ITI Planning Committee 2017/2018 Meetings

Introduction

This WIKI page documents the activities of the ITI Planning Committee during the 2017/2018 committee year (August 2017 - July 2018). These activities include:

• Call for Proposals : August-October
• Review and selection of Proposals : October-December
• Updates/Additions to Educational Materials/White Papers/Etc. : December-July

Interesting informal guidance from Mark Sinke https://www.forcare.com/blog/a-future-direction-for-ihe

Voting Rights

IHE ITI Voting Rights Page Member Roster

Proposal Evaluation Matrix

• Active Google sheet
• FTP directory with proposals

Proposal Webinars

Webinar Organization

Each webinar will be organized as follows (this will vary slightly depending upon how many proposals we will be reviewing:

• Each webinar will be divided into 20-minute time-slots, with the remaining time for introductory remarks and follow-up discussion.
• Each 20-minute time slot will be allocated to a profile/white paper proposal… the first 10 minutes will be taken up by a presentation by the proposal author, with the remaining 10 minutes reserved for discussion and any disposition (if required).
• Each 10-minute presentation will be comprised of a maximum of 5 Powerpoint slides, presenting the proposal problem statement concisely and completely.
• Presenter should focus on describing the Problem, and avoid speaking to their Solution. Emphasis on expressing the scope and scale of the Problem.

These are Decision meetings so attendance will be recorded to support membership responsibilities.

Webinar 1 DECISION

All times are Central Time. This call will be recorded and publicly posted.

Date	Time	Coordinates	Recording of the meeting
2016-Oct-04	10:00am-11:00am CDT	Join Webex(password "meeting")	recording is not available, sorry

Time	Proposal	Author/Presenter	Comments
10:00am-10:01am	Webinar Introduction, process	Daniel Berezeanu, John Moehrke : Co-Chairs	The goal for this series of webinars is to just explain and socialize the problem. The goals is NOT for the presenter to talk about the solution. And the goals is NOT for the ITI PC to prioritize or select which brief proposals move forward. Presenters should be prepared to present their brief proposal papers, or a power point with the same basic concepts. All webinars will be recorded and publicly posted. All ITI PC members are expected to review the webinars (live or via the recordings) prior to the F2F meetings. Since this is a decisional call, roll will be taken.
segment 1	Order and Referral by Form (ORF) and ORF Presentation	Juerg P. Bleuer	Directional information exchange between institutions such as requests for referral, requests for previous imaging results, requests for second opinions etc. as well as corresponding responses are often done by means of structured forms. However, forms for these purposes are in general proprietary constructs and seldom suitable for further machine processing.
segment 2	Cross-Community Metadata Update (XCMU) and XCMU presentation	Juerg P. Bleuer	The Cross-Community Document Reliable Interchange Supplement (XCDR) enriches the Cross-Community Access (XCA) Profile with the capability to create documents in one community and store them (inclusive their metadata) in another community, in that way providing a cross-community counterpart of the XDS/XDR transaction ITI-41 "Provide and Register Document Set-b". The aim of the given supplement is to make a step forward and create means for changing metadata of documents residing in another community, i.e. to provide a cross-community counterpart of the ITI-57 transaction "Update Document Set" defined in the XDS Metadata Update Supplement.
segment 3	PAM US extension and PAM presentation	Dr. Anna Orlova	Patient registration process and data collection during this process are implemented differently in different healthcare organizations in the US. This creates problems with patient record matching in health information systems and with the overall information trust across organizations involved in information exchange. We propose to re-evaluate the relevant HL7® v2.5.1 segments from the IHE ITI PAM Profile for patient registration with the subject matter experts from the AHIMA Standards Task Force and develop the US national extension constraints on these segments as needed.
segment 4	RESTful ATNA PUT	Rob Horn	Support CREATE for AuditEvent so that Apps using FHIR can record audit events. Leverage Rad-Standardized Operational Log of Events

Webinar 2 DECISION

All times are Central Time. This call will be recorded and publicly posted.

Date	Time	Coordinates	Recording of the meeting
2017-Oct-06	10:00am-11:00am CDT	Join Webex(password "meeting")	recording of the webinar.

