Report from the Technical Committees

Transcription

1 Document Number: HITSP 08 N 360 Date: October 6, 2008 Report from the Technical Committees Arlington, VA October 6, 2008 Presented by: Joyce Sensmeier MS, RN-BC, CPHIMS, FHIMSS HITSP Technical Committee Co-Chairs enabling healthcare interoperability 0

2 1 AHIC Use Cases 2008 Provider Consumer Population Consultations and Transfers of Care Remote Monitoring Immunizations and Response Management Personalized Healthcare Patient Provider Secure Messaging Public Health Case Reporting

3 2 Technical Committee Leadership Provider Perspective 210 members Allen Hobbs, PhD, Kaiser Permanente Steve Hufnagel, PhD, DoD/Medical Health System (MHS) Mike Lincoln, MD, Department of Veterans Affairs Consumer Perspective 191 members Mureen Allen, MD, FACP, ActiveHealth Management Charles Parisot, EHR Association Scott Robertson, PharmD, Kaiser Permanente

4 3 Technical Committee Leadership Population Perspective members Floyd Eisenberg, MD, MPH, Siemens Medical Solutions Peter Elkin, MD, Mayo Clinic College of Medicine Anna Orlova, PhD, Public Health Data Standards Consortium Administrative and Financial Domain 48 members Don Bechtel, Siemens Medical Solutions Durwin Day, Health Care Service Corporation Deborah Belcher, GE Healthcare

5 4 Technical Committee Leadership Security, Privacy & Infrastructure Domain members Glen Marshall, Siemens Medical Solutions John Moehrke, GE Healthcare Walter Suarez, MD, Institute for HIPAA/HIT Education and Research Care Management and Health Records Domain - 47 members Keith Boone, GE Healthcare Corey Spears, McKesson Health Solutions Total Technical Committee Membership 505 individuals

6 Trending in Technical Committee Membership HITSP Membership Total # of TC Members Jan-06 Apr-06 Jul-06 Oct-06 Jan-07 Apr-07 Jul-07 Oct-07 Jan-08 Apr-08 Jul-08 Months Number of Members

7 Trending for Technical Committee Meeting Attendance Participation: HITSP Face to Face Meetings Total Participants February, 2006 June, 2006 August, 2006 March, 2007 June, 2007 October, 2007 March, 2008 June, 2008 Meeting Dates Participation: HITSP Face to Face Meetings

8 Report from the Population Perspective Technical Committee: IS10 Immunization & Response 7

9 8 Report from the Population Perspective Technical Committee: IS 10 Immunizations & Response IS 10 TP 13 TP 20 TP 22 TP 30 TP 70 T 15 T 16 T 17 T 23 T 24 T 29 T 31 T 33 HITSP Immunizations and Response Interoperability Specification HITSP Manage Sharing of Documents Transaction HITSP Access Control Transaction Package Patient ID Cross Referencing HITSP Manage Consent Directives Transaction Package Immunization Query and Response Transaction Package HITSP Collect and Communicate Security Audit Trail Transaction HITSP Consistent Time Transaction HITSP Secured Communication Channel Transaction HITSP Patient Demographics Query Transaction HITSP Pseudonymize Transaction HITSP Notification of Document Availability Transaction Document Reliable Interchange HITSP Transfer of Documents on Media Transaction

10 9 Report from the Population Perspective Technical Committee: IS 10 Immunizations & Response T 63 Emergency Message Distribution Element Transaction T 64 Identify Communication Recipients Transaction T 66 Terminology Service Transaction T 81 Retrieval of Medical Knowledge Transaction C 19 HITSP Entity Identity Assertion Component C 26 HITSP Nonrepudiation of Origin Component C 62 Unstructured Document Component C 72 Immunization Message Component C 78 Immunization Document Component C 80 Clinical Document and Message Terminology Component C 82 Emergency Common Alerting Protocol Component C 83 CDA and CCD Content Modules Component C 88 Anonymize Immunizations and Response Management Data Component TN 901 Technical Note for Clinical Documents

