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Final Current Standards Landscape Analysis
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  1. Final Current Standards Landscape Analysis June 3rd, 2014

  2. HIE/Ph. Interm. 2 5 2 7 4 Out of State PDMP In-State PDMP EHR or Pharmacy System Hub 1 8 8 PMP/HITI User Stories with Alternate Workflows EHR or Ph. to In-State PMP: 1a: EHR to In-state PMP 1b: Ph. to In-state PMP 2a: EHR to In-state PMP via HIE 2b: Ph. to In-State PMP via HIE 3a: EHR to In-state PMP via Hub 3b: Ph. Intermediary to In-State PMP via Hub EHR or Ph. to Out-of-State PMP: 1a+4: EHR to out-of-state PMP via In-state PMP 1b+4: Ph.to out-of-state PMP via In-state PMP 2a+4: EHR to out-of-state PMP via HIE & In-state PMP 2b+4: Ph. to out-of-state PMP via Ph. Int& In-state PMP 2a+5: EHR to out-of-state PMP via HIE 2b+5: Ph. to out-of-state PMP via HIE 2a+7a+6: EHR to out-of-state PMP via HIE + Hub 2b+7a/7b+6: Ph to out-of-state PMP via HIE/Ph. Int + Hub 3a+4: EHR to out-of-state PMP via Hub & In-State PMP 3b+4: Ph. to out-of-state PMP via Hub & In-State PMP 1a+8: EHR to out-of-state PMP via In-State PMP & Hub 1b+8: Ph. to out-of-state PMP via In-State PMP & Hub 3a+6: EHR to out-of-state PMP via Hub 3b+6: Ph. To out-of-state PMP via Hub 3 7 6 3 Hub

  3. Summary of Transactions

  4. 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

  5. Health IT System Standard PDMP Standard Translation Summary Analysis ASAP Web Services PMIX-NIEM Architecture HL7 V2 Messaging Intermediary PDMP Hub NCPDP SCRIPT Medication History • Strategy Details • Implementation Guide focus will shift to those organizations providing transformations/translation/ ETL services • ASAP can provide point-to-point PDMP data exchange for Pharmacies and EHRs a like – can be transformed into PMIX Architecture via Appriss, Inc. (PMPi) • Intermediaries provide translation service or metadata transformations as “wrappers” • Data elements will need to be modified or added, specified within the PDMP & HITI Implementation Guide Example Container/Payload Configuration PMIX Architecture SCRIPT Med History (Patient Data) (Authentication)

  6. Transaction Workflows

  7. Current In-State EHR Workflow (Direct) Transaction 1a NARxCheck EHR System In-State PDMP NARxCheck Legend Request Response

  8. Current In-State EHR Workflow (HIE) Transaction 2a HL7 A04 NCPDP SCRIPT with PMIX Wrappers Third Party Software HL7 QRY^T12 HL7 ADT feeds NCPDP SCRIPT (Med History) HL7 QRY^T12 EHR System HIE In-State PDMP HL7 OBX XML Report NCPDP SCRIPT (Med History) HL7 DOC^T12 - CCD XML Response NCPDP SCRIPT with PMIX Wrapper HL7 DOC^T12 Legend Request Response

  9. Current In-State Pharmacy Workflow (Direct) Transaction 1b Pharmacy IT System In-State PDMP NARxCheck NARxCheck Legend Request Response

  10. Current In-State Pharmacy Workflow (Pharmacy Int. / Switch) Transaction 2b ? ? Pharmacy System Pharmacy Intermediary/ Switch In-State PDMP ? ? SCRIPT used for medication history but does not currently pull Controlled Substance history from Intermediaries using SCRIPT standard. Legend Request Response

  11. Current In-State EHR Workflow (Hub) Transaction 3a – Not Effective Workflow? Currently Active? PMIX HL7 PMIX In-State PDMP EHR System PDMP Hub Interface PMIX PMIX Legend Request Response

  12. Current In-State Pharmacy Workflow (Hub) Transaction 3b – Not Effective Workflow? Currently Active? Translation? In-State PDMP Pharmacy System Translation? PMIX PDMP Hub ? PMIX Legend Request Response

  13. Current Interstate EHR Workflow Transaction 2a + 7a + 6 EHR System HIE In-State PDMP Third Party Software PMIX-NIEM NCPDP SCRIPT (Medication History) PMIX-NIEM XML PMIX-NIEM XML PMIX-NIEM Out-of-State PDMP PDMP Hub PMIX-NIEM Legend Request Response

  14. Current Interstate Pharmacy Workflow Transaction 2a + 2b + 7a + 7b + 6 HIE In-State PDMP Pharmacy System Third Party Software PMIX Wrappers NCPDP SCRIPT PMIX-NIEM XML PMIX-NIEM XML PMIX-NIEM Pharmacy Int. / Switch NCPDP SCRIPT PDMP Hub Out-of-State PDMP PMIX-NIEM ? Legend Request ? Response

  15. System Transaction-Relationship Flow Legend Known To Confirm