Time	Proposed Document	Author/Presenter	Description
10:00am-10:20am	XDS Metadata Guidelines for Affinity Domains and Communities	Karima Bourquard	Although the XDS profile definition gives guidance for the use of metadata elements such as classCode, typeCode and eventCodeList, it leaves it up to the implementers in an Affinity Domain to use these metadata elements for the categorization of their documents and images studies. This leads to problems with cross-community exchange of metadata between Affinity Domains, as is common in XCA-linked XDS infrastructures, and to implementation and interoperability problems. Several national initiatives have already started to look at ways to define national implementation guidelines for interoperable XDS metadata elements and value sets. Questions/Comments: There is an existing WP about Metadata (from 2008) How international will this WP be, can you expand your community involvement? What metadata aspects will be addressed? Do you want to address Policy?
10:20am-10:40am	Survey of Network Interfaces Forum (SNIF) and Presentation	Ruth Berge	The U.S.A. most providers now have access to electronic records but federal strategic planning and the healthcare industry have new strong interest in interoperability as a path to better patient care. This means that more providers and systems will be updating and adding to their basic capabilities to send and receive healthcare related data. The industry needs to improve the ways that this exchange is enabled. There are no hard numbers from the industry on HL7 interfaces. In fact the lack of information is notable. The U.S.A. has a proposal to measure exactly how data is exchanged Questions/Comments: Connectathon uses a basic connection definition could be an interesting start Content profile vs Infrastructure ? Have you considered UDDI or service registry or other / Focus on the need not the solution
10:40am-10:59am	AS4 Option on XCA, XDR, and XCPD and presentation	Massimiliano Masi	As part of the European Union’s efforts at supporting digital integration between all Member States, such an environment has been developed under the Connecting Europe Facility (CEF) legislation. Main requirements for the environment relate to security, reliability, nonrepudiation, trust between communication partners in different countries and uses a subset of OASIS ebMS3.0 and the corresponding OASIS AS4 profile for point to point delivery of digital documents. To enable the exchange of electronic health data between different contact points in such regulated messaging environments, it is necessary to enable in the existing IHE profiles supporting cross-border exchange with the prescribed standards of the messaging environment. Questions/Comments Is it the goal to re-use existing infrastructure Can you expand on the current problem and how to solve it Can you add an example? Will you be wrapping existing transactions? What is the international need for this use case? Is it regional? Is the target need for an asynchronous smime what is the need?
????	spare time	tbd	If time is available we will pull in proposals from the third webinar
10:59am	Discussion, Next Steps	Co-Chairs	Review agenda face-to-face meeting

Webinar 3 DECISION

All times are Central Time. This call will be recorded and publicly posted.

Date	Time	Coordinates	Recording of the meeting
2017-Oct-10	11:00am-12:00am CDT	Join Webex(password "meeting")	Download recording

Time	Proposed Document	Author/Presenter	Description
11:00am-11:20am	FHIR conformance resource publication	Elliot Silver	Given we have existing IHE Profiles of FHIR, and the that the FHIR community desires StructureDefinition, ValueSet, and CapabilityStatement resources for implementation and conformance; this proposal will produce and publish these resources, with the intent to register them on http://registry.fhir.org. May be a subset of profiles. Should also produce a procedure that others may use. May experiment with GITHUB and others. Will record issues with FHIR. Questions/Comments Can you expand size vs features options? Can you clarify the scope? What is the size of this proposal? What is the downside of not doing this? How does DSTU4 influence this proposal? What group of people would be needed in each section?
11:20am-11:40am	XDWm	Mauro Zanardini	The world of mobile is unceasingly growing, paving the way for computerization of some healthcare processes such as communication from ambulances, availability of professionals and remote patient monitoring, which are hardly manageable by a computer. Even if the healthcare is going down this path, adopting mobile solutions to improve the quality of its services, managing workflows through mobile devices and applications is still very backward and not well-defined, even though it is a key aspect of the entire patient care process. Applications such as telemonitoring and remote consulting are particularly affected by this lack, not allowing to take full advantage of the potential of remote management. Questions/Comments Will you keep the same constraints as in XWD/ known workflow? Will there be a specific constrain What is the main driver for the profile, legislation, commercial Are there specific workflows that are not addressed by current profiles ? Will other profiles (for notification) be associated? Is there an expectation that this profile will pass XWD content or would it be converted ? Is there an existing FHIR mechanism that you are looking at ?
11:40am-11:59am	ITI TF Maintenance	Lynn Felhfer	At the beginning of a new publication cycle, it is good to quantify the TF maintenance work in the queue, since a dedicated but finite number of ITI Technical Committee members is responsible for both creating new work items and maintaining the growing list of existing documents: Questions/Comments How difficult are the CP’s on your list, is there a level of difficulty associated with each?
11:59am	Discussion, Next Steps	Co-Chairs	Review agenda face-to-face meeting

F2F Meeting DECISION

Webex for meeting https://himss.webex.com/himss/j.php?MTID=mad049fae9e05dc24209405ef66da2931

Monday, October 16 - Tuesday, October 17, 2017

RSVP Survey Link by October 2, 2017.

Note: Only IHE International members can attend events onsite. Interested in joining us onsite? Visit the IHE Online Application to submit your application today!