11 Report from the Population Perspective Technical Committee: Public Health Case Reporting 10

12 11 Report from the Population Perspective Technical Committee: Public Health Case Reporting TP 13 - HITSP Manage Sharing of Documents Transaction Package TP 20 - HITSP Access Control Transaction Package TP 21 - HITSP Query for Existing Data Transaction Package TP 22 - HITSP Patient ID Cross-Referencing Transaction Package TP 30 - HITSP Manage Consent Directives Transaction Package TP 50 - HITSP Retrieve Form for Data Capture Transaction Package T 14 - HITSP Send Laboratory Result Message Transaction T 15 - HITSP Collect and Communicate Security Audit Trail Transaction T 16 - HITSP Consistent Time Transaction T 17 - HITSP Secured Communication Channel Transaction T 23 - HITSP Patient Demographics Query Transaction T 24 - HITSP Pseudonymize Transaction T 29 - HITSP Notification of Document Availability Transaction T 31 - Document Reliable Interchange T 33 - HITSP Transfer of Documents on Media Transaction T 63 - Emergency Message Distribution Element Transaction T 64 - Identify Communication Recipients Transaction

13 Report from the Population Perspective Technical Committee: Public Health Case Reporting T 66 - Terminology Service Transaction T 81 - Retrieval of Medical Knowledge Transaction C 19 - HITSP Entity Identity Assertion Component C 26 - HITSP Nonrepudiation of Origin Component C 32 - HITSP Summary Documents Using HL7 Continuity of Care Document (CCD) Component C 35 - HITSP Lab Result Terminology Component C 36 - HITSP Lab Result Message Component C 48 - HITSP Encounter Document Using IHE Medical Summary (XDS-MS) Component C 62 - Unstructured Document Component C 75 - Healthcare Associated Infection (HAI) Report Component C 76 - Case Report Pre-Populate Component C 80 - Clinical Document and Message Terminology Component C 82 - Emergency Common Alerting Protocol Component C 83 - CDA and CCD Content Modules Component C 87Anonymize Public Health Case Reporting Data Component TN 901Technical Note for Clinical Documents 12

14 13 Report from the Population Perspective Technical Committee: Public Health Case Reporting TN901 - Technical Note for Clinical Documents HITSP Document Construct Relationship CDA/CDD Document based constructs use C83 and C80 HITSP defines multiple constructs based upon CDA/CCD documents To maintain and apply consistent constraints, HITSP utilizes: C83 CDA and CDD Content Modules C80 Clinical Document and Message Terminology C83 and C80 promote consistent choices for: CDA structures in all document sections of all HITSP documents Content Modules Vocabularies choices for similar concepts

15 14 Report from the Population Perspective Technical Committee: Next Steps Immunization and Response Consensus regarding message and document approaches 2009 Convene groups to understand overall scope of inventory management, private and public sectors Public Health Case Reporting Update Data Element Table 1. Coordinate with AHRQ Common Formats for Patient Safety Reporting 2. Coordinate with C80 (terminology) and C83 (context) Specify constraints Ongoing efforts with CSTE regarding reportable conditions

16 15 Report from the Consumer Perspective Technical Committee IS 12 Patient-Provider Secure Messaging (PPSM) IS 77 Remote Monitoring (RMON) IS 03 & 05 Consumer Access to Clinical Information (extensions) Advance Directives Access to Consumer-Friendly Clinical Information

17 16 Report from the Consumer Perspective Technical Committee IS 12: PPSM Completed and submitted to IRT for review Public Comment Period Target: IS submission to panel for December 2008

18 17 Report from the Consumer Perspective Technical Committee PPSM Architectural Variants The most generic variant selected as foundation. First two variants are supported as simplified implementations

19 18 Report from the Consumer Perspective Technical Committee C62 Unstructured Document Component (new) Support for a wide variety of content (PPSM and advance directives-sow) New component Simple/unstructured text Scanned Documents PDFs References: IHE XDS-SD, PDF/A ISO b Coordination between CPTC, SPI, Admin & Finance Minimal document header (compatible with other HITSP CDA docs) to support wide applicability Secured Messaging Advance Directives

20 19 Report from the Consumer Perspective Technical Committee IS 77: Remote Monitoring Completed and submitted to IRT for review Public Comment Period Note: Access to the Continua (draft) guidelines requires to sign an NDA. Contact John Donnelly. Target: IS submission to panel for December 2008 Two main challenges: Convergence to a single interface between Device Intermediaries and Remote Monitoring Mgmt Systems (used either in Homes or in Care Delivery Organizations) Request to IHE and Continua for harmonization Tight schedule synchronization between completion of IEEE standards, Continua Implementation Guidelines, and IS completion for panel approval in December.

