Hub 3b: Ph. Intermediary to In-State PMP via Hub EHR or Ph. to Out-of-State PMP: 1a+4: EHR to out-of-state PMP via In-state PMP 1b+4: Ph.to out-of-state PMP via In-state PMP 2a+4: EHR to out-of-state PMP via HIE & In-state PMP 2b+4: Ph. to out-of-state PMP via Ph. Int& In-state PMP 2a+5: EHR to out-of-state PMP via HIE 2b+5: Ph. to out-of-state PMP via HIE 3a+4: EHR to out-of-state PMP via Hub & In-State PMP 3b+4: Ph. to out-of-state PMP via Hub & In-State PMP 1a+8: EHR to out-of-state PMP via In-State PMP & Hub 1b+8: Ph. to out-of-state PMP via In-State PMP & Hub 3a+6: EHR to out-of-state PMP via Hub 3b+6: Ph. To out-of-state PMP via Hub

  6. Summary of Transactions

  7. Solution Planning Work Group Approach

  8. Identify effective workflows Prioritize workflows according to current landscape analysis, standards evaluation, and future state models Collapse workflows to represent proposed solutions incorporated in the Implementation Guide Analyze pros/cons, technical feasibility, impact to stakeholders, adoptability, scalability, etc. Next Steps for SPWG 6/10, 6/17

  9. Current Landscape Workflows Proposed Solution Set Workflows Summary Analysis + Relevant Workflows 1 EHR  In-State PDMP Pharmacy  In-State PDMP EHR  In-State PDMP Pharmacy  In-State PDMP EHR  Intermediary  In-State PDMP Pharmacy  Intermediary  In-State PDMP 2 EHR  Intermediary* Pharmacy  Intermediary EHR  Intermediary  Hub  PDMP(s) Pharmacy  Intermediary  Hub  PDMP(s) 3 EHR  Hub  PDMP(s) Pharmacy  Hub  PDMP(s) EHR  Hub Pharmacy  Hub Aligns to in-scope Use Case scenarios Approach may require translation mapping between ASAP, NCPDP SCRIPT Medication History, and H L7 V2 Messaging to PMIX Architecture Implementation Guide will have to include data element modifications/additions to fully support PDMP & HITI Use Case requirements EHR  In-State PDMP  Hub  PDMP(s) Pharmacy  In-State PDMP  Hub  PDMP(s) *Intermediary - An entity that routes the transaction to a receiving entity. May perform value added services such as translating data from one format to another

  10. Health IT System Standard PDMP Standard Translation Summary Analysis ASAP Web Services PMIX-NIEM Architecture HL7 V2 Messaging Intermediary PDMP Hub NCPDP SCRIPT Medication History • Strategy Details • Implementation Guide focus will shift to those organizations providing transformations/translation/ ETL services • ASAP can provide point-to-point PDMP data exchange for Pharmacies and EHRs a like – can be transformed into PMIX Architecture via Appriss, Inc. (PMPi) • Intermediaries provide translation service or metadata transformations as “wrappers” • Data elements will need to be modified or added, specified within the PDMP & HITI Implementation Guide Example Container/Payload Configuration PMIX Architecture SCRIPT Med History (Patient Data) (Authentication)

  11. Data Element Analysis

  12. Implementation Guide – Data Elements and Attributes

  13. Data Requirements Analysis - PDMP & HITI Use Case

  14. Data Requirements Analysis - PDMP & HITI Use Case

  15. Consolidated Standard Data Set– PDMP & HITI Use Case

  16. Standard Data Set– MITRE WG Recommendation

  17. Next Steps • Review: Minimum Dataset Requirements • Next Solution Planning WG meeting is Thursday, June 5 from 12:00pm – 1:00pm ET • Next All Hands meeting is Tuesday, June 10 from 12:00pm - 1:00pm ET • Reminder: All PDMP & HIT Integration Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Harmonization materials, Use Case, Project Charter and general information will be posted on the PDMP Wiki page • http://wiki.siframework.org/PDMP+%26+Health+IT+Integration+Homepage

