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Meaningful Use Workgroup. Paul Tang, Chair George Hripcsak, Co-Chair. December 20, 2013. Meaningful Use Workgroup Members. J . Marc Overhage , Siemens Healthcare Patricia Sengstack , Bon Secours Health Systems Charlene Underwood, Siemens Michael Zaroukian, Sparrow Health System - PowerPoint PPT Presentation
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Paul Tang, ChairGeorge Hripcsak, Co-Chair
Meaningful Use Workgroup
December 20, 2013
2
Meaningful Use Workgroup Members
Chairs• Paul Tang , Palo Alto Medical Foundation• George Hripcsak, Columbia UniversityMembers• David Bates , Brigham and Women’s
Hospital• Christine Bechtel , National Partnership for
Women & Families• Neil Calman , The Institute for Family Health• Arthur Davidson, Denver Public Health
Department• Paul Egerman, Businessman/Entrepreneur• Marty Fattig, Nemaha County Hospital
Auburn, Nebraska • Leslie Kelly Hall, Healthwise• David Lansky, Pacific Business Group on
Health• Deven McGraw , Center for Democracy &
Technology
• J. Marc Overhage, Siemens Healthcare• Patricia Sengstack, Bon Secours Health
Systems• Charlene Underwood, Siemens• Michael Zaroukian, Sparrow Health
System• Amy Zimmerman, Rhode Island Office of
Health & Human ServicesFederal Ex officios• Tim Cromwell, Department of Veterans
Affairs• Joe Francis , Veterans Administration• Greg Pace, Social Security Administration• Martin Rice, HRSA• Robert Tagalicod, Centers for Medicare &
Medicaid Services, HHS
Workplan
Date Meeting Tasks12/20/2013
9:30-11:30 ET• Review recommendations
• Pop/public health• Affordable care • Health disparities• Follow-up items
• Review of feedback from Standards Workgroups included in recommendations review (i.e. case reports, registries, images, PGHD)
1/6/20149:30-11:30 ET
• Follow-up items• Review of recommendations
1/17/1411:00-1:00 ET
• Follow-up items• Review of recommendations
1/28/141:00-3:00 ET
• Follow-up items• Review of recommendations
2/4/14 • Present to HITPC
3
4
Review of Population and Public Health Objectives Stage 3 MU
Arthur Davidson, MD, MSPHMeaningful Use Workgroup
December 20, 2013
Agenda
5
Review Stage 1 Public/Population Health Meaningful Use Measures
Review Public Health Efforts Regarding Standards and Interoperability Framework Components
Review of proposed Stage 3 Meaningful Use Measures
6
Hospital 1st v. 2nd v. 3rd yearPH Menu Objective Performance
Source: CMS Presentation – Rob Anthony, December 4, 2013
7
Immunization • New guide provides improvements• Progress with providers is better • ONC test criteria are making interoperability better • PH moving toward accepting data coming form certified
products• Next version (Feb 2014) of Implementation Guide (IG) will
include bi-directional w/ History and forecast back to provider
Electronic Laboratory Reporting (ELR) • New version of IG is available to HL7 members and includes
many improvementsSyndromic Surveillance (SS)
Successful centralized infrastructure utilizing BioSensehttp://www.hl7.org/dstucomments/showdetail.cfm?dstuid=104
Update on Current Measures: - Immunization, ELR, SS
8
9
Electronic Laboratory Reporting (ELR) – Pattern of Adherence to Standards• Public Health has consistently made efforts to abide by
standards and in turn minimize impact on clinical partners• Proof of PH’s commitment to build on standards and
processes used for other use cases,. • ELR Release 1 (HL7 Version 2.5.1: ORU^R01)1was built on
the HISTP Lab-to-EHR Implementation Guide• ELR Release 2 is the current profile for Electronic
Laboratory Reporting to Public Health (MU Stage 1 and 2).
