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Structured Data Capture (SDC) Pilots Template. Insert the Name of Your Pilot / Organization Here MM/DD/YYYY. Pilot Team. Identify the members of your organization who will be supporting this pilot. If possible include the role he/she will play in the pilot and contact information.

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Structured data capture sdc pilots template

Structured Data Capture (SDC)Pilots Template

Insert the Name of Your Pilot / Organization Here


Pilot team
Pilot Team

Identify the members of your organization who will be supporting this pilot. If possible include the role he/she will play in the pilot and contact information

Goal of the pilot
Goal of the Pilot

Please include a write up or create a Visio diagram of what you intend to show/prove/support during the pilot process.

Make this an actionable statement with specifics.

Also include in this description what you hope to gain from this pilot.

Which of the 4 sdc standards are you piloting
Which of the 4 SDC Standardsare you Piloting?

Please use this section to document which of the 4 SDC Standards (CDE Template, Form Template, Sharing API, or EHR Auto-populate) you are intending to pilot. Please be as specific as possible.

What relevant purpose from the use case does your pilot support
What Relevant Purpose (from the Use Case) does your Pilot support?

Patient Centered Outcomes Research (PCOR)

Patient Safety Reporting

Public Health Reporting

Determination of Coverage

Other: ____(Please specify)

Link to download Consensus Approved Use Case:

Identify the use case actors systems involved
Identify the Use Case Actors/Systems Involved: support?

  • A pilot may involve the following participants from the structured data capture ecosystem:

    • Provider

    • EHR System

    • Form/Template Repository

    • External Data Repository

Minimum configuration
Minimum Configuration support?

  • What is your current technical / infrastructure set up?

  • What systems / applications will you be using to conduct the pilot?

  • Examples:

    • Ambulatory Electronic Health Record (EHR) system

    • Form/Template repository

    • External database (which one/type)

    • Existing interfaces

    • New interfaces (to be developed as part of the pilot)

Timeline support?

  • What is your proposed timeline given we want to wrap-up Pilots by _______?

  • Guidance: ~6 months minimum / ~1 year maximum

  • Evaluation: starts @ 6-9 months / final evaluation when pilot is complete

  • Example Timeline

    • September – Kickoff and Logistics

    • October – Start Pilots

    • November – Continue with Pilots

    • March – Conclude Pilots

Success criteria
Success Criteria support?

What will you/your organization use to determine the success of this pilot? This needs to be quantitative and not subjective in as much as possible.

Example: Establish a process within your organization where XX% of their Incident Reports are completed electronically.

In scope out of scope
In Scope / Out of Scope support?

If you already know what will be in and out of scope for your pilot (beyond the Implementation Guidance (IG) or the Use Case) please document it here.


Risks challenges
Risks & Challenges support?

Identify any risks or challenges

Questions needs
Questions / Needs support?

Please include those items you wish to consider any questions you have or hope the pilot addresses.

Additionally, please include those items you need in order to succeed.

We will try to accommodate as many of these needs as possible within the scope of ONC, S&I and SDC (and resource availability).

Useful links
Useful Links support?

SDC Wiki Main Page:

Use Case:

SDC Standards & Harmonization

Pilots Wiki Page:

Appendix a sdc workgroup activities and timeline
Appendix A: SDC Workgroup Activities and Timeline support?

FEB 13

MAR 13

APR 13

MAY 13

JUN 13

JUL 13

AUG 13

SEP 13

OCT 13

NOV 13

Kick Off


Use Case &



Standards & Harmonization

Pilots &

Testing …



SDC All-Hands Work Group

Use Case WG

Standards & Harmonization WG


Work Stream

  • Forms SWG

    • CDE Structure Standard

    • Container/Template Standard

Standards SWG

EHR Interaction Standard

Auto-populate standard


Work Stream

Common Formats SWG…


PCOR Content SWG…

NLM Lead