ecr Digital Bridge Requirements Workgroup Meeting Minutes

Transcription

1 ecr Digital Bridge Requirements Workgroup Meeting Minutes Date: September 22, 2016 Conference Call: Time: 12:00PM 1:00PM ET Participant Code: Web Link: Web Conference registration: Facilitators: Shandy Dearth Proposed Agenda 1. Meeting Start 2. Discussion/Review of Requirements Workgroup Charge 3. Discussion/Review of Project Scope 4. Discussion of Project Milestones 5. Discussion of Meeting Cadence 6. Discussion/Review of Business Process Materials 7. Discussion of Next Steps Meeting Notes 1. Reviewing the charge approved by Digital Bridge Governance Body a. The charge has been wordsmithed slightly, but it is the same charge. Jim discussed that the charge was threefold: 1) Reaching consensus recommendation on business process, functional requirements; 2) Inventory existing ecr resources; 3) Recommend next steps for governance and technical work group. The PM Office feels that these deliverables should make clear the constraints around ecr and the objectives for an ecr process. b. We then discussed that workgroup norms and level set expectations for the Requirements workgroup. 1) Be an active participant, contribute and provide feedback; 2) Much will be done offline; 3) Be open to new ideas and ways of doing things; 4) Ask questions; 5) Be polite and courteous; 6) Understand how this affects other stakeholder groups. 2. What is in and out of scope a. We reviewed what was in scope vs out of scope. There was a discussion about return messages back to the provider/clinical care setting, it was decided that while it may not be implementable immediately, it is good to have it in scope and have requirements around this issue. b. Walter Suarez began the overall discussion of in/out of scope with a comment about how the information presented made sense. He then asked for an example based on what was discussed on the last call. Jim described the above example. There was a discussion that there is no need to reengineer the clinical and PH workflows. Just want to keep in scope SOME kind of message back to the provider, this could be message received, could be additional info needed, could be treatment guidelines. c. Art Davidson asked if we could modify the third bullet to include not just PH and clinical delivery but any appropriate intermediaries. It s not just two entities, but multiple. Jim felt that the intermediary is acting on behalf of either clinical care or PH (i.e., ecr is not tri-directional communication between clinical care, public health, and some other third entity). Art felt that someone has to own RCKMS, and make it available. Jim offered the solution of: 1) Reportable conditions need to be managed is a requirement (i.e., reportable conditions can be added, removed); 2) Triggers need to be managed is also a requirement (i.e., diagnoses, lab tests and results can be added, removed). Shu agrees with Art and asks that something be included in the communication bullet to indicate that communications include intermediaries as appropriate. Page 1 of 5

2 3. Requirements Assumptions a. Rich Paskach asked if we would be working with the 2016 notifiable conditions list or 2017, and if we want this to be flexible enough to adapt to the 2017 list? Jim thinks that the requirements should support modifications to the national list of notifications. This is a business requirement, we should state that new conditions can be added. b. Shu asked why just nationally notifiable, but not reportable conditions? The requirement should be that the system is flexible to cover both. The list of nationally notifiable conditions ( is offered as a frame of reference for the Requirements Workgroup. If there is an alternative published list it can be reflected in the requirements. Kathy Turner clarified that the 2016 NNC list was offered as a targeted minimal list to use as a starting point. c. We discussed that the RCTC has a large set of potential trigger sets, do we focus in on just a few or focus on all? Jim recommended that we pass that question on to the Technical Workgroup when it launches. Kathy offered that the Requirements Workgroup should decide what the trigger concepts cover (e.g., diagnoses, lab results), while the Technical Workgroup decide how the trigger concepts should be encoded in value sets (e.g., ICD-10, LOINC). d. Walter Suarez had two comments. We are mixing together workgroup scope and requirements assumptions, and the top two were actually requirements assumptions and should have a subheader indicating that. The second two are workgroup participation assumptions and should have a sub-header to indicate that. Regarding workgroup scope assumptions, there are existing ecr workflow diagrams that should be integrated into this effort. Digital Bridge is committed to using existing materials and tools. Many of the existing workflow diagrams are already incorporated, and if not they are technical and will be incorporated by the Technical Workgroup. e. Vivian asked that if we have not yet shared an inventory of background material that we integrated, we should do that now. That will reassure people. The Requirements Workgroup is building an inventory of existing ecr artifacts (e.g., implementation guides, value sets, webbased services) and associating them to ecr functional requirements. 4. Deadlines a. We discussed the proposal of increasing the amount of workgroup meetings for the next 2 weeks. We will need to post the topics for the next meeting as soon as the previous meeting ends to ensure that each stakeholder can send the appropriate representatives. We will also edit documents live during the meetings so we limit the need for out of meeting work for all who are able to attend. Workgroup members who cannot attend are still expected to review the documents offline. We discussed that the previously scheduled Governance Body meetings on 9/29 and 10/6 will be superseded by the Requirements Work Group to manage the aggressive schedule. We will go through activities based on the order of task flow. Thus, we know what is coming next. If you have contributions to make, please plan to participate based on where we finish at the end of a meeting 5. Business process materials a. Requirements Workgroup will develop an inventory of existing ecr artifacts. It is requested that all artifacts be from within the last 5 years at the very most. The example from the slides presented give the format. b. Business process matrix helps define the scope of ecr and describes our objectives and outputs for a broad collection of stakeholders. There was a discussion of this being one or multiple rows of a matrix, it was suggested that we try to keep the effort to one row/objective. There can be many other items in the other columns, but we should attempt to keep it to one objective. We will do task lists last. Page 2 of 5