• Public health has demonstrated readiness for standards and will credibly achieve that for Stage 3.
http://www.odh.ohio.gov/~/media/ODH/ASSETS/Files/opi/infectious%20disease%20surveillance/v251_IG_LB_LABRPTPH_R1_INFORM_2010FEB.ashx
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Key Principle for PH Stage 3 MU
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• Adhere to Standards and Interoperability Framework Components Whenever Feasible
Component PurposeConsolidated CDA Standard message formatStructured Data Capture
Populate standard forms
Health eDecisions Clinical decision support (e.g., triggers for PH screening or collecting data)
Data Access Framework
Query data: 1) by provider and 2) across multiple organizations and by population
12
Cancer Reporting• Stage 3 MU Cancer Implementation Guide (IG) should
move to consolidated clinical document architecture (c-CDA) because: – EHR vendors are required to use this format for
Transition of Care documents in Stage 2 MU– eliminates burden of supporting two different formats
for cancer reporting– c-CDA has harmonized and improved templates
across multiple sources– cancer program is ready to move to this new standard
13
Cancer c-CDA: Next Steps• Align Cancer IG sections with c-CDA sections (high level
completed)• Add a new document-level template c-CDA R2:
"Ambulatory Healthcare Provider Cancer Event Report”• Add Cancer Diagnosis Section to c-CDA • Perform Gap and Overlap analysis of entries, data
elements, attributes, and value sets• Put new document through HL7 ballot process
Timeline– High level gap analysis performed in November 2013– Detailed gap/overlap analysis work starting in January
2014– Ballot in May 2014
Public Health and c-CDA - Progression for some areas
14
Pertussis (NY State)
Pertussis (San Diego)
Tuberculosis (Delaware)
EHDI (N. Dakota)
2012 2013 2014+
EHDI (Oregon)
Cancer Registry
15
Reporting protocol for
HAI
Executable expressions of detection and case reporting
algorithms
HAI detection rules applied to patient-specific
data
Additional rules applied to
populate full HAI report
Healthcare Facility
Reporting system provides protocol and algorithm
Publicly Reported HAI
data
Electronic HAI ReportClinical
DocumentArchitecture
(CDA)
Reporting system publishes facility-specific
HAI data
CDA transmission:- Manual upload- Automated send
Electronic Healthcare Associated Infection (HAI) Detection and Reporting:
Supporting Patient Safety
Specifications:•eMeasures
• Decision rules
• Computer code
Electronicsystems:
•EHR
•Pharmacy
•ADT
•Lab
CDC
CDCPrograms
CMS
PublicHealth
Healthcare
NHSN
HeD
16Sources: Communicable Disease CDA Pilot Project Report. 2012. URL: https://wiki.phdsc.org/index.php/CDAEHDI CDA Pilot Project Report. 2013. URL: https://wiki.phdsc.org/index.php/EHDI-Pilot
CDA/SDC for Public Health Pilot ProjectsPublic Health Reporting Architecture
Progress : What’s been completed
Public Health Infrastructure
Or Health
Information Exchange (HIE)
Form Manager
Form Receiver
Content Creator
Form Filler
1. Request Form
2. Provide pre-population data
3. Pre-populated Report Form
4. Populated Report Form5. Send–Receive
CDA ReportContent
Consumer
EHR VendorsCore Solutions
ConnexinAllscripts
(Test Harness)Epic 2012
(Test Harness)
Public Health Electronic
Health Record System
Provider
Information Systems:Surveillance Systems
EHDI System
Public Health Information Systems
Delaware Electronic Reporting Surveillance
System (DERSS)New Your State Universal
Public Health Node (UPHN)
San Diego County(Atlas Public Health)Oregon EHDI System
(Filemaker)North Dakota EHDI System
(OZ Systems)
CDA-based Case Reports:Tuberculossis
PertussisNewborn Hearing
Screening Outcome Report
Continuity of Care Document (CCD)
(pre-population data)
Public Health Infrastructure
(Orion Rhapsody)
HIE(OZ Systems)
Form Manager
Form Receiver
Content Creator
16
17
Communicable Disease Reporting – CDA/SDC Pilot in NYC and WI
1. Parse2. Retrieve Form3. Pre-populate web
form
4. Send URL with pre-populated web form
Electronic Medical Record (EMR)
Vendor Test Environ-
ment
(i.e., EPIC)
Reporting Module/Form
Manager
Continuity of Care Document (CCD)
NYC and WI Public Health Infrastructure
Electronic Disease Surveillance
System
Current Progress (as December 2, 2013) – Finalize Testing in Vendor Environment
