PDMP & HITI Solution Planning Workgroup Session

1. PDMP & HITI Solution Planning Workgroup Session June 5, 2014

2. Agenda Solution Planning Approach Current Standards Landscape Summary Questions to be Answered Relevant Workflows Evaluation of Proposed Solutions

3. Solution Planning Work Group Approach

4. Summary of Current Standards Landscape Key Takeaways: • EHR  HIE  PDMP transaction model is currently in use as a transaction model {SCRIPT/PMIX} • EHR  In-State PDMP direct model not general used • If used, interface layer necessary to perform necessary translations to PMIX • PDMP  PDMP, Hub  PDMP, HIE PDMP transactions leverage PMIX-NIEM Architecture • Translation from EHR system standards (eg. HL7 messaging) to PMIX must occur prior to Hub to PDMP transaction • Thus, translations can occur from the EHR system to the HIE, the HIE to the Hub, the EHR system to the Hub, or the HIE to the PDMP • Pharmacy IT systems do not need to go through pharmacy intermediary • Pharmacy IT can route through HIE, but generally do not for purposes of controlled substance data exchange • SCRIPT used for medication history exchange, but not currently for PDMP-specific data exchange within Pharmacy IT landscape • Network intermediaries (Emdeon, Surescripts) can provide PDMP data exchange translations and infrastructure • NABP PMPi will be capable of translation services

5. Questions to be answered: • How do we define intermediaries and their relationships to Health IT systems? • Can we collapse all types of intermediaries into one entity? (i.e. pharmacy, switch, HIE, etc.) or do they require to be differentiated • Pharmacies may have need for intermediaries • Future state use of intermediaries or networks to provide controlled substance history reports • Can Pharmacy IT systems and EHR systems be collapsed or need to be differentiated? • Differences in pharmacy and clinician workflows / data systems and expectations in PDMP data transmitted? • Differences in care settings - Ambulatory vs. Acute; In-hospital pharmacies vs. retail pharmacies. Are different standards needed for different EHR systems or different pharmacy settings? • Are there certain workflows that are unfavorable?

6. Current Landscape Proposed Solution Set Relevant Workflows 1 EHR  In-State PDMP Pharmacy  In-State PDMP EHR  In-State PDMP Pharmacy  In-State PDMP EHR  Intermediary  In-State PDMP Pharmacy  Intermediary  In-State PDMP Legend 2 Proposed EHR  Intermediary* Pharmacy  Intermediary Potential EHR  Intermediary  Hub  PDMP(s) Pharmacy  Intermediary  Hub  PDMP(s) Remove 3 EHR  Hub  PDMP(s) Pharmacy  Hub  PDMP(s) EHR  Hub Pharmacy  Hub • Aligns to in-scope Use Case scenarios • Approach may require translation mapping between ASAP, NCPDP SCRIPT Medication History, and H L7 V2 Messaging to PMIX Architecture • Implementation Guide will have to include data element modifications/additions to fully support PDMP & HITI Use Case requirements EHR  In-State PDMP  Hub  PDMP(s) Pharmacy  In-State PDMP  Hub  PDMP(s) *Intermediary - An entity (service, or set of services) that routes the transaction to a receiving entity. May perform value added services such as translating data from one format to another

7. Evaluate Proposed Solutions Solution Plan:

8. Next Steps • Review: Transaction and solution evaluations • Next All Hands meeting is Tuesday, 6/10 from 12:00 pm to 1:00 pm ET • Data Elements Analysis • Next Solution Plan Workgroup Session is Thursday, 6/12 from 12:00 pm to 1:00 pm ET • Continue Workflow – Standards Evaluations • Evaluate prioritization of proposed solutions • Goal: Finalization of solution set • Reminder: All PDMP & HIT Integration Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Harmonization materials, Use Case, Project Charter and general information will be posted on the PDMP Wiki page • http://wiki.siframework.org/PDMP+%26+Health+IT+Integration+Homepage