Lab Results Interfaces S&I Framework Initiative

1. Lab Results InterfacesS&I Framework Initiative Bi-Weekly Initiative Meeting May 9, 2011

2. Agenda • Remembering the Mission • Moving Forward • Workgroup Updates • Face to Face Meeting • Q&A + Group Discussion

3. Remembering the Mission To enable ambulatory primary care physicians to receive and meaningfully use standardized, structured electronic lab results… • Establish the nationwide Implementation Guide for electronic submission of Lab Results to Ambulatory EHRs. • EHR vendors, LIS vendors and Labs agree that they can implement the IG and use it to transmit and consume lab results without a middleman • Providers broadly adopt EHRs that conform to the LRI IG - facilitated by Meaningful Use, State HIEs, RECs, and product options in the marketplace* • * Success Metrics SWG to help determine the appropriate baseline metrics and target outcomes

4. Use Case Consensus • Closing in on full consensus for the use case • Meaningful Use gives us a unique opportunity to make an impact nationwide – the use case volunteers have stepped up in a big way to produce a high-quality product • Congratulations to the volunteers and their support staff on their effort to bring this to completion on such tight timelines

5. Summer of Standards Harmonization IG Recomm-endation F2FMeeting Begin Code Development • April: • Lab Reporting Implementation Guide Analysis – policy and Conceptual Designs drafted • In-scope Test approach reviewed and outlined • May: • Recommendations for IG • Clinical Information Models drafted • Conceptual Designs completed • Vocabulary alignments completed • Complete Public Health High Level Roadmap • June: • Final F2F Meeting to come to consensus (proposed Jun 13-15) • Prepare documented specifications and handoff to RI/DP • Model and XML-Driven Specifications drafted • Finalized XML and Model-Driven Spec Handoffs to RI/DP and begin working code development • July: • Recommendation to HITSC • Initial Pilot Implementations • August: • Review working code/pilots with UCR/Harmonization (user acceptance) • September: • “Key Stakeholder” Messaging and Outreach • Fall: • Draft MU Stage 2 Rule Major Upcoming Milestones We Are Here

6. Use Case and Functional Requirements • The Final LRI Use Case Documentation Package was posted for consensus voting by 4/25 with resolution of comments and final consensus targeted for COB 5/5. • The work of LRI is not done. • To continue the great work you did developing the use case and functional requirements, we will need our members to continue supporting the initiative through the harmonization, architecture and build activities! • We also have a few WGs initiated from the use case that will continue… • Use Case Simplification (Cross Spanning Initiative) – Thursdays 10-11am EDT    • Public Health Reporting – See next slide…

7. Public Health Reporting WG • Volunteer Co-leads: TBD Action Items • Began discussion on scope of Public Health WG efforts • Outline scope for public health agency, inpatient EHR and ambulatory EHR • Outline a scope diagram and description • Start to outline (in a roadmap) the path forward that will harmonize the outbound laboratory messaging interface for results reporting to an EHR with results reporting to a public health agency. • Use Case Volunteers – please bring your public health expertise to this workgroup

8. Implementation Guide Analysis WG • Volunteer Co-Leads: Ken McCaslin, Quest Diagnostics and Hans Buitendijk, Siemens Healthcare Action Items • Finalize review of policy variances (escape sequences, identifiers, etc..) • Finalize initial alignment of both HL7 implementation guides to consensus LRI Use Case • Target an implementation guide “path forward” within 2-3 weeks. Next Steps • Begin message structure variance analysis • Agreement on approach to OIDs and UCUM

9. Clinical Information Model & Vocabulary WG • Volunteer Lead: Cindy Johns, LabCorp Action Items • Continue walkthrough of In-Scope Tests to identify most important tests to be piloted • Walk through the most common and critical in-scope tests, to determine the appropriate vocabularies and value sets to be applied. • Continued review of existing clinical information models from FHIM and HL7 • Work on mapping FHIM data elements to IG data elements • Drafted a Laboratory CIM for review • The CIM may be road-mapped as a longer-term milestone

10. Architecture & Implementation Requirements WG • Robert Lutolf and Rob Allen, Gensa Action Items • Developed a draft deployment model for review • Provides a high level overview of how the LRI Implementation Guide (when completed) can be conceptually deployed • Developed a draft abstract model for review • Highlight the necessary components/services needed to enable exchange of lab reporting data Next Steps • Come to consensus on conceptual deployment and abstract model over the next 2-4 weeks

11. Face to Face Meeting • Tentatively scheduled for June 13-15, located at HHS in Washington D.C. • Expenses to be covered by volunteers • WG leads are beginning to meet to set the agenda and key target items to be resolved. • Full consensus should be achieved at this meeting

12. Q&A + Group Discussion