5. Physician/ICP submits addition information directly to system
Next Steps – Identify, Recruit, and Implement in Hospital using EPIC EMR System
State/Local Surveillance
System
Key Outcomes• Shift in tradition al public health
case report (PHCR) use case• Leverage existing standard
(i.e., CCD -> cCDA)• Light-weight service for EMR
vendors to connect to various jurisdiction reporting end-points
• Minimize development in EMR System
• Extensibility/ portability to other EMR vendors
• State and LHD can configure forms based on reporting and business needs specific to jurisdiction
18
Structured Data Capture (SDC)- Tiger Team and Selected Pilots
• Public Health Tiger Team – Community based effort to identify, develop, and
implement SDC Public Health Pilots
• Proposed Public Health Pilots– EHDI– Cancer Reporting– Case Reporting
http://wiki.siframework.org/Public+Health+Tiger+Team+Meeting+Archives
18
19
20
Health eDecisions - Use Cases
• Use Case 1: standard format for sharing CDS knowledge artifacts– Rules, order sets and documentation templates
– Goal: CDS knowledge authored in standard format can be imported and used in any EHR system
• Use Case 2: standard interface for accessing CDS Web services– Goal: CDS capability encapsulated using standard
interface can be integrated with any EHR system
20
21
Use Case 1 Focuses on three artifact types:1. Event Condition Action Rules2. Order Sets3. Documentation Templates
Health eDecisions – Use Case 1 (CDS Artifact Sharing)
21
Health eDecision - Use Case 1: Pilot Partnerships
22
EHR Pilot Content SupplierDesign Clinicals
Order Set – Heart Failure
Zynx Health
Allscripts Rule – NQF 068 (Million Hearts)
newMentor
Allscripts RCKMS - San Diego Pertussis
CDC/CSTE
VA Documentation Template – UTI
Wolters Kluwer Health
22RCKMS: Reportable Condition Knowledge Management System
23
Public Health State, Local, Territorial Agencies
RCKMS Long term ScopeReportable Condition
Knowledge Management System (RCKMS)
Authoring Framework
Subscription Management
Including Notifications
DatabaseWho, What, When,
Where, How
Structured Output
Generator
PH Reports
Query/View
HeD Compliant format
- Triggering Criteria- Reporting Actions- Links
DSS Web Service
Other Web Services
HeD
(1) Health eDecision (Hed)
(2) Open CDS
PH Reporters (Clinicians)
Hospital Labs
LIMS
EHR
National, Clinical & Public Health Laboratories
LIMS
Ambulatory Care
EHR
Web Service
(3) Open CDS
Local
Output file Options1) HeD file download2) OpenCDS in Cloud3) OpenCDS Locally Deployed
23
24
S&I Data Access Framework Use Cases
24
25
Data Access Framework - examples
DRAFTImproving population and public health: Stage 3 Priorities
26
• Efficient and timely completion of case reports
• Efficient and timely means of defining and reporting on patient populations to drive clinical care and identify areas for improvement
• Shared information with public health agencies or specialty societies
• Bidirectional public health data exchange
Target Outcome GoalsMU Outcome Goals
• Providers know the health status of their patient population
• Public health officials know the health status of their jurisdiction
• Providers and specialty societies can track and manage domain specific events related to practice and devices
• Providers and public health officials share information to improve individual and population health
• Patient lists• Sharing immunization
data• Cancer and specialty
registry• Electronic lab reporting• Submission of electronic
syndromic surveillance data
Stage 3 Functionality Goals MU Outcome GoalsStage 1 + 2 Functional
Objectives
DRAFTImproving population and public health: Case Reports
27
• Efficient and timely completion of case reports
• Efficient and timely means of defining and reporting on patient populations to drive clinical care and identify areas for improvement
• Shared information with public health agencies or specialty societies
• Bidirectional public health data exchange
Functionality Needed to Achieve Goals
• CEHRT uses external data to prompt the end-user when criteria are met for case reporting. The date and time of prompt is available for audit. Standardized (e.g., consolidated CDA) case reports are submitted to the state/local jurisdiction and the data/time of submission is available for audit.
