CIC Mtg Minutes_July 28 2008

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					           Clinical Interoperability Council Meeting Minutes

Date/Time: July 28, 2008 at 10:00 am ET
Presiding Co-chair: Crystal Kallem
Name                          Affiliation                        E-mail Address
  Ed Hammond / co-chair       HL7 Duke                 
X Crystal Kallem / co-chair   AHIMA                    
X Meredith Nahm / co-chair    Duke                     
  Rita Altamore               WA DOH                   
  Kay Avant                   UT Health Science Ctr    
  Joseph Baptist              Nictiz                   
  Steve Bentley               NHS                      
  Chad Bennett                IFMC                     
  Qammer Bokhari              Blue Cross and Blue Shield
  Jim Case                    AAVLD                    
  Mike Cassidy                HL7 US - Siemens         
  Kevin Coonan                Tolven, DEEDS, EC SIG    
X Patty Craig                 The Joint Commission     
X Peter Cress
  Laurecia Dailey-Evans       Sunquest Info Systems              laurecia.dailey-
    Bob Davis                 X12                      
    Isobelle de Zegher        Novartis                 
X   Ann Diamond               ACOG
X   Gary Dickinson            CentriHealth             
X   Mark Diehl                CDPHP / ADA
X   James Dove
    Kristi Eckerson           N-G (CDC)                
    Floyd Eisenberg           Siemens                  
    Peter Elkin               Mayo Clinic              
    Isobel Frean              Bupa                     
    Scott Getzin              Eli Lilly
    William Goossen           Results4Care             
    Matt Greene               VA                       
    Monica Harry              CHI                      
    Laura Heermann            IHC                      
    Emily Honeycutt           Duke Clinical Research Institute
    Stan Huff                 Intermountain Health
    Charles Jaffe             HL7                      
    Linda King                Eli Lilly                
X   Bron Kisler               CDISC                    
    Helmut Koenig             Siemens                  
X   Thom Kuhn                 ACP                      
    Seija Kurkinen            HL7 Finland, HUS
    Rebecca Kush              CDISC                    
    Ken Lauver                Sunquest Info Systems    
    Dragana Lojpus            CHI
    Suzanne Maddux            CAST                     

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Name                        Affiliation                        E-mail Address
    Mike Martin             AVMA                     
    Susan Matney            Siemens                  
    Brian McCourt           Duke Clinical Research Institute
    Jim McClay              UNMC                     
    Larry McKnight          Siemens                  
    Don Mon                 AHIMA                    
    Terri Monk              Duke                     
    Sabrina Mukhopadhyay    Cal2Cal Europe Ltd       
    Karen Nocera            The CBORD Group          
    Andrew Norton           HL7 Siggas NHS           
    Masaharu Obayashi       Kanrikogaku Ltd.         
    Craig Parker            ASU                      
    Vesa Patadinen          UTT/HL7 Finland          
    Andrew Perry            HL7 UK                   
    Frank Ploeg             UMCG/HL7 NL              
    Yvonne Pynacher Hordy   TNO/HL7 NL               
    Barbara Rath            Brighton Collaboration at
                            Childrens Hospital, Basel
X   Dianne Reeves           NCICB                    
    John Roberts                                     
    Mitra Rocca             Novartis                 
X   Bill Rosen
    David Rowed             Ocean Informatics        
    Carol Ryan
    Laura Sato              NHS CFH                  
    Rob Savage              AIRA                     
    Kim Salamone            HSAG                     
    James Scroggs
    Mark Shafarman          HL7 US                   
    Harry Solomon           GE                       
X   Bruce Tapple            Shared Health
    Sheila Teasdale         AMA                      
    Mitra Rocca             Novartis                 
    John Roberts                                     
    David Rowlands          Standards Australia      
X   James Scroggs
X   Anita Walden            Duke Clinical Research Institute
    Max Walker              DHS                      
X   Steve Ward              Eli Lilly
    Thomas White            NY DoH                   
    Tim Williams            CAP SNOMED               
    Pat Wilson              3M                       
    Pele Yu                 University of Alabama at 
                            Birmingham School of Medicine

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I.     Additions to the Agenda

       No additions to the agenda.

II.    Approval of the June Meeting Minutes

       Motion: Thom Kuhn moved to approve the minutes; second by Mark Deihl.
       0 – Against, 0 – Abstentions, 15 – Approved; motion passed.

III.   Review and Vote on Cardiology DAM Project Scope Statement

       Brian McCourt is still working on agreements with stakeholders and the
       revised project scope statement. The committee will review and vote on
       the CV DAM scope statement during the next CIC conference call on
       August 25th.

