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EHR WG Agenda

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1 EHR Work Group Schedule

Cambridge, Massachusetts WGM; May, 2010







HL7 Working Group Meeting, EHR Work Group

Orlando, Florida May 2011

Day Time Meeting room: Chair Scribe Room Comments

Q1 (Affiliates Council) Q1 = 0900-1030

AM

Q2 (Affiliates Council) Q2 = 1100-1230

Sunday

Q3 (Affiliates Council) Lunch 1230-1330

2011-05-15

PM Q4 (1530 to 1700 HL7/CEN/ISO meeting) Q3 = 1345-1500

Q4 = 1530-1700

Meeting room:

Q0

Introductions (including areas of interest / reasons for attending) Dickinson, Mon, Ritter, Helen unable to attend this WGM

Review/Accept minutes Van Dyke

Review Agenda/Goals of the Work Group for the week

Q1 Review HL7 Project List/Update on projects

AM ISO TC/215 Update

International EHR Discussion/What is needed beyond R2

Dickinson, Mon, Ritter, Visit with Child Health to discuss R2 findings and calendar

Q2 Canada BluePrint - Infoway PHR project Van Dyke for R2 normative ballot. Potentially discuss ballot

feedback/comments/ and Child health representative ---2

representatives

Monday PHR/ISO review/comments reconciliation Dickinson, Ritter, Van Pat Don - Board Commitments

2011-05-16 Dyke

PM Q3







Joint with ArB (EHR Hosting) Dickinson, Ritter, Van Pat Don - Board Commitments

Reconciliation of Public Health Profile Ballot Comments (at PHER) Dyke

Q4 PHR/ISO comments/reconciliation (small group)





EHR WG BOF: Topic to be determined (1715-1815 )

Q5 Co-chair Dinner

Meeting room:

Q0

Dickinson, Mon, Ritter,

AM Q1 Joint with CIC and Medical Devices (CIC Hosting)

Van Dyke

1st half of quarter: Diabetes Data Project Review: Crystal Kallem (CIC) Dickinson, Mon, Ritter,

Q2 Van Dyke





Joint with SOA and PHER. (EHR Hosting) Mon, Ritter, Van Dyke

Tuesday

2011-05-17 PM Q3 Intro to Electronic Health Record FM Course (Gary)





EHR FM Mon, Ritter, Van Dyke

Intro to Electronic Health Record FM Course (Gary)

Q4

Don at Board of Directors Meeting



Q5

Meeting room:

Q0

NIST --Ken Gebhart Dickinson, Mon, Ritter,

Q1 Van Dyke





AM EHR R2 Comment Only Ballot Reconciliation Dickinson, Mon, Ritter,

IN Chapter Development for R2 Van Dyke



Q2

Wednesday

2011-05-18

EHR R2 Comment Only Ballot Reconciliation Dickinson, Mon, Ritter,

Q3 IN Chapter Development for R2 Van Dyke



EHR R2 Comment Only Ballot Reconciliation Mon, Ritter Dickinson, Van Dyke at SAIF

PM

Q4 IN Chapter Development for R2



Q5 HL7 Networking Reception (5:15PM to 6:30PM)

Don leaving for ISO Wednesday night

Meeting room:

Q0

EHR R2 Comment Only Ballot Reconciliation Dickinson, Ritter, Van Don Mon

Q1 IN Chapter Development for R2 Dyke

AM

Thursday EHR R2 Comment Only Ballot Reconciliation Ritter, Van Dyke Gary out Don out

2011-05-19 Q2 IN Chapter Development for R2



Q3 Introduction to PHR Tutorial (Gora Datta)

PM Q4 Introduction to PHR Tutorial (Gora Datta)

Q5



Q1

AM

Q2

Friday

Q3

2011-05-20

PM Q4

Q5









1 of 13

EHR TC WGM Schedule

September 10-15, 2006









Day Time Event / Place / Person / Time Preparation materials Completed? Follow up / To Do