• Recommended as certification criteria only
Stage 3 Functionality Goals
DRAFTImproving population and public health: Registries
28
• Efficient and timely completion of case reports
• Efficient and timely means of defining and reporting on patient populations to drive clinical care and identify areas for improvement
• Shared information with public health agencies or specialty societies
• Bidirectional public health data exchange
Functionality Needed to Achieve Goals
• EPs/EHs use CEHRT to electronically submit standardized (i.e., data elements, structure and transport mechanisms), commonly formatted reports to two registries (e.g., local/state health departments, professional or other aggregating resources)
• EP/EH Registries examples: cancer, children with special needs, and/or early hearing detection and intervention or external entities that maintain the registry (e.g., hypertension, diabetes, body mass index, devices, and/or other diagnoses/conditions) that could include accountable care organization, public health agency, professional society, or specialty community. EHs Only: health-care associated infections
Stage 3 Functionality Goals
DRAFTImproving population and public health: Immunization history
29
Functionality Needed to Achieve Goals
• Eligible Professionals, Hospitals, and CAHs receive a patient’s immunization history supplied by an immunization registry or immunization information system, allowing healthcare professionals to use structured historical immunization information in the clinical workflow
• Recommended CEHRT Functionality– Ability to receive and present a standard set of structured,
externally-generated immunization history and capture the act and date of review within the EP/EH practice
Stage 3 Functionality Goals
• Efficient and timely completion of case reports
• Efficient and timely means of defining and reporting on patient populations to drive clinical care and identify areas for improvement
• Shared information with public health agencies or specialty societies
• Bidirectional public health data exchange
DRAFTImproving population and public health: Electronic lab reporting
30
• Efficient and timely completion of case reports
• Efficient and timely means of defining and reporting on patient populations to drive clinical care and identify areas for improvement
• Shared information with public health agencies or specialty societies
• Bidirectional public health data exchange
Functionality Needed to Achieve Goals
No Change from Stage 2
EH Objective: Capability to submit electronic reportable laboratory results to public health agencies, except where prohibited, and in accordance with applicable law and practiceMeasure: Successful ongoing submission of electronic reportable laboratory results from Certified EHR Technology to public health agencies for the entire EHR reporting period.
Stage 3 Functionality Goals
DRAFTImproving population and public health: Syndromic Surveillance
31
• Efficient and timely completion of case reports
• Efficient and timely means of defining and reporting on patient populations to drive clinical care and identify areas for improvement
• Shared information with public health agencies or specialty societies
• Bidirectional public health data exchange
Functionality Needed to Achieve Goals
No Change from Stage 2EP MENU Objective: Capability to submit electronic syndromic surveillance data to public health agencies, except where prohibited, and in accordance with applicable law and practice
EH Objective: Capability to submit electronic syndromic surveillance data to public health agencies, except where prohibited, and in accordance with applicable law and practice
EP/EH Measure: Successful ongoing submission of electronic syndromic surveillance data from Certified EHR Technology to a public health agency for the entire EHR reporting period
Stage 3 Functionality Goals
DRAFTFormer Objective Details Proposed Merged Registry Objective(404, 405, 407 - EH objective)
EH Objective: Capability to electronically submit standardized (i.e., data elements, structure and transportmechanisms), commonly formatted reports to two registries (e.g., local/state health departments,professional or other aggregating resources) from the Certified EHR Technology, except where prohibited,and in accordance with applicable law and practice. This objective is in addition to and does not replaceprior requirements for submission to an immunization registry. Measure: Documentation (or registry acknowledgement) of ongoing successful electronic transmission ofstandardized reports from the CEHRT to two registries (either mandated or voluntary)). Attestation ofsubmission for at least 10% of all patients who meet registry inclusion criteria during the entire EHRreporting period as authorized, and in accordance with applicable State law and practice.
Registries include: cancer, health-care associated infections, children with special needs, and/or earlyhearing detection and intervention or external entities that maintain the registry (e.g., hypertension,diabetes, body mass index, devices, and/or other diagnoses/conditions) that could includeaccountable care organization, public health agency, professional society, or specialty community)should maintain the registry
Certification criteria: EHR is able to build and then send a standardized report (e.g., standard messageformat) to an external mandated or voluntary registry, maintain an audit of those reports, and track totalnumber of reports sent.
