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“ Jericho / UT Austin Pilot” PowerPoint PPT Presentation


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“ Jericho / UT Austin Pilot”. Privacy with Dynamic Patient Review. Presented by: David Staggs and Michael Dufel Jericho Systems Corporation. Agenda. Administrative issues Pilot scope Pilot data flow Test scenarios Transaction and Document tests Discussion Pilot Timeline

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Jericho ut austin pilot

“Jericho / UT Austin Pilot”

Privacy with Dynamic Patient Review

Presented by:

David Staggs and Michael Dufel

Jericho Systems Corporation


Agenda

Agenda

  • Administrative issues

  • Pilot scope

  • Pilot data flow

  • Test scenarios

  • Transaction and Document tests

  • Discussion

  • Pilot Timeline

  • Plan of Action


Pilot administrivia

Pilot Administrivia

  • This pilot is a community led pilot

    • Limited support provided by the ONC

      • JohnathanColeman (Security Risk Solutions)

      • Zachary May (ESAC)

      • Penelope Hughes (ONC)

      • LibbieBuchele (ONC Sponsor)

  • In conjunction with DS4P bi-weekly return of an All Hands meeting

  • Access to DS4P Wiki, teleconference, and calendar

  • Meeting times: Tuesdays 11AM (ET)

    • Dial In: +1-650-479-3208Access code: 662 197 169URL:https://siframework1.webex.com/siframework1/onstage/g.php?t=a&d=662197169


Scope of the pilot

Scope of the Pilot

  • Define the exchange of HL7 CDA-compliant PCD between a data custodian and a PCD repository that includes a report on the outcome of the request to the healthcare consumer (subject).

  • Additional goal: use identifiers to identify the subject/ PCD repository for use in reporting the outcome of the “secondary user” request use case to subject by subsequent EHR custodians.

  • Stretch goal: mask and/or redact the clinical document based on data segmentation and PCD choices retrieved from the PCD repository.


Pilot data flow

Pilot Data Flow

, = Clinical data

A,B =

PCD data

= audit record

1st Requestor

And Subsequent Custodian of Data being Provided at 

B

Custodian of Data being Provided at 

PCD Repository

2nd Requestor

Patient


Test approach

Test Approach

Sections included in each test scenario in the DS4P Pilot Execution Script:

  • Scenario

  • Actors

  • Preconditions

  • Test steps

  • Test results

  • Log Capture

  • Data Set Verification


Test cases

Test Cases

DS4P Pilot Execution Script:

  • Consent To Patient Discovery : No Consent

  • Consent To Patient Discovery : 1st Requestor (1st)

  • Consent To Patient Discovery : 2nd Requestor(2nd)

  • Consent To Document Query : No Consent

  • Consent To Document Query : 1st To PC - Allow

  • Consent To Document Query : 2ndTo PC - Deny

  • Consent To Document Query : 2ndto SC - Deny

  • Consent To Document Retrieve : No Consent

  • Consent To Document Retrieve : 1stto PC - Allow

  • Consent To Document Retrieve : 2ndTo PC - Deny

  • Consent To Document Retrieve : 2ndto SC - Deny

  • Consent To Document Retrieve : With Segmentation


Test cases visual representation

Test Cases (Visual Representation)

PC = Primary Custodian

SC = Secondary Custodian


Original query response

Original Query & Response

Complete solution must retrieve PCD during ITI 55, ITI 38, ITI 39


J ut pilot sequence detail a

J-UT Pilot Sequence Detail (A)

Retrieving & applying PCD, reporting during patient discovery


J ut pilot sequence detail b

J-UT Pilot Sequence Detail (B)

Retrieving & applying PCD, reporting when returning document list


J ut pilot sequence diagram c

J-UT Pilot Sequence Diagram (C)

Retrieving & applying PCD, reporting when returning a clinical document


Transaction tests last meeting

Transaction Tests (Last Meeting)

  • NwHIN messages

    • Test messages must comply with NwHIN specification

    • Request for PCD from Document Custodian

    • ITI 55: Data Set A

    • ITI 38: Data Set B

    • ITI 39: Data Set C

    • ATNA audit record from Document Custodian

    • ITI 55: Audit data Set A

    • ITI 38: Audit data Set B

    • ITI 39: Audit data Set C


Document tests

Document Tests

  • HL7 Documents

    • HL7 Documents must comply with HL7 specification

    • Clinical document from Document Custodian

    • Must include a reference to the patient consent repository

    • PCD document from PCD Repository

    • Must follow HL7 Privacy Consent Directive

    • Must include specific elements


Discussion

Discussion

  • Review of J-UT DS4P Test Document Draft

    • Overview

    • Scenario Tests

    • Transaction Tests

    • Document Tests

    • Appendixes: Test Results


Pilot timeline

Pilot Timeline

  • General Timeline, conditioned on agreement of stakeholders


Plan of action

Plan of Action

  • Upon agreement of the participants the POA is:

    • Identify the elements available from previous DS4P pilots

    • Scope level of effort, decide on extended scenario

    • Determine first draft of functional requirements

    • Review standards available for returning information on requests

    • Determine any gaps or extensions required in standards

    • Stand up information holders and requestors

    • Create XDS.b repository holding PCD

    • Identify remaining pieces, create test procedures

    • Document and update IG with results of our experience


Backup slides

Backup Slides


Ds4p standards material

DS4P Standards Material

  • Location of DS4P Standards Inventory:

    http://wiki.siframework.org/Data+Segmentation+-+Standards+Inventory

  • Location of DS4P Standards Mapping Issues:

    http://wiki.siframework.org/file/view/Copy%20of%20DataMappingsIssues%2005102012.xlsx/333681710/Copy%20of%20DataMappingsIssues%2005102012.xlsx

  • General Standards Source List:

    http://wiki.siframework.org/file/view/General%20SI%20Framework%20Standards%20Analysis.xlsx/297940330/General%20SI%20Framework%20Standards%20Analysis.xlsx

  • Standards Crosswalk Analysis

    http://wiki.siframework.org/Data+Segmentation+for+Privacy+Standards+and+Harmonization (at bottom of page, exportable)

  • Implementation Guidance

    http://wiki.siframework.org/file/view/Data%20Segmentation%20Implementation%20Guidance_consensus_v1_0_4.pdf/416474106/Data%20Segmentation%20Implementation%20Guidance_consensus_v1_0_4.pdf


Ds4p references

DS4P References

  • Use Case: http://wiki.siframework.org/Data+Segmentation+for+Privacy+Use+Cases

  • Implementation Guide: http://wiki.siframework.org/Data+Segmentation+for+Privacy+IG+Consensus

  • Pilots Wiki Page: http://wiki.siframework.org/Data+Segmentation+for+Privacy+RI+and+Pilots+Sub-Workgroup


Pilot data flow1

Pilot Data Flow

, = Clinical data

A,B =

PCD data

= audit record

1st Requestor

And Subsequent Custodian of Data being Provided at 

B

Custodian of Data being Provided at 

PCD Repository

2nd Requestor

Patient


Pilot data flow2

Pilot Data Flow

Clinical exchange #

, = Clinical data

A,B =

PCD data

= audit record

1st Requestor

And Subsequent Custodian of Data being Provided at 

B

Fetch PCD

Fetch PCD

Custodian of Data being Provided at 

Clinical exchange # 

Send audit

Send audit

PCD Repository

2nd Requestor

Patient


Pilot data flow 1

Pilot Data Flow (1)

, = Clinical data

A,B =

PCD data

= audit record

1st Requestor

Custodian of Data being Provided at 

PCD Repository

2nd Requestor

Patient


Pilot data flow 2

Pilot Data Flow (2)

, = Clinical data

A,B =

PCD data

= audit record

1st Requestor

Custodian of Data being Provided at 

PCD Repository

2nd Requestor

Patient


Pilot data flow 3

Pilot Data Flow (3)

, = Clinical data

A,B =

PCD data

= audit record

1st Requestor

And Subsequent Custodian of Data being Provided at 

B

Custodian of Data being Provided at 

PCD Repository

2nd Requestor

Patient


Pilot data flow 4

Pilot Data Flow (4)

, = Clinical data

A,B =

PCD data

= audit record

1st Requestor

And Subsequent Custodian of Data being Provided at 

Custodian of Data being Provided at 

PCD Repository

2nd Requestor

Patient


Pilot data flow 5

Pilot Data Flow (5)

, = Clinical data

A,B =

PCD data

= audit record

1st Requestor

And Subsequent Custodian of Data being Provided at 

Custodian of Data being Provided at 

PCD Repository

2nd Requestor

Patient


Pilot data flow updated

Pilot Data Flow (updated)

, = Clinical data

A,B =

PCD data

= audit record

1st Requestor

And Subsequent Custodian of Data being Provided at 

B

Custodian of Data being Provided at 

PCD Repository

2nd Requestor

Patient


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