Meeting Location:

RSNA Headquarters, Oakbrook,IL 
820 Jorie Blvd # 200, Oak Brook, IL 60523

The following agenda is a draft and may be adjusted based on needs of the meeting NOTE: THIS AGENDA WILL BE SUBJECT TO CONTINUOUS REVISION; IT WILL BE LIKELY REVISED UP TO AND DURING THE MEETING.

Agenda/Minutes October 16

• 9:00 - Start
  • Co-Chairs, Domain Sponsors
    • Introductions
    • Housekeeping
    • Domain Sponsor Announcements
    • Procedures, voting privileges, etc.
    • Agenda review
• 9:15-9:45 CT -- ITI Capacity and Evaluation Criteria Active Google sheet
  • ITI co-chairs
    • Goal: Focus on the value the proposal would bring to the community. Do not consider the solution.
      • Is the Problem clear?
      • Concentrate on describing the interoperability problem you are trying to solve.
      • We are trying to gage the relative importance of the problem you are trying to solve, give us insight on the potential adoption of such a standard.
      • Would this standard be usable internationally?
      • Give us an idea of the urgency of solving the interoperability use case you are describing.
    • Each Item will be estimated by consensus at the end of the day
      • very rough estimate of size -- sort by size (aka relative size among new items)
      • Estimate of benefit to community
      • Staffed? participation from community
      • The significance and urgency of the interoperability problem in the business of healthcare?
      • Benefit to global community
      • Degree of expected adoption (for White Paper relates to it's use )
      • Alignment with IHE development domains outside of ITI
      • Alignment with internal responsibilities of ITI
    • Items identified as "Must Do" will be sized, and that effort deducted from available resources
• 9:45-10:00 CT -- PAM US Extension -- Anna
  • This could be re-formed as volume 4 content; provided this has been reviewed, have we gotten any feedback from IHE US from doing the work related to this item?
    • We will be presenting this to them in November
  • Are you proposing to expand the use cases?
    • Yes
  • Is the scope of the National Extension still PAM
    • Yes
  • Will notification of Record availability, Acknowledgement of receipt, Consent and audit be included?
    • No
  • What is the interoperability problem?
    • View slide 1
  • Will IHE USA do the trial implementation phase?
    • They should
• 10:00-10:30 CT -- FHIR Conformance resources publication -- Elliot
  • Start with minimally witting the structure definitions with easy wins
  • Schedule mismatch with the FHIR vs IHE vs ONC timelines
  • Factors in the R4 release, normative ballot must pass or fail in May
    • There will be 3 blocks with increasing normative probability
  • Interoperability problem in documenting the IHE resources
  • Resources: Elliot and John and profile authors
  • What is the size of the work you are proposing in the next year
    • The minimal work for quick wins (Author is happy)
    • Committee has reviewed and gotten community feedback
• 10:30-11:00 CT -- Break
• 11:00-11:30 CT -- Order and Referral by Form (ORF) -- Juerg
  • Why is GRPH for mobile RFD insufficient for your use case?
    • The questionnaire is not content driven
    • The questionnaire resources are not defined and do not use FHIR Ressources
  • What is the value of this profile without a specific workflow, trying to propose a generic questionnaire might be too difficult. Could we just solve the initial use cases?
    • No we really need to keep it generic
  • Is it an ITI use case?
    • The content is broad enough it could be, but also might fit in QRPH
  • What is the driver for this profile?
    • Legislation will be in place in Swiss, but Germany, Austria, Germany and France are also looking into this type of solution.
  • Could we create a White paper to describe this pattern?
    • The generic content is broad enough that it would be a profile.
• 11:30-12:00 CT -- Cross-Community Metadata Update (XCMU) -- Juerg
  • Federal law required that the patient can change the Confidentiality code or Access to the actual document?
    • It’s both, we are in a matrix architecture
  • Why can you not use BPPC and/or APPC (document identifier based) to solve this use case?
    • The problem is policy based as the Confidentiality code has to be changed across communities
  • XCDR would not work, would ITI**42 work to solve the use case?
    • No really, as it's not effective cross communities
  • Structural registry integrity considerations?
    • The patient needs to be able to deprecate without deleting
  • If the Trial Implementation does not go to final Text for 3**4 year would this timeline be acceptable?
    • Yes, we want to move this profile forward
  • What if the ITI committee finds a new technical solution, what would happen to the existing implementations?
    • Implementations are not specific, and we are looking for IHE conformance