32
DRAFTFormer Objective Details Case reports – 402B
Stage 3 Proposed for Future StageCertification criteria: The EHR uses external data to prompt the end-user when criteria are met for case reporting. The date and time of prompt is available for audit. Standardized (e.g., consolidated CDA) case reports are submitted to the state/local jurisdiction and the data/time of submission is available for audit.
EP Objective: Capability to use externally accessed or received knowledge (e.g. reporting criteria) to determine when a case report should be reported and then submit the initial report to a public health agency, except where prohibited, and in accordance with applicable law and practice.
Measure: Attestation of submission of standardized initial case reports to public health agencies on 10% of all reportable disease or conditions during the entire EHR reporting period as authorized, and in accordance with applicable state/local law and practice.
Certification ONLY
33
Affordable care:Stage 3 Priorities
34
• CDS support to avoid duplicative care
• CDS support to avoid unnecessary or inappropriate care
MU Outcome Goals
• Eliminate duplicative testing
• Use cost-effective diagnostic testing and treatment
• Minimize inappropriate care (overuse, underuse, and misuse)
• Formulary checks• Generics
Stage 3 Functionality Goals MU Outcome GoalsStage 1 + 2 Functional
Objectives
Affordable care:Clinical Decision Support
35
Examples of Functionality Needed to Achieve Goals
• Demonstrate use of multiple CDS interventions that apply to quality measures in each of the six NQS domains. Recommended interventions include:
– Preventive care– Chronic disease management (e.g., diabetes,
coronary artery disease) – Appropriateness of lab and radiology orders – Advanced medication-related decision support
(e.g., renal drug dosing) – Improving the accuracy/completeness of the
problem list– Drug-drug and drug-allergy interaction checks
• CEHRT should provide tools that enable the ability to provide these interventions
• Related work that can inform: S&I HealtheDecisions, HITSC Clinical Quality WG
Stage 3 Functionality Goals
• CDS support to avoid duplicative care
• CDS support to avoid unnecessary or inappropriate care
Reducing health disparities:Stage 3 Priorities
36
• Patient conditions are treated appropriately (e.g. age, race, education, LGBT)
MU Outcome Goals
• Eliminate gaps in quality of health and health care across race, ethnicity, and sexual orientation
• Language• Gender • Race• Ethnicity
Stage 3 Functionality Goals MU Outcome GoalsStage 1 + 2 Functional
Objectives
Reducing health disparities:Additional Patient Information
37
Functionality Needed to Achieve Goals
• CEHRT provides the ability to capture– Patient preferred method of communication*– occupation and industry codes– Sexual orientation, gender identity (optional fields) – Disability status
o Differentiate between patient reported & medically determined
• Communication preferences will be applied to the clinical summary, reminders, and patient education objectives
– Providers should have the ability to select options that are technically feasible for them, these could include: Email, text, patient portal, telephone, regular mail
• Recommended as certification criteria only
Stage 3 Functionality Goals
• Patient conditions are treated appropriately (e.g. age, race, education, LGBT)
38
Reduction of Disparities – previous deeming recommendations
• Reduction of disparities in gap area• Identify areas where attesters should be
required to demonstrate they have reduced health care disparities in high-risk populations
39
Follow-up Items
Feedback from HITSCImaging Sharing and PGHD
Improving quality of care and safety:Imaging
40
•For both Eligible Professionals and Hospitals imaging results should be assessable through CEHRT. Results consisting of the image itself and any explanation or other accompanying information•Recommended as a Menu Item for EPs and Core for EHs
Functionality Needed to Achieve Goals
Stage 3 Functionality Goals
• All relevant data accessible through EHR
• CDS supports timely, effective, safe, efficient care and prevention
• CDS helps avoid inappropriate care
HITSC Clinical Operations WG Charge
12/18/2013 41
• How full image sets or designated key images are shared between different facilities and specialists: the high level architecture e.g. role PACS, Archives, and EMRs
• How this is deployed with central and distributed reading facilities