21 20 Report from the Consumer Perspective Technical Committee Remote Monitoring Interface #1 Interface #2 Business Actors may be combined: e.g. RM Mgt Syst & EHR or RM Mgt Syst & PHR Significant reuse of existing & new constructs in Interfaces 3, 4, 5, 6 and 7 Device Device Intermediary Interface #6 Remote Monitoring Mgmt System Interface #3 Interface #7 PHR System Health Info Exchange Interface #4 Interface #5 EHR System

22 21 Report from the Consumer Perspective Technical Committee Devices that are being considered this cycle include: Blood pressure monitor Glucometer Pulse oximeter Thermometer Weighing scale

23 22 C74 - Remote Monitoring Observation Document Concept Specifies the medical information collected by remote health monitoring devices, based upon HL7 CDA Measurements captured by devices; notes, summaries, and other kinds of narrative information that may be added by caregivers or by the users Graphs that may be added by intermediary devices that represent trends of users health Example systems include PHRs, EHRs, Practice Management Applications and other stakeholders Selected Standard Implementation Guide for CDA Release 2.0 Personal Health Monitoring Report (PHMR)

24 23 T73 - Aggregate Device Information Communication Concept Allows a system (such as a home hub, a cell phone, a set top box, a monitoring station) to report device observations through a local or remote connection to an information management system Selected Standard The Tier 2 analysis has resulted in two alternatives: One approach is based on the use of the IHE DEC Integration Profile (HL7 V2.x). This approach is widely used today within Hospitals to connect clusters of devices to EHRs The other approach is based on the use of IEEE Device Specialization conveyed as a document (ASN1 encoded with MDER or XER)) by HITSP T31 (IHE-XDR). This approach is primarily targeted at home monitoring Public Comment is expected on the selection that should be made between these alternatives. IHE and Continua Health Alliance are currently working collaboratively to analyze the approaches and propose their recommendation to HITSP.

25 24 Report from the Consumer Perspective Technical Committee IS 03 & IS 05 Updates A number of items identified last year (as gaps in use cases) prioritized for possible completion this year IS03 / IS gap items: Advance Directives Consumer-Friendly Clinical Information Provider Lists (2009)

26 25 Report from the Consumer Perspective Technical Committee Advance Directives (partial in 2008) C62: Unstructured document Consumer-Friendly Clinical Information / translations T81: Retrieval of Medical Knowledge Provider Lists Identified scope of work Generating provider lists current efforts Setting permissions - TBD Other uses- TBD Working on identifying the key actors and interactions Given complexity, work extended to 2009

27 26 Report from the Consumer Perspective Technical Committee T81: Retrieval of Medical Knowledge Transaction (new) Supports the retrieval of medical knowledge References: HL7 v 3.0 Context-Aware Information Retrieval Specification: URL Implementation Guide Based on the Infobutton concept

28 27 Report from the Provider Perspective Technical Committee ISO-8 Personalized Health Care Use case Scenario's Clinical Assessment. A family health history is gathered from or by the consumer in an interoperable form to be used by consumers and clinicians. This information is accessed by clinicians and used in conjunction with personal medical history, current health status, and personal preferences to develop a diagnostic plan. Genetic Testing, Reporting, and Clinical Management. A medical testing laboratory performs genetic or genomic testing after it receives genetic/genomic test orders and any accompanying information necessary for the testing in an interoperable form. The testing laboratory performs the tests, develops the patient report, and transmits this information back to authorized providers. Clinicians utilize this new diagnostic information for the management of their patients. Both clinicians and consumers have access to this information via the PHR.