• 12:00-12:30 CT -- XDS Metadata Guidelines for Affinity Domains and Communities -- Karima
  • Can you specify the metadata, when metadata is use case driven?
    • Affinity domains should be working with the metadata characterization around document exchange not the policy definitions related metadata (such as access control policy)
• 12:30-13:30 CT -- Lunch
• 13:30-14:00 CT -- AS4 Option on XCA, XDR, and XCPD -- Massimiliano Masi
  • Why is this an IHE issue?
    • To have expertise from the ITI committee, and this will augment wider IHE interoperability standards adoption.
  • Can you explain why you cannot solve interoperability problem with existing profiles?
    • Security approach base on closed system interoperability
    • Security for an environment that does not support TLS connections
  • Shipping information across borders is restrained by policies more than encryption.
    • The AS4 message encryption can provide additional security mechanisms for different environments
  • Shared link from chat
  • Additional questions will be tomorrow morning
• 14:00-14:30 CT -- Survey of Network Interfaces Form (SNIF) -- Ruth
  • Are you trying to solve a pointer issue if conformance statements exist?
    • It could be a good way to solve it when conformance statements are available (ex: Dicom)
  • Would the result by machine-readable?
    • Yes, the documentation in a format the software can read
  • Could we create a WP to fully document the problem and the ideas how to record the interface information?
    • Yes, this can be accomplished in a years work cycle.
  • Intended connectivity vs potential connectivity?
    • This is about intended connectivity
  • Multiple standards (DICOM, FHIR …) already have conformance statements, how does this help ?
    • We could start by creating some documentation for the standards that do not have such (HL7V2 and XDS) in year 1
  • link from chat
  • link from chat
  • More questions tomorrow
• 14:30-15:00 CT -- XDWm (Joint meeting with PCC)-- Mauro
  • What is missing from remote patient monitoring?
    • Using a mobile device to orchestrate the task management of the remote monitoring of patients.
  • Is the second apache that XDW already allows? RPE already allows for that workflow?
    • Yes
  • I have been working with the FHIR workflow, could you map XDW to FHIR workflow Resources; you would need to have mapping and explanations. You could start with e-prescribing as an example
    • That would make the profile much easier, but would make the profile useless, we want to make this profile universal .
  • Would you have a translation process between mobile (REST) and XDW?
    • We want to enable the mobile app to participate in XDW workflow.
  • If the device is so underpowered, is it realistic to believe they will be able to coordinate workflow, could they not simply use a more basic mechanism?
    • Not really that would not suffice to our use case
• 15:00-15:30 CT -- Break
• 15:30-16:00 CT -- RESTful ATNA PUT -- Rob
  • Is it staffed?
    • Yes
  • Is bulk delivery part of your success criteria?
    • It’s a nice to have.
  • What is the workload for this profile?
    • It could be done with a CP, but I was told to write it up as a profile.
  • Could this be a new transaction to an existing profile?
    • Probably.
• 16:00-16:30 CT -- CP Maintenance advocacy -- Lynn
  • Test tools link
• 16:30-17:00 CT -- Review ALL: Follow up questions? Action Items for proposals?
  • AS4
    • AS4 questions: What is the problem it will solve?
    • Once you have deployed AS4, the certificate chain will allow end-to-end security across borders.
    • AS4 is currently being used in other business domains and is a complete package allowing for end-to-end security.
    • What is the need that is not currently supported by the existing ATNA profile?
    • The EU has adopted a different standard than what IHE choose, and now we have to review the standard we are using.
    • Is this a Profile or a WP or a Technical guide?
    • What are the characteristics of a success?
    • Would additional wording in ITI-19 be sufficient? We don’t know for the moment, we would have to due-diligence.
    • Could AS4 be presented as a really small profile proposal and after technical evaluation re-evaluation of the profile would be assessed .
  • ORF
    • ORF, do you want a profile or guidebook/handbook?
    • Does it need to be testable at an IHE Connectathon?

• 17:00-17:30 CT -- Straw prioritization -- Rank from top priority to bottom priority.
• 17:30-18:00 CT -- Size Estimations -- Preliminary (more Tuesday)
• SUSPEND

Agenda October 17

• 9:00- 9:30 CT -- Agenda review, Clarify goal is Prioritize based on market need. Secondary goal is to give guidance toward Tech meeting preparation.
• 9:30-10:00 CT -- Any clarifying Questions on prior presentation
• 10:00-10:30 CT -- Continue Size Estimates
• 10:30-11:00 CT -- Break
• 11:00-11:30 CT -- First Round of Formal Priortization
• 11:30-12:00 CT -- Results debate: Outlier discussion. Do we understand the "Problem"?
• 12:00-12:30 CT -- Marketing opportunties
• 12:30-13:30 CT -- Lunch
• 13:00-14:00 CT -- Lunch
• 13:30-14:00 CT -- Second Round of Formal Priortization
• 14:00-14:30 CT -- ITI Board Report Gila
• 14:30-15:00 CT -- Educational Presentations
• 15:00-15:30 CT -- Break
• 15:30-16:00 CT --
• 16:00-16:30 CT --
• 16:30-17:00 CT --
• 17:00-17:30 CT --
• 17:30-18:00 CT --
• ADJOURN

Agenda November 16 - Joint TC/PC

See Technical Committee for Agenda during November 15 and 16