• What methods and technical standards are used to push, pull, or view images in one place that originated or were interpreted in another place
• Issues encountered sharing reports and interpretations, or auditing, with or alongside the images themselves
• Inclusion of time series data in scope in addition to radiological images
Recommendations for Image Sharing
42
TIER 1Exchange of Text-Based
Reports
TIER 2Exchange of
Non-Radiology/Cardiology Images
TIER 3Exchange of
Radiology/Cardiology Images - Full Study
TIER 4 Exchange of
Radiology/Cardiology Images- Key Images
CONTENT
Plain text +/- structured headings,
scanned/rendered document
"Clinical Capture" images with or without metadata
Complete set of images of diagnostic quality
IHE Key Image Note (KIN) and images referenced therein
ENCODING
PDF, HL7 2.x OBX segment content, CDA L1, or CDA L2 + CCDA
DIR template
Without metadata: JPEG, PNG, DNG, PDF, H.264; with
metadata: DICOM
DICOM (object appropriate to modality)
VOCABULARY
LOINC to describe study/procedure, LOINC for structured headings
LOINC to describe study/procedure (in DICOM
header/XDS metadata)
LOINC to describe study/procedure
LOINC to describe study/procedure, DICOM
DCID 7010 for titles
PUSHHL7 V2 ORU/MDM
MLLP over VPN/TLS, DIRECT SMTP or XDR
preferred
DIRECT SMTP or XDR, DICOM DIMSE/ULP or STOW
over VPN/TLS, IHE XDR-I
DICOM DIMSE/ULP or STOW over VPN/TLS, IHE XDR-I
DICOM DIMSE/ULP or STOW over VPN/TLS, IHE XDR-I
PULL
IHE XDS IHE XDS-I, DICOM WADO-URI or WADO-RS over VPN/TLS
IHE XDS-I, DICOM WADO-URI or WADO-RS over VPN/TLS
IHE XDS-I, DICOM WADO-URI or WADO-RS over VPN/TLS
VIEW
IHE IID, else pull (WADO-URI+/-XDS-I for rendered JPEGs when
sufficient)
IHE IID, else pull (WADO-URI+/-XDS-I for rendered
JPEGs when sufficient
Abbreviations/Terminology
12/18/2013 43
• Metadata: in this context, patient identifiers, dates, acquisition technique
• KIN: IHE Key Image Note • KOS: DICOM Key Object Selection • DIMSE: DICOM Message Service Element (traditional DICOM PS 3.7)• ULP: Upper Layer Protocol (traditional DICOM PS 3.8 TCP/IP
protocol)• MLLP: HL7 V2 Minimal Lower Layer Protocol (used by all IHE HL7 V2
stuff)• IID: IHE Invoke Image Display• STOW: DICOM Store Over the Web by RESTful Services (STOW-RS)
Discussion from HITSC
• Very difficult to set certification criteria with so much optionality in recommended standards
• Need guidance on specific purposes and use case scenarios for certification
• “Our challenge was to provide a parsimonious collection of constrained standards for consumer and professional applications in tightly coupled (modality to PACS), and loosely coupled (web-based, cloud hosted image exchange) architectures. We all agreed that we need to be very careful when writing certification criteria to avoid optionality such that vendors will be forced to implement many different standards (the "OR" of meaningful use becomes the "AND" of certification)” http://geekdoctor.blogspot.com/2013_12_01_archive.html
04/19/2023 Office of the National Coordinator for Health Information Technology 44
DRAFTEngaging patients and families in their care: Patient Generated Health Data
45
Stage 3 Functionality Goals
• Enabling active participation by patients and families to improve health and care
• Provide ability to contribute information in the record, including patient reported outcomes (PRO)
• Patient preferences recorded and used
Functionality Needed to Achieve Goals
• Eligible Providers and Hospitals provide the capability for patients to electronically submit patient-generated health information through structured or semi-structured questionnaires (e.g., screening questionnaires, intake forms, risk assessment, functional status), secure messaging or provider-selected devices using CEHRT. (Provider-selected devices pending consideration by HITSC)
• Recommended as a Menu item• Low threshold
46
Standards Recommendations
• ONC should consider the Direct transport standard for secure messaging and data from devices
• ONC should consider the HL7 Care Team Roster standard
• ONC should consider the HL7-CCDA for structured and unstructured questionnaires
• ONC should consider the Continua standard for data from devices
• We encourage standards that support mobile access to patient data and PGHD given the proliferation of mobile devices. However, we do not recommend mandating a specific standard at this time given that might stifle innovation.
47
Recommendations for Development of Consumer Standards
• ONC should consider an S&I Initiative to create needed collaborative care