29 Report from the Provider Perspective Technical Committee: PHC Roadmap 28

30 29 Report from the Provider Perspective Technical Committee: Identified Constructs HITSP/C19 - Entity Identity Assertion HITSP/C32 - Summary Documents Using HL7 Continuity of Care Document (CCD) HITSP/C36 - Lab Result Message Component HITSP/C37 - Lab Report Document HITSP/C48 - Encounter Document Using IHE Medical Summary (XDS-MS)

31 30 Report from the Provider Perspective Technical Committee : Identified Constructs HITSP/C62 Unstructured Document Component HITSP/C69 - Generic Order Component HITSP/C80 - Clinical Document and Message Terminology Component HITSP/C84 - Consult and History and Physical Note Component HITSP/C90 Clinical Genomic Decision Support Component

32 31 Report from the Provider Perspective Technical Committee : Identified Constructs HITSP/T15 - Collect and Communicate Security Audit Trail HITSP/T16 - Consistent Time HITSP/T17 - Secured Communication Channel HITSP/T23 - Patient Demographics Query HITSP/T29 - Notification of Document Availability HITSP/T31 - Document Reliable Interchange HITSP/T33 - Transfer of Documents on Media HITSP/T40 - Patient Generic Health Plan Eligibility Verification Transaction

33 32 Report from the Provider Perspective Technical Committee :Identified Constructs HITSP/T68 - Health Plan Authorization/Referral Request and Response HITSP/T85 Administrative Transport to Health Plan HITSP/TP13 - Manage Sharing of Documents HITSP/TP20 - Access Control HITSP/TP22 - Patient ID Cross-Referencing HITSP/TP30 - Manage Consent Directives HITSP/TP89 Sharing Imaging Results

34 33 Report from the Provider Perspective Technical Committee: Framework for Personalized Healthcare Personalized Health Care Integration into Clinical Practice Intervention Development and Review Expansion of the Science Base Health Information Technology Adapted from DHHS PHC, Opportunities, Pathways, Resources 2007

35 34 Report from the Provider Perspective Technical Committee Emergency Responder Use Case SITUATION: IS04 Version 1.0 was issued Dec GAP/Overlap closure projects NEXT STEP: IS04 Version for public review 2008 ER-EHR New Constructs for for OASIS EDXL DE and CAP Other New Constructs developed by other TCs 2009 and beyond HITSP Constructs for NEMSIS and DEEDS harmonized vocabulary pre-hospital EMS document content (e.g., field and run reports) SITREP and Patient Tracking

36 35 Report from the Provider Perspective Technical Committee: Emergency Responder Use Case Construct HITSP/T40 HITSP/T63 HITSP/T64 HITSP/T66 HITSP/T67 HITSP/T68 HITSP/T85 HITSP/C48 HITSP/C62 HITSP/C82 New/Repurposed 2008 construct Insurance Coverage and Eligibility Emergency Message Distribution Element Transaction Identify Communication Recipients (service) Terminology Service Clinical Referral Request Transport Transaction Patient Health Plan Authorization Request and Response Administrative transport to health plan Encounter/ Discharge Doc. Using IHE Medical Summary (XDS-MS) Unstructured Document Component Emergency Common Alerting Protocol (CAP)

37 36 Report from Provider TC: ER-EHR Projects Status HITSP Nursing Terminology - done NEMSIS chaired work group: 1. Finding a method of assigning and adopting unique identifiers for both incidents and patients so data from heterogeneous systems can be linked - pending 2. Common approaches of delivering third party incident information such as telematics data to the Emergency Communications System (ECS) and emergency responders - actively working 3. Reaching agreement between healthcare and other emergency responders on a common terminology ( Managed List ) for incident types - pending 4. Harmonizing the data taxonomies of hospital (DEEDS), EMS (NEMSES), and other emergency responders to the extent necessary to implement the ER-EHR October funding start of work at Univ. of Utah Additional gap area projects are: 1. Decision Support Tool interoperability monitoring external progress 2. Core Services - monitoring external progress 3. Situation Awareness Messaging - monitoring external progress 4. Emergency Contact Registry (ECON) done 5. Life Critical Remote Monitoring - pending

