PCC TC Face to Face July 18-22-2016

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Monday July 18, 2016

Attendees: Present: Emma Jones, Denise Downing, George Cole, Thom Kuhn, Chris Melo, Steve Moore, Elena Vio, Celina Roth, Kristen Boyd, Andrea Forquet (student)

  • Introductions
  • Agenda Review
  • Updates from IHE International: Celina Roth
    • IHE International Announcements – call for new co-chairs, ballot closes on Friday, July 22, term begins September 1st , Co-chair meeting Wednesday & Joint Meeting, Celina introduced Kristen Boyd IHE USA Assoc Manager (new Sarah), Sept 12-Oct 7 system registration for Connect-a-Thon
  • Updates from IHE International Board: George Cole
    • Board meeting - end of April 2016. IHE Board is discussing IHE work and uptake of profiles
      • Business focus on SWOT strategy with emphasis on Priorty and Threats, opportunities
      • Formation of Task Forces
        • 1. Innovation - with focus on the Internet of Things - IHE do not want to be left out
        • 2. Use Cases group
        • 3. Understanding Adoption - Plan on providing a presentation to the board at the Sept meeting
          • Focus is on cataloging things that have gone to implementation and not yet final text
          • Need metrix for what makes a successful profile
          • Provide advice to planning on how to approve profiles
          • Need to determine the key to success
        • 4. Inbound marketing - in line with start-up companies and entrepreneurial companies (current start-up companies/entrepreneurs listening instead of shouting’s, doing marketing in a way that entices your audience)
        • 5. Restructuring IHE - a lot of members, several ideas talked about, joining or merging several groups, not HL7 - HL7 is a separate list, HL7 FHIR & IHE Connectathons Celina presented
      • September meeting need to present to the Board about what profiles are in trial implementation, developing metrics for what makes a successful profile/themes for advice to the planning committees
      • Proposal for professional certification - GASQ -Global Assoc for Software Quality – IHE will contract with, will go forward with for professional individual certification
        • No discussion about product certification that is HIMSS conformity assessment for the international community, International Community get organizations ready for testing or conformity assessment, Charles Persot is very knowledgeable about this
        • Question asked about product certification - HIMSS uses conformity assessment to get orgs ready for cert testing
        • Link to the [IHE Board meeting minutes][1].

DCP Comments review: Led by George Cole

Present: Emma Jones, Denise Downing, George Cole, Thom Kuhn, Chris Melo, Steve Moore, Elena Vio, Celina Roth, Kristen Boyd, Andrea Forquet (student), Lisa Nelson, Keith Boone

  • Reviewed comments –

Already took care of typos, groupings in the text were taken out, did change actor names, but wasn’t completed consistently throughout the document Theme of comments related around confusion about if there was a structure about one shared care plan, reworded/added content to row 155 (first paragraph) of profile Will show work for Actor diagram deleting Actor Care Plan Consumer and keeping Actor Care Plan Contributor, will need to change other areas of the profile swim lane diagram, section 3Y2.2, etc. the other issue is what to do about Governance – closed issue?? Review row 345 – 350

BED Comments review: Led by Keith Boone

Attendees: Present: Emma Jones, Denise Downing, George Cole, Chris Melo, Steve Moore, Elena Vio, Celina Roth, Kristen Boyd, Andrea Forquet (student), Keith Boone, Tone Southerland

  • Reviewed comments:

There is a new Actor Definition Glossary from July 14, 2014 on IHE.net website which deleted several terms in the profile’s Appendix A – Actor Summary Definitions

  • Voting:
    • George motioned to move the profile to Trial Implementation
    • Emma seconded the motion
    • Discussion - none
    • Abstain - 2
    • Opposed – 0
    • Profile moved to Trail Implementation
  • Transaction numbers assigned to the profile: 23, 24, and 25

Profile Summaries

Present: Emma Jones, Denise Downing, George Cole, Chris Melo, Steve Moore, Elena Vio, Celina Roth, Kristen Boyd, Andrea Forquet (student), Keith Boone, Tone Southerland

  • Tone discussed about updating wiki summaries by profile authors, Keith will update BED for the wiki, Elena will update XCHT-WD