IV.    Review DRAFT CIC Outreach Plan

       The CIC co-chairs have begun drafting an outreach plan. The draft plan
       was not yet available to share with the committee; however, Meredith
       Nahm reviewed communities proposed in plan to date which included:
            Clinical Professional Societies
            Related standards organizations
            Informatics Professional Societies
            Academic Medical Centers
            Informatics Academic Programs
            Vendors
            Fellow HL7 Working Groups
            Secondary Data Use Stakeholders

       Committee recommended additions included:
         • Separate vendors from HIE entities (e.g., RHIOs, NHIN, etc.)
         • Add provider organizations, e.g. American Healthcare Association
           and other national provider organizations
         • Add the Medical Group Management Association (MGMA) and
           other organizations that represent the operational aspect of
           physician practices
         • Add payers (e.g., CMS, insurance companies, etc.)
         • Separate the roles versus stakeholder organizations. One
           organization may have multiple roles. This may help clarify the list
           of communities for outreach.
         • Add Government entities

       The draft outreach plan will be reviewed with Chuck Jaffe and Ed
       Hammond prior to the next CIC conference call.

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V.   Pilot Project Proposal - Engagement of Health Related Professional

     Gary Dickinson introduced a project proposal to engage health related
     professional societies during the last CIC conference call. The CIC co-
     chairs met with Gary in between meetings to discuss feasibility of
     conducting a small pilot project to test the proposed plan aimed at
     collecting actions and attributes from clinical groups already involved in
     HL7. We consider the pilot project a precursor and pathway to a Master
     Data Element list for healthcare.

     This project will be conducted under the CIC Infrastructure Project.

     T. Kuhn: A better description of the words “action” and “attributes” would
     help make the scope and purpose more clear. A more detailed project
     description would help individuals take the project concepts back to their
     organizations for education, buy-in, and support. Also, the approach on
     the surface seems orthogonal with a RIM-base approach and work in
     other HL7 working groups.

     G. Dickinson: From the perspective of the EHR model definitions of action.
     We want specialty groups to tell us what actions they perform (raw data
     dictionary) so that we can begin to categorize and understand places
     where harmonization is required (harmonized data dictionary). This will
     initiate the beginning of a master data element dictionary for healthcare.

     M. Nahm: Want to clarify that the project is consistent with the RIM-based
     approach. As stated in the draft CIC process, as clinical specialty societies
     join the CIC and begin to define clinical domains, Clinical Domain Analysis
     Models (DAMs) will be produced. CIC is currently working with HL7
     working groups to define the interface, (i.e., when the clinical content gets
     handed to the appropriate working group and when mapping to the RIM
     occurs). In the draft CIC process, we think the use case and domain of
     interest should first be declared, and then CIC and the clinical specialty
     will engage the appropriate HL7 working group. At that point, the clinical
     content will be mapped to the RIM (most likely appropriate DMIM) and be
     handed off to the working group for creation of appropriate technical

     ACTION: CIC co-chairs will work with Gary Dickinson to create a more
     detailed description of the pilot project.

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VI.     CIC SWOT Analysis

        The two outstanding sections of the SWOT Analysis were opened for

        Update statement to say: “Resources not commensurate with the job”

        Co-chairs called for comments on the two sections updated from the last
        call. Crystal Kallem also requested clarification on the statement “(needs
        to be broader; look at modular functionality – clinical system functionality)”.
        A call participant stated that it was his comment and clarified that the point
        was intended to indicate that everything efforts related to interoperability
        should be conducted in conjunction with national standards (i.e., HITSP)
        and Certification (i.e., CCHIT). In an effort to be more inclusive of
        international standards, the committee agreed to the following update: CIC
        will “maintain alignment with international standards and certification”.

        No additional comments. The SWOT analysis will be considered final after
        the above updates are incorporated.

VII.    DRAFT CIC September Workgroup Meeting Agenda

        Crystal shared that the co-chairs are in the process of drafting the agenda
        for the Sept workgroup meeting. The draft provided is very preliminary, but
        the co-chairs wanted to gather input from the full workgroup as to the
        types of discussions that would be most valuable. The co-chairs are trying
        to minimize the number of formal presentations to allow time for actual
        work as well.

        There were no comments from committee members.

VIII.   Updated CIC Process Description

        Crystal Kallem shared that the process description was updated prior to
        the last conference call and is available on the CIC wiki for member
        review. Feedback on the updated process description is welcome. We
        believe our next step will be to coordinate time with the EHR and Patient
        Care working groups to review the process description and further define
        potential overlap and interactions between groups.

        There were no comments from committee members.

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      ACTION: CIC co-chairs will work with EHR and Patient Care co-chairs to
      continue discussing how to coordinate clinical content hand-offs to other
      HL7 working groups.

IX.   Next Steps/Future Agenda Topics

      Future Monthly Conference Calls/Meetings
      Monthly CIC conference calls will be held on the fourth Monday of each
      month at 10:00 am Eastern Time (US). We will assess the status of
      the monthly conference call day/time in September to determine if it needs
      to be adjusted.
          - Conference Call: August 25th at 10:00 am Eastern Time (US)
          - F2F Meeting: September 18th, 9:00 am-5:00 pm - CIC Meeting
             during the HL7 Working Group Meeting, Vancouver, BC, Canada
          - No Conference Call on September 22nd due to HL7 Working Group
             Meeting the week prior

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