38 Report from the Provider Perspective Technical Committee: Emergency Responder Use Case 37 Information Exchange Requirement - Data Requirement Component Transaction Transaction Package IER01 Emergency Contact NA NA TP22 IER02 Clinical Summary C32 NA TP13 IER03 Run Report GAP PDF GAP T63, T64 NA IER04 Present Episode of Care C28, C48 GAP T63, T64 TP13 IER05 Discharge Summary C48 NA TP13 IER06 Situation Report GAP PDF GAP T63, T64 TP13 IER07 Medical Device Data GAP GAP T63, T64 NA IER08 Info Provider Data (e.g., telematics) GAP PDF GAP T63, T64 NA IER09 Decision Support GAP GAP T63, T64 NA IER10 Patient Identification NA T23 TP22 IER11 Public Health Data GAP NA TP13 IER12 Public Health Protocol GAP GAP T63, T64 NA IER13 Ins. Coverage & Eligibility NA T40 NA IER14 Ins. Care Authorization/Denial NA NA T68 IER15 Alert (patient en route) NA NA C82 IER16 Transfer-of-care information C28 T63 TP13

39 38 Report from the Provider Perspective Technical Committee : Consultations and Transfers of Care IS09 was completed September 22, 2008 Produced by Provider Perspective TC Input from Admin and Finance, Care Management, Security TCs Work based upon Consultation and Transfers of Care Detailed Use Case, March 21, 2008 TN900, Security and Privacy Technical Note TN901, Technical Note for Clinical Documents

40 39 Report from the Provider Perspective Technical Committee : Consultations and Transfers of Care What it covers: Consultations: information exchange supporting consult request, performance, and resulting Transfers of care: information exchange for request and actual transfer For both consults and transfers Supports information exchange to verify eligibility and authorization for services

41 40 Report from the Provider Perspective Technical Committee : Consultations and Transfers of Care Summary of IS09 constructs used Lab-related (C35, C36, C37, T14) Document-related (C32, C48, C62, C84, T29, T31, T33, TP13, TP22) Radiology-related (C41, TP89) Security/infrastructure-related (T15, T16, T17, T85, TP20) Eligibility/referral-related (T40, T67, T68, T79) Entity/identity-related (C19, T23, TP22)

42 41 Report from the Provider Perspective Technical Committee : Consultations and Transfers of Care IS09 gaps Some clinical data without a HITSP construct Example-ECG Functional status instruments poorly supported We need a CDA implementation guide for assessment instruments including functional status Nursing documentation Highly variable, no good standard for nursing summaries, notes, etc. CDA probably applicable here but needs development

43 42 Report from the Provider Perspective Technical Committee : Consultations and Transfers of Care IS09 gaps Identifying consultant and transfer setting Few tools to identify providers and facilities meeting a complex set of preferences Patient and referring/transferring provider preferences are multi-faceted Prefs include specialty, network, location, co-pay preferences Needs Cross TC work and SDO engagement

44 43 Report from the Provider Perspective Technical Committee : Consultations and Transfers of Care IS09 gaps Decision support (IER 5) No current HITSP-defined DSS interoperability Needs cross-tc work and possibly SDO engagement (e.g., HL7)

45 44 Report from the Provider Perspective Technical Committee : Consultations and Transfers of Care IS09 Lessons Learned Tables relating constructs, actors, IER, and ER were very helpful to clarify/speed the work Tight timelines met by able help of the entire TC team! Particular thanks to Steve Hufnagle, Mike Glickman, & Allen Hobbs Huge debt to Suzi Hines and Gila Pyke

46 Questions? 45

47 46 Report from the Security, Privacy & Infrastructure Domain Technical Committee Completed editorial changes to existing construct documents (out for Public Comment in September) Developed 10 new constructs (out for Public Comment in September) Modified 3 existing constructs (out for Public Comment in September) Worked with PTCs to ensure new constructs meet the requirements of the use cases

48 47 Report from the Security, Privacy & Infrastructure Domain Technical Committee Continued to work with TC-Leadership to address NHIN issues related to the use of SPI constructs in the NHIN Trial Implementations (ongoing) Longer term plan of maintenance updates to constructs and TN900 (e.g. revisions to TP30: Manage Consent Directives to incorporate additional coding/base standards which are now available)