Q1

AM

Q2

Sunday

Q3

2010-10-03

PM Q4

Q5

Event / Place / Person / Time

Q0

AM Q1

Monday Q2

2010-10-04 Q3

PM Q4

Q5

Event / Place / Person / Time

Q0

AM Q1

Tuesday Q2

2010-10-05 Q3

PM Q4

Q5

Event / Place / Person / Time

Q0

AM Q1

Wednesday Q2

2010-10-06 Q3

PM Q4

Q5

Event / Place / Person / Time

Q0

AM Q1

Thursday Q2

2010-10-07 Q3

PM Q4

Q5

Event / Place / Person / Time

Q0

AM Q1

Friday Q2

2010-10-08 Q3

PM Q4

Q5









2 of 13

Topic

Joint meeting (definition)





Joint meeting with Security Work Group









Joint meeting with Public Health and Emergency

Response Work Group (Michelle Williamson; Gora

Datta)









HL7 Marketing Council (Jill Kaufman)









Joint resolution of outstanding EHR Interoperability

Model questions/issues (Structured Documents Work

Group, Security Work Group, and EHR

Interoperability Work Group)

Birds-Of-a-Feather: AHIC / HITSP Use Case Analysis









Birds-Of-a-Feather: PHR-S FM international outreach

and use of EHRs / PHRs in developing countries

(Gora Datta)







PHR-S FM international outreach and use of EHRs /

PHRs in developing countries (Gora Datta)





Governance and Operations Manual (GOM) review

(Corey Spears)

EHR WG Project List (Pat Van Dyke)



Publications Working Group (John Ritter)







eClinical Forum's mapping of QREC's conformance

criteria (Mitra Rocca)

EHR-S FM Release 2 (Don Mon)







Recommendations from Functional Profile

Development Teams regarding EHR-S FM Release 2

PHR-PHI ISO/HL7 results of international survey

(Mitra Rocca)

PHR-S Functional Profiles (Afshin Khosravi and

Lenel James)

PHR Parking Lot of Issues and Tasks

CMS Pilot Project (to export PHR-related Medicare

data)

Emergency Contact information in the PHR









PHR Tooling









Proposed EHR-S and PHR-S Functional Profiles









General Practice EHR-S Functional Profile for Ireland

(30 minutes) (Dr. Brian O'Mahony)

DETAILS OF THE TOPIC

Joint Meetings are traditionally held between the EHR WG and those WG's who either impact, or are impacted

by, the EHR WG's products. During the Joint Meetings, WGs often coordinate approaches, share resources,

discuss troublesome issues, and make plans for future (collaborative) work.









Rita Altamore, Kristi Eckerson, Alean Kirnak, Michelle Williamson

1) Michelle verified that the HL7 EHR WG will still host the PHER WG in a joint session during Wednesday Q2 at

the Orlando WGM. PHER will present any work they have been able to move forward on, specifically, regarding

the identification of the Public Health Extensions to the EHR-S Functional Model. PHER will also provide an

update on the Vital Records Functional Profile of the EHR-S FM and the Vital Records Domain Analysis Model.

[Note: the International Affiliates should be invited to attend the EHR - PHER joint meeting to offer international

feedback.

Discussion items include:

- What is the Marketing Council's (MC's) role within HL7?

- What is the Ambassador Briefing program? (Are there EHR and PHR Briefings?)

- Recruit non-U.S. Ambassadors to present EHR and PHR Briefings



Other topics (if time permits):

- When does the MC meet?

- What activities has the MC conducted?

- What MC activities are planned for the future?

- What role does the EHR WG (and its work-products) play in the MC's efforts?

- How can the EHR WG help the MC? (Gather media hits? Pass along Conference announcements? Other?)

- How can the EHR WG leverage the MC to outreach to conferences, societies, organizations, governments,

nations, etc.? will gather a team of Security Work Group and Structured Documents Work Group members to

Gary Dickinson

discuss/resolve the five outstanding questions/issues regarding EHR Interoperability Model work-products.

Discuss alignment analysis activities, normative EHR/IM, HITSP Roadmap (EHR/IM and EHR/LM), additional

work on CDAr2 Reference Profile (to include access control, audit and traceability aspects). Kim Salamone and

Gora Datta will act as a program committee for the EHR Interoperability presentations in Vancouver. Ken Lunn

(NHS, HL7 BOD) will be requested to offer his April 2008 SOA-oriented presentation (or its current equivalent).



