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PDMP & Health IT Integration Standards and Harmonization. June 3 rd , 2014. PDMP Harmonization Timeline. (Today). 3/25 Harmonization Kick-off. 7/29 Harmonization Close. Candidate Standards List. End-to-end Review & Community Consensus. Standards Evaluation. Solution Plan.

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pdmp harmonization timeline
PDMP Harmonization Timeline

(Today)

3/25 Harmonization Kick-off

7/29 Harmonization Close

Candidate Standards List

End-to-end Review & Community Consensus

Standards Evaluation

Solution Plan

UCR-Standards Mapping

Gap Mitigation Plan

Create IG Template

IG Development

HITSC Evaluation*

Solution Planning

IG Development

review solution planning workgroup session 5 29 current state transaction standards landscape

Review: Solution Planning Workgroup Session 5/29Current-State Transaction: Standards Landscape

slide5

HIE/Pharmacy Intermediary

2

5

2

7

4

Out of State PDMP

In-State PDMP

EHR or Pharmacy System

Hub

1

8

8

3

7

6

3

Hub

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

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

next steps for spwg 6 10 6 17
Identify effective workflows

Prioritize workflows according to current landscape analysis, standards evaluation, and future state models

Collapse workflows to represent proposed solutions incorporated in the Implementation Guide

Analyze pros/cons, technical feasibility, impact to stakeholders, adoptability, scalability, etc.

Next Steps for SPWG 6/10, 6/17
slide13

Current Landscape Workflows

Proposed Solution Set Workflows

Summary Analysis + 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

2

EHR  Intermediary*

Pharmacy  Intermediary

EHR  Intermediary  Hub  PDMP(s)

Pharmacy  Intermediary  Hub  PDMP(s)

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 that routes the transaction to a receiving entity. May perform value added services such as translating data from one format to another

slide14

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)

next steps
Next Steps
  • Review: Minimum Dataset Requirements
  • Next Solution Planning WG meeting is Thursday, June 5 from 12:00pm – 1:00pm ET
  • Next All Hands meeting is Tuesday, June 10 from 12:00pm - 1:00pm ET
  • 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
contact information
Contact Information
  • For questions, please feel free to contact your support leads:
  • Initiative Coordinators:
    • Johnathan Coleman jc@securityrs.com
    • Sherry Green sgreen@namsdl.org
  • ONC Leads:
    • Mera Choi mera.choi@hhs.gov
    • Jennifer Frazier Jennifer.Frazier@hhs.gov
    • Helen Caton-Peters Helen.Caton-Peters@hhs.gov
  • SAMHSA Leads
    • Jinhee Lee Jinhee.Lee@samhsa.hhs.gov
    • Kate Tipping Kate.Tipping@samhsa.hhs.gov
  • Support Team:
    • Project Management:
      • Jamie Parker jamie.parker@esacinc.com
      • Ali Khan Ali.Khan@esacinc.com (Support)
    • Use Case Development:
      • Ahsin Azim Ahsin.Azim@accenturefederal.com
      • Presha Patel presha.patel@accenture.com
  • Standards Development Support:
    • Alex Lowitt alexander.s.lowitt@accenturefederal.com
  • Harmonization Support:
    • Divya Raghavachari divya.raghavachari@accenturefederal.com
    • Atanu Sen atanu.sen@accenture.com
  • Implementation Guide Development:
    • Rita Torkzadehrtorkzadeh@jbsinternational.com
    • Vijay Shah vshah@jbsinternational.com
  • Vocabulary and Terminology Subject Matter Expert:
    • Mark Roche mrochemd@gmail.com
current in state ehr workflow direct
Current In-State EHR Workflow (Direct)

Transaction 1a

NARxCheck

EHR System

In-State PDMP

NARxCheck

Legend

Request

Response

current in state ehr workflow hie
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

current in state pharmacy workflow direct
Current In-State Pharmacy Workflow (Direct)

Transaction 1b

Pharmacy IT System

In-State PDMP

NARxCheck

NARxCheck

Legend

Request

Response

current in state pharmacy workflow pharmacy int switch
Current In-State Pharmacy Workflow (Pharmacy Int. / Switch)

Transaction 2b

NCPDP SCRIPT (Medication History)

?

Pharmacy System

Pharmacy Intermediary/ Switch

In-State PDMP

NCPDP SCRIPT (Medication History)

?

Legend

Request

Response

current in state ehr workflow hub
Current In-State EHR Workflow (Hub)

Transaction 3a – Not Effective Workflow? Currently Active?

In-State PDMP

EHR System

PMIX

?

PDMP Hub

?

?

Legend

Request

Response

current in state pharmacy workflow hub
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

current interstate ehr workflow
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

current interstate pharmacy workflow
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

questions to be answered
Questions to be answered:

Differences in pharmacy and clinician workflows / data systems and expectations in PDMP data transmitted?

How do we define intermediaries and their relationships to Health IT systems?

What components of PDMP report are extracted for decision support?

Can EHR and Pharmacy IT systems handle the proposed standards (in the context of PDMP systems)?

What standard(s) fit into message and workflow configuration per transaction type?

Are transactions collapsible in terms of capability of leveraging same standard?

Are all transactions necessary?

What is the cost associated with the proposed solutions?

How do we define an aggregator? (collection of response from different PDMPs back to recipient)

Parking lot item: Differences in care settings - Ambulatory vs. Acute; In-hospital pharmacies vs. retail pharmacies. Are different standards needed for different EHR systems?

initiative progress current status
Initiative Progress & Current Status

Standards Evaluation

  • Narrowed down candidate standards via mapping to Use Case Requirements
  • Identified and analysed gaps for all narrowed down standards in the Gap Mitigation Plan

Solution Planning

  • Determining standards currently in general use per transaction workflow
  • Select harmonized standard solution based on current and recommended standards landscapes

Implementation Guide

Development

  • Develop Implementation Guide (IG) based on selected solution