49 48 New & Updated SPI constructs use in Interoperability Specifications Doc # C62 C82 Document Name Unstructured Document Emergency Common Alerting Protocol IS08 CTC IS09 PHC IS10 PHCR IS12 PPSM IS11 IRM IS77 RMON IS03 CE Networks IS03 ER EHR IS05 CE Media C87 Anonymize Public Health C88 T23 T63 T64 T66 T67 T81 Anonymize Immunization Patient Demographics Query (*new option) Emergency Message Distribution Element Identify Communication Recipients Terminology Services Clinical Referral Request Transport Retrieval of Medical Knowledge New Interoperability Specifications Existing Interoperability Specifications T85 TP22 Administrative Transport to Health Plans Patient ID Cross Reference (*new option)

50 49 C62 Unstructured Document Concept Capture and storage of patient identifiable, unstructured document content, such as text, PDF, images rendered in PDF Selected Standards IHE XDS-SD ISO PDF/A b

51 50 C82 Emergency Common Alerting Protocol Concept Multicast notification message sent to an identified channel Intended recipients are populations such as all emergency departments in XXX county, within a geographic area, etc Construct can only be used to transport text message alerts Selected Standards OASIS CAP v1.1

52 51 New Approach to Anonymize Construct Existing C25 construct contains anonymization requirements for two different use cases (Bio and Quality) Adding new requirements to same construct (from new use Public Health Care Reporting and Immunization Management) would be inefficient and less effective Would require constant updates to construct, and constant updates to IS s that use it New Approach Dedicate separate anonymize construct to each use case Modify current anonymize construct (C25) to focus only on the IS02 Biosurveillance Develop two new anonymize constructs, one for Public Health Case Reporting (C87) and one for Immunizations and Response Management (C88) Create a new construct for the Quality IS

53 52 C87 Anonymize Public Health Case Reporting Data Concept Provides specific instruction for anonymizing repurposed data created as part of routine clinical care delivery Defines anonymization requirements specific to Public Health Case Reporting data Selected Standards ISO Pseudonymisation TS# 25237

54 53 C88 Anonymize Immunizations and Response Management Data Concept Provides specific instruction for anonymizing repurposed data created as part of routine clinical care delivery Defines anonymization requirements specific to Immunizations and Response Management data Selected Standards ISO Pseudonymisation TS# 25237

55 54 TP22 Patient ID Cross-Referencing Concept Identifying and cross-referencing different attributes for the same patient. It contains following transactions: Patient ID Cross-Referencing Patient Identity Feed Updated to include an optional transaction - Patient Identity Management transaction - for Pediatrics Demographics Selected Standards IHE PIX IHE Technical Framework Supplement, Pediatric Demographics HL7 v2.5 HL7 v2.3.1

56 55 T23 Patient Demographics Query Concept Involves request for patient demographic information, and a response with a list of patient demographics for matching patients, if any were found Updated to include Pediatric Demographics option which makes use of six additional demographic fields to aid record matching in databases with many pediatric records Selected Standards IHE PDQ IHE Technical Framework Supplement, Pediatric Demographics HL7 v2.5/v2.5.1

57 56 T29 Notification of Document Availability Concept Defines mechanism for a healthcare stakeholder (e.g. provider, public health, etc) to notify providers or the patient about information that is available for retrieval pertaining to an identified patient Updated to expand the use of this construct for notifications from other contexts such as public health, or other sources Selected Standards IHE NAV

58 57 T63 Emergency Message Distribution Element Concept Multicast notification message sent to an identified radio channel Intended recipients are populations such as all emergency departments in XXX County sd Emergency Message Distribution Element Transaction Message Receiver Message Transmitter Send Alert Message() Selected Standards OASIS EDXL-DE

59 58 T64 Identify Communication Recipients Concept Identification of communication recipients Delivery of alerts and bidirectional communications (e.g., public health agencies notifying a specific group of service providers about an event) Selected Standards IHE PWP

60 59 T66 Terminology Service Concept Used to transform human or computer vocabularies. Retrieve and resolve a value set with the appropriate terminology or code system Retrieve a value set with an appropriate map from one terminology to another Selected Standards IHE SVS HL7 CTS Release 1

61 60 T67 Clinical Referral Request Transport Concept Transport for provider-toprovider referral request interaction. Bundle referral request document & other relevant clinical documents of interest, and optionally send a trigger message to receiving provider system sd Clinical Referral Request Transport Interaction Referral Requestor Convey Printed Referral Request() Request Referral (HL7 ORM and HITSP/C48) Referral Dispatcher Selected Standards IHE Document-based Referral Request (DRR)