The goal of the presentation should be to provide a backgrounder as to why Use-Cases are important, how they

are developed, why a Gap Analysis is helpful, what the EHR-S FM, PHR-S FM, and Interoperability Models are,

how the analysis is performed (and by whom), how much time is involved, who receives the results, how useful

the results are to the recipients, whether the analysis is useful to the EHR TC (and how so), whether the analysis

is useful to HL7 (and how so), a recommendation as to how people might see the results (and apply them in their

own countries), an invitation to join the existing efforts, an challenge to launch similar efforts in other countries, a

recommendation as to how to collaborate on future efforts, a recommendation as to how to collect, manage, and

Gora Datta (full presentation and discussion):

- Overview of the PHR-System Functional Model and profiles

- International outreach and use of PHR-S FM and profiles

- Developing countries perceive the need for EHR standards differently than do developed countries.

- What is the state of EHRs and PHRs in developing countiries?

- What are the implications for the EHR WG, PHR WG, etc.?

Report to the EHR WG and discussion:

- Developing countries perceive the need for EHR standards differently than do developed countries.

- What is the state of EHRs and PHRs in developing countiries?

- What are the implications for the EHR WG, PHR WG, etc.?

The EHR WG conducts its business via a Governance and Operations Manual (GOM). The GOM needs to be

updated to streamline and clarify the EHR WG's activities.

- The EHR WG had a list of about 25 projects that were in various stages of development (most of them are

finished).

- The EHR WG's Publications Working Group handles much of the publication-related duties of the WG, such as

collecting the WG's work-products, packaging the materials for voting, rendering the materials for submission to

HL7 HQ, posting the materials on various web sites, and reviewing media announcements.

- Need to develop a blueprint for each publishing activity.

Mitra Rocca will present the results of the eClinical Forum's review of QREC's EHR-S conformance criteria.



- We have input from the stakeholders that may be used to develop the next release of the EHR-System

Functional Model.

- We need to select a project manager.

- Team needs to be assembled and brainstorm an approach, scope, timeline, etc.

Various teams have developed profiles of the existing EHR-S FM. The EHR-S FM may need to be updated. The

teams will share insights and recommendations regarding possible changes to the EHR-S FM.

Mitra Rocca: will present results of the October 2007 international survey of the use of PHR's and of the state of

Personal Health Informatics.

Afshin Khosravi (Trilogy Integrated Resources) will present the Health Authority Functional Profile of the PHR-S

FM.

Payer-Linked PHR-S Functional Profile (Lenel James)

(See the "PHR Parking Lot of Issues and Tasks" worksheet)

Don Mon will present Lorraine Doo's (CMS) report regarding the export of PHR-related Medicare data to a few

vendors in Utah and Arizona, USA.

Question: Should Emergency Contact Information functionality appear as a Conformance Criterion along with the

general Contact Information functionality criteria -- or should Emergency Contact Information functionality appear

as a standalone function (with all of its conformance criteria's priorities listed as "MAYs" so that people can easily

include then with the general Contact Information)?



Proposed "Emergency Contact" addition to the Personal Health Record System Functional Model (per Larry

Williams):

ID: PH 2.5.0

NAME: Manage 'Emergency Contact Information' Lists

STATEMENT: Manage the account holders 'emergency contact information' and provide the ability to manage

the 'emergency contact information' over time in accordance with organizational policy and jurisdictional law.

DESCRIPTION: Access to account holder 'emergency contact information', particularly in times of immediacy,

such as a motor vehicle crash in which an account holder is incapacitated, can be critical to patient outcomes.

EXAMPLE: The 'Emergency Contact Information' list affords account holders the opportunity to list at a minimum

a name and telephone number for at least one contact person. A designee of the account holder, emergency

healthcare providers would notify this individual if the account holder was seriously injured, or rendered

unconscious in a crash or emergency situation.

CONFORMANCE CRITERIA:

1) The system SHALL provide the ability to capture, display and report at minimum a name and telephone

number for at least one contact person.

2) The system SHALL provide the ability to capture the source, date and time of all updates to the 'Emergency

Contact Information' list.

