Finalized Solution Plan

July 1st, 2014

Solution Planning Work Group Approach

1. Overlay standards currently in general use per transaction - focus on transactions for integrated solutions

3. For prioritized workflow, propose solutions for harmonizing standards in order to pull PDMP information into EHR or Pharm. IT Systems synchronously

2. Document pros and cons for each proposed solution and prioritize in terms of technical feasibility

Dev

elop

Tec

hnic

al A

rchi

tect

ure

C

an E

HRs

and

Ph

arm

acy

ITs

hand

le p

ropo

sed

Stan

dard

s?

Repo

rt fi

ndin

gs to

Co

mm

unity

Solution Planning Approach

1. How to take HL7 V2, NCPDP SCRIPT, ASAP and transform to PMIX Architecture-NIEM Standards?

2. What gaps have been identified to perform necessary query out of HIT specific to PDMP?

3. Define technical architecture of total solution.

Variant 1: Intermediary provides translation functionality

Variant 2: Translation is handled at EHR, providing mapping to PMIX from native EHR standards

Variant 3: Interface engine at EHR-level provides functionality to send PMIX message derived from native EHR standards.

EHR /Pharmacy

Ph. Interm.

HIE

PDMP Hub

PDMP

Most preferred workflow

Translation / Routing

EHR Origin Standard:HL7 V2 (acute)NCPDP SCRIPT (ambulatory + optional acute settings)ASAP Web Services

PDMP StandardPMIX

Pharmacy Origin Standard:HL7 V2 (in hospital)NCPDP SCRIPT (large retail pharmacies)ASAP Web Services

Begin detailing solution and

technical details

(standards)

PrioritizeEHR/Pharm Hub

Solution

Develop holistic solutions for Hub, Intermediary, and Direct workflows

Leverage Hub Solution for EHR/Pharm Intermediary

workflow guidance

Defer direct connection workflow model due to limited scalability and restriction of interstate data

sharing

Develop IG content based on PDMP Hub solution

Develop IG content based on PDMP

Intermediary solution

Develop IG content based on PDMP Direct solution

Deferment does not equate to elimination of workflows from

inclusion in future solution plans and iterations/updates to the

Implementation Guide

EHR Prioritization

# Workflow Model Prioritization Justification

3a EHR to PDMP Hub to PDMPs High

• Capable of facilitating interstate data exchange with reduced complexity• PDMP Hubs are compliant with state regulations regarding access and routing of

PDMP-data• Future hub capabilities support efficient workflow model• Interstate data exchange drives organized data sourcing and in turn, is critical

element to most interoperable state of data flow

2a EHR to Intermediary to PDMP (PDMP Hub to PDMP)

Medium

• Scalable• Provides flexibility in accommodating multiple standards • Ability to leverage existing connections for clinical data• Increased complexity due to additional connections and implication of

policy/regulations on third party use

1a EHR to In-State PDMP Low

• Supports unique implementations and PDMP infrastructure• Restrictive in expanding efficient interstate data sharing• Reduced complexity, though not as highly scalable• Perhaps necessary where policy hinders use of third parties for

translation/transformation

Pharmacy IT Prioritization

# Workflow Model Prioritization Justification

3b Pharmacy IT to PDMP Hub to PDMPs High

• Same as transaction 3a• Existing pilots established using workflow

2b Pharmacy IT to Intermediary to PDMP (PDMP Hub to PDMP)

Medium

• Same as transaction 2a• Concern regarding cost to participate• May allow for future-state PDMP-data access through third parties

1b Pharmacy IT to In-State PDMP Low

• Same as transaction 1a• Pharmacies typically leverage third party for medication history• Limited perceived interest from user community

Solution Plan Finalization

Implementation Approach Focus:

Process:1. Document PMIX payload + container data elements2. Map HL7 V2, NCPDP SCRIPT Medication History, and ASAP Web Services

message queries to PMIX Standarda. Detail required fields based on PMIX specification b. Identify gaps and optionality of request standards

3. Identify and document appropriate transport protocol that accommodates message content

4. Detail messaging schemas

HL7 V2.7 Messaging

NCPDP SCRIPT 2014041

ASAP Web Services V1.R1

PMIXNIEM XML

GRAHub-to-Hub

Appendix