62 61 T81 Retrieval of Medical Knowledge Concept Enables request and receipt of additional knowledge about medical concept based on specific context parameters sd Retrieval of Medical Knowledge Does not prescribe knowledge content of message returned Knowledge Requestor Retrieve topic medical knowledge() Knowledge Resource Provides specifications for query/receipt of additional knowledge Retrieve sub-topic medical knowledge() Selected Standards HL7 v3.0 Context-Aware Information Retrieval

63 62 T85 Administrative Transport to Health Plan Concept Transport for administrative transactions between provider and health plan Example: pharmacy obtaining health plan eligibility, or physician requesting referral or authorization information from a health plan Selected Standards CAQH CORE Phase II, #270 rule sd Administrative Transport Interaction Administrative Client Administrative Server Administrative Request() Administrative Response or Error()

64 63 Report from the Care Management & Health Records Domain Technical Committee Released 12 new constructs: TP 70 Immunization Query and Response Transaction Package TP 89 Sharing Imaging Results Transaction Package C72 Immunization Message Component C74 Remote Monitoring Observation Document Component C75 Healthcare Associated Infection (HAI) Report Component C76 Case Report Pre-Populate Component C78 Immunization Document Component C80 Clinical Document and Message Terminology Component C83 CDA and CCD Content Modules Component C84 Consult and History & Physical Note Component C90 Clinical Genomic Decision Support Component TN 901 Technical Note for Clinical Documents

65 64 Report from the Care Management & Health Records Domain Technical Committee (cont) Updated 2 Constructs C32 HITSP Summary Documents Using HL7 Continuity of Care Document (CCD) Component C48 HITSP Encounter Document Using IHE Medical Summary (XDS- MS) Component Partial Restructuring of CMHR Components Completed Reviewed 7 AHIC Use Cases Developed Gap Filling Plans for Nursing Documentation Functional Status Assessments

66 65 Report from the Administrative and Financial Domain Technical Committee Current Work Completed editorial changes T40 - Patient Health Plan Generic Eligibility Verification Transaction Completed new construct T68 - Patient Health Plan Authorization Request and Response Transaction T79 - Pharmacy to Health Plan Authorization Request and Response Transaction Reviewing proposed 2009 Use Cases Long Term - Develop a Technical Note document for Administrative and Financial Domain TN902

67 66 Report from the Administrative and Financial Domain Technical Committee Construct Work HITSP Doc # TITLE RMON IS77 PPSM 2008 Use Cases PHC IS08 CTC IS09 IRM PHCR 2007 Use Case E-EHR IS04 T40 Patient Health Plan Eligibility Verification Transaction x x x x T68 Patient Health Plan Authorization Request and Response Transaction x x x x T79 Pharmacy to Health Plan Authorization Request and Response x x

68 67 Report from the Administrative and Financial Domain Technical Committee Existing Constructs Modified to Meet New Use Case Requirements Doc # T40 Construct Patient Health Plan Eligibility Verification Transaction Change Description Updates to support service/procedure specific inquiry and response Replaced CORE Phase 1 rules with new CORE Phase 2 rules Renamed to remove word Generic in the name

69 68 Report from the Administrative and Financial Domain Technical Committee New Construct Development Work New Construct Construct Description Selected Standards T68 Patient Health Plan Authorization Request and Response T79 Pharmacy to Health Plan Authorization Request and Response Transaction Used by a healthcare provider (other than a retail pharmacy) to request approval from a health plan to authorize certain healthcare services, when required by the patient s health plan contract. The health plan responds to the healthcare provider authorization request. Used by a retail pharmacy to request approval from a health plan to authorize certain healthcare services, when required by the patient s health plan contract. The health plan responds to the healthcare provider authorization request. ASC X v4010a NCPDP Telecommunication Standard Implementation Guide version 5.1

70 69 Report from the Administrative and Financial Domain Technical Committee Current Work Plan Project/task Target date Support Prospective TC with 2008 Use Cases 11/16/2008 Draft Administrative and Financial Technical Note /15/2008 Review & Comment on Proposed 2009 Use Cases 10/16/2008