  18. Contact Information • For questions, please feel free to contact your support leads: • Initiative Coordinators: • Johnathan Coleman jc@securityrs.com • Sherry Green sgreen@namsdl.org • ONC Leads: • Mera Choi mera.choi@hhs.gov • Jennifer Frazier Jennifer.Frazier@hhs.gov • Helen Caton-Peters Helen.Caton-Peters@hhs.gov • SAMHSA Leads • Jinhee Lee Jinhee.Lee@samhsa.hhs.gov • Kate Tipping Kate.Tipping@samhsa.hhs.gov • Support Team: • Project Management: • Jamie Parker jamie.parker@esacinc.com • Ali Khan Ali.Khan@esacinc.com (Support) • Use Case Development: • Ahsin Azim Ahsin.Azim@accenturefederal.com • Presha Patel presha.patel@accenture.com • Standards Development Support: • Alex Lowitt alexander.s.lowitt@accenturefederal.com • Harmonization Support: • Divya Raghavachari divya.raghavachari@accenturefederal.com • Atanu Sen atanu.sen@accenture.com • Implementation Guide Development: • Rita Torkzadehrtorkzadeh@jbsinternational.com • Vijay Shah vshah@jbsinternational.com • Vocabulary and Terminology Subject Matter Expert: • Mark Roche mrochemd@gmail.com

  19. Appendix

  20. Current In-State EHR Workflow (Direct) Transaction 1a NARxCheck EHR System In-State PDMP NARxCheck Legend Request Response

  21. Current In-State EHR Workflow (HIE) Transaction 2a HL7 A04 NCPDP SCRIPT with PMIX Wrappers Third Party Software HL7 QRY^T12 HL7 ADT feeds NCPDP SCRIPT (Med History) HL7 QRY^T12 EHR System HIE In-State PDMP HL7 OBX XML Report NCPDP SCRIPT (Med History) HL7 DOC^T12 - CCD XML Response NCPDP SCRIPT with PMIX Wrapper HL7 DOC^T12 Legend Request Response

  22. Current In-State Pharmacy Workflow (Direct) Transaction 1b Pharmacy IT System In-State PDMP NARxCheck NARxCheck Legend Request Response

  23. Current In-State Pharmacy Workflow (Pharmacy Int. / Switch) Transaction 2b NCPDP SCRIPT (Medication History) ? Pharmacy System Pharmacy Intermediary/ Switch In-State PDMP NCPDP SCRIPT (Medication History) ? Legend Request Response

  24. Current In-State EHR Workflow (Hub) Transaction 3a – Not Effective Workflow? Currently Active? In-State PDMP EHR System PMIX ? PDMP Hub ? ? Legend Request Response

  25. Current In-State Pharmacy Workflow (Hub) Transaction 3b – Not Effective Workflow? Currently Active? Translation? In-State PDMP Pharmacy System Translation? PMIX PDMP Hub ? PMIX Legend Request Response

  26. Current Interstate EHR Workflow Transaction 2a + 7a + 6 EHR System HIE In-State PDMP Third Party Software PMIX-NIEM NCPDP SCRIPT (Medication History) PMIX-NIEM XML PMIX-NIEM XML PMIX-NIEM Out-of-State PDMP PDMP Hub PMIX-NIEM Legend Request Response

  27. Current Interstate Pharmacy Workflow Transaction 2a + 2b + 7a + 7b + 6 HIE In-State PDMP Pharmacy System Third Party Software PMIX Wrappers NCPDP SCRIPT PMIX-NIEM XML PMIX-NIEM XML PMIX-NIEM Pharmacy Int. / Switch NCPDP SCRIPT PDMP Hub Out-of-State PDMP PMIX-NIEM ? Legend Request ? Response

  28. Questions to be answered: Differences in pharmacy and clinician workflows / data systems and expectations in PDMP data transmitted? How do we define intermediaries and their relationships to Health IT systems? What components of PDMP report are extracted for decision support? Can EHR and Pharmacy IT systems handle the proposed standards (in the context of PDMP systems)? What standard(s) fit into message and workflow configuration per transaction type? Are transactions collapsible in terms of capability of leveraging same standard? Are all transactions necessary? What is the cost associated with the proposed solutions? How do we define an aggregator? (collection of response from different PDMPs back to recipient) Parking lot item: Differences in care settings - Ambulatory vs. Acute; In-hospital pharmacies vs. retail pharmacies. Are different standards needed for different EHR systems?

  29. Initiative Progress & Current Status Standards Evaluation • Narrowed down candidate standards via mapping to Use Case Requirements • Identified and analysed gaps for all narrowed down standards in the Gap Mitigation Plan Solution Planning • Determining standards currently in general use per transaction workflow • Select harmonized standard solution based on current and recommended standards landscapes Implementation Guide Development • Develop Implementation Guide (IG) based on selected solution

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