3 Action Items PMO to send out new meeting invites for additional meetings through 10/13/2016 Share refined workgroup charge that includes the objectives, assumptions and deliverables (see below) Next Steps Review business process matrix (excluding the task set) and provide feedback by Wednesday, September 28. Meeting Attendees (X = Present) Lumpkin, John (RWJF) X Truong, Hoa (Deloitte) X Hornaday, Richard (Allscripts - Primary) Wiesenthal, Andy (Deloitte) X Caplea, Geoff (Allscripts - Alternate) Doyle, James (Epic - Primary) X Sharazi, Dari (APHL - Primary) Alban, Christopher (Epic - Alternate) Meigs, Michelle (APHL - Alternate) X Chaput, Dan (Ex Officio - ONC) Zarcone, Patina (APHL - Alternate) Daniel, Jim (Ex Officio - ONC) Xu, Wu (ASTHO - Primary) X Paskach, Richard (HealthPartners - Primary) Karras, Bryant (ASTHO - Alternate) X Boehm, Curtis (HealthPartners - Alternate) X Conn, Laura (CDC - Primary) X Suarez, Walter (Kaiser Permanente - Primary) X Helmus, Lesliann (CDC - Alternate) Isbell, Kevin (Kaiser Permanente - Alternate) X Hagemann, Kirsten (Cerner - Primary) X Wall, Joe (Meditech - Primary) Harmon, Bob (Cerner - Alternate) X Dearth, Shandy (Chair and NACCHO - Primary) Lichtenstein, Meredith (CSTE - Primary) X Davidson, Art (NACCHO - Alternate) X Altamore, Rita (CSTE - Alternate) X Lowe, Jelisa (PHII) X Hui, Janet (CSTE - Alternate) X Cook, Jessica (PHII) X Engel, Jeff (CSTE - Alternate) X Jellison, Jim (PHII) X Turner, Kathy (CSTE - Alternate) Tchamako, Jimica (PHII) X McGarvey, Sunanda (CSTE - Alternate) X Rembert, Juneka (PHII) X Chang, Benson (Deloitte) X Miller, Trish (PHII) X Stinn, John (Deloitte) Rupp, Mark (UNMC - Primary) X Stratton, Ben (Deloitte) Organization Represented Organization Category Present? RWJF Sponsor ONC/HHS Ex-Officio X PHII PMO X Deloitte PMO X HealthPartners Provider X Kaiser Permanente Provider X UNMC Provider APHL Public Health ASTHO Public Health Page 3 of 5

4 CDC Public Health X CSTE Public Health X NACCHO Public Health X AllScripts Vendor X Cerner Vendor X Epic Vendor Meditech Vendor X Requirements Work Group Charge (refined Sep 22, 2016) This charge to the Requirements Work Group reflects decisions made at the Sep Digital Bridge ecr Governance Body (Governance Body) meeting. The Requirements Work Group is charged with defining functional requirements for electronic case reporting (ecr). For background on ecr, please see the Digital Bridge web site (digitalbridge.us). The deliverables from the Requirements Work Group are intended to inform a subsequent Technical Architecture Work Group. Specific tasks for this charge include: 1. Reach consensus recommendations on ecr business process description* 2. Reach consensus recommendations on ecr functional requirements* 3. Inventory existing ecr resources 4. Recommend next steps for Governance Body and Technical Architecture Work Group *Draft materials provided by Digital Bridge Project Office The Requirements Work Group s deliverables should: 1. Describe scope, assumptions, constraints of ecr process 2. Describe clear goal(s) and objective(s) of ecr process Decision-Making The Requirements Work Group will use the same decision-making rules used by the Governance Body. Assumptions The work of the Requirements Work Group is scoped to the following initial assumptions: 1. The ecr requirements must support the 2016 Nationally Notifiable Conditions ( 2. The ecr requirements must support the data elements included the electronic initial case report (eicr) identified by the Council for State and Territorial Epidemiologists (CSTE). 3. In-scope: a. High-level, non-technical ecr functional requirements (these describe what ecr needs to provide, not how it will be implemented; the Technical Work Group will address how the requirements will be implemented). b. Bi-directional communication between clinical care settings and public health agencies (this could entail an intermediary entity between a health care provider and a public health agency (e.g. RCKMS, HIE). 4. Out of scope: Page 4 of 5

5 a. Technical implementation details (e.g., non-functional requirements describing IT security standards). b. Changes to process(es) for the delivery of patient care (i.e., clinical workflow re-engineering). c. Communication between public health agencies (e.g., transfer of case report from one state to another; case notification from state health department to CDC). Page 5 of 5