- Tooling for the EHR-S FM and PHR-S FM

- Hyperlinked PDF

- Embedded links to Glossary items

- SQL version of the FM's

- Excel spreadsheet version of PHR-S FM (similar to EHR-S FM spreadsheet version)

- Profile development ABt Incorporated software for PHR-S FM (similar to EHR-S FM Abt software)?

- ABt Incorporated is willing to work with Corey to add Profiling rules to its software

- XML-based version (per Corey Spears)

Profiles that are in the planning stage include:

- Public Health EHR-S Functional Profile

- Mobile Health Record EHR-S Functional Profile

- Claim-for-Payment EHR-S Functional Profile

- Health System -Linked PHR-S Functional Profile

- Clinical Research PHR-S Functional Profile

- (See "EHR TC Project List 20080505.xls")



- Certification of General Practitioner Information Technology (GPIT) systems in Ireland. For more information,

see:

- www.dohc.ie/gpit ("Requirements for Certification 2007")

- www.icgp.ie/gpit

- www.hse.ie (The Health Service Executive)

- www.icgp.ie Use Case on Biosurveillance: A report on the details of the work-effort.

AHIC-HITSP (Irish College of General Practitioners)

Goals for the week

Topic ID

1

2

3



4

5



6

7

8

9

10



11



12

13



14

15

16



17

18



19

20

21

22

23

24

25

26

27



28

29

PHR Parking Lot of Issues and Tasks

Develop a list of possible PHR-S FM functional profiles then promote them to target stakeholder groups.

Develop a hybrid EHR-S FM / PHR-S FM functional profile for "tethered" PHRs.

Develop a PHR-related "Health Platform Functional Model"? Attempt to develop a “Health Platform Functional

Profile” of the PHR-S FM first. If it cannot be done, then consider creating a “Health Platform Functional Model”.

DM: Health information exchange between an EHR-S and a PHR-S.

The "Manage-Hierachy of Action Verbs" needs to be vetted. Then the PHR-S FM needs to updated according to

the consensus reached on the "Manage-Hierarchy of Action Verbs".

Refine the PHR-S FM Glossary.

Analyze PHR-S FM for consistent use of Glosary terms.

Analyze ONC/AHIC/HITSP Use Cases vis-à-vis the EHR-S FM, PHR-S FM, and EHR Interoperability Model.

Distribute the PHR-S FM internationally.

Develop a strategic plan and a method/mechanism for formally, consistently, and continually acquiring

international feedback regarding the PHR WG’s efforts and work-products.

Promote translation of PHR-S FM to non-English languages. Announce at Affiliates meeting that the EHR WG will

host a 20-minute session during a certain Quarter.

Promote international use of standards-based PHRs.

Promote international standards-based certification of PHRs. Host a discussion for all internationally-oriented

PHR-related topics.

Generate PHR-S FM –related media announcements or articles

Perform outreach / education. Include the Education Work Group and the Marketing Council.

Promote the PHR Ambassador Briefing program by offer invitations to become an authorized speaker and

invitations to host/recommend briefings

Collaborate with related organizations / professional societies

Review "wp131_en.pdf" from Working Party 131, European Commission, regarding the protection of PHR data

from within an EHR system (per Kathleen Connor)

Discuss methods of involving the World Health Organization in PHR WG –related work-products and projects.

Consider promoting the use of the PHR-S FM in developing countries (per Gora Datta’s recent report to the PHR

Promote the development (and registration) of PHR-S Functional Profiles.

List and prioritize the PHR WG’s "Next Steps".

Distribute the “Parking Lot of PHR-S FM issues and tasks” to various stakeholders (including ISO TC/215).

Render the PHR-S FM in various forms (e.g., XML, database, spreadsheet, and hyper-linked PDF).

Discuss Emergency Responder –associated functionality and conformance criteria (as proposed by Larry

Williams).

Interoperability, the use of CCD’s, and plug-and-play between EHR’s and PHR’s (per Jim Mhyre).

Review list of open items from PHR-S Functional Profiling efforts (Health Authority PHR-S Functional Profile;

Payer-Linked PHR-S Functional Profile)

Discuss other national or international topics of interest.

Update and publish a “Parking Lot of PHR-S FM issues and tasks”.



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