CP Discussion Present: Emma Jones, Denise Downing, George Cole, Chris Melo, Steve Moore, Elena Vio, Celina Roth, Kristen Boyd, Andrea Forquet (student), Keith Boone, Tone Southerland, Thom Kuhn

  • CP 222 - RPM transaction numbers wrong, the transaction numbers in RPM had already been used in RCK Supplement, will use the following new numbers: 15, 21, 22. Need to update the CP and the RPM profile, Denise will update all

Profile proposal for ED transport. Problem presented by Andrea (student and EMS provider in the Rhode Island and Boston)

  • Andrea Forquet (student) wants to solve an EMS discharge issue – EMT transfers from one facility to another (i.e., rehab hospital) the transfer of care document is electronic or can be paperwork that is in a sealed envelope for transfers, EMTs do not have access to the electronic record to gather the information needed during the transport, the EMT spends approx. 30 minutes collecting all the needed information prior to transporting the pt, current IHE profile-Transport Record Summaries Profiles (this has 2 profiles with 3 supplements) the profile doesn’t address the EMT transport and worker needs, need to review NEMSIS.org and see how it relates to the issue trying to resolve.
    • Suggestion by Tone to look at Interfacility transport - IHE Profile
    • Possible Workflow profile

Sequoia Project - eHealth Exchange Content testing Evolution Update provided by Tone Southerland and Didi Davis

Present: Emma Jones, Denise Downing, George Cole, Elena Vio, Celina Roth, Kristen Boyd, Andrea Forquet (student), Keith Boone, Tone Southerland, Thom Kuhn, Didi Davis, Matt Blackmon, Steve Moore

  • US scope, using IHE profiles, pilot testing 3 tools to collect various documents C32 CCDA 1.1, 2.1, wanting to get feedback for pain points from users trying to produce documents - CCDA documents and sharing, developed 24 pain points from the feedback, took the issue to HL7 Structured Documents Work Group, HL7 didn’t want to get into the Implementation Issues, ongoing discussion around where certain content (narrative content – Operative, Progress Note, etc.) should be placed, HL7 Structured Documents WG had 2 meetings about this, they will provide clinical guidance about where to place narrative content,
  • Brought to IHE - do we do a national extension or white paper-open for discussion, there is a lack of support from vendors for unstructured documents, it doesn’t support MU requirements, it does meet customers need, IHE could develop some Use Case and provide guidance for unstructured content,
  • This project could provide education about guidance for testing, need a valid XML, displayed with a style sheet, and show to clinicians and add security around the output,

The project is going to raise the bar with suggestions and how people are implementing this with an Implementation Guide, pilot has ended, good cross-section of documents majority are 2.1, identified gaps in modeling efforts and showing some of the errors in the tool

  • HL7 Scorecard – the testing data wasn’t PHI, had test pts (Obama, Mickey Mouse), maintain static data from product testing and program testing
  • Metadata Query Response problem – 1/3 of the 24 pain points were this issue (from providers when you query for data the query fails because the metadata is bad) need guidance on the metadata
  • Is IHE involved with the EU Trillion Bridge Project? George has been a little involved
  • Topic for discussion for the IHE PCC Planning Meeting put on agenda next F2F meeting
  • Summary: Pilot Content Testing - an introduction and update from the project group
    • Validation Tools Evaluation
      • Creating CCDA documents
      • Pilot was geared towards C32, CCDA 1.1 and CCDA 2.1
      • Majority of the documents received are 2.1 documents
      • Tools evaluating are Gazelle, Diameter Health, SITE
      • Goals are to capture what implementers are experiencing - what are their pain points? [24 pain points that are being tracked][2].
        • schema issues
        • implementation issues
        • Took list of pain points to HL7 SDWG. Feedback - they were interested in tackling the schema issue but not the specific "where does this piece of data go"
        • SDWG discussed for 2 minutes now has moved onto Example Task force
        • SDWG will add additional guidance and linkages from the example task force.
    • Input from PCC
        • Suggest providing Support for the use of XDS-SD to support providers workflow. ONC MU cert has caused decreased use of XDS-SD
        • Suggest providing guidance on the point of exposure for providers is that some folks are standing up the validator and rejecting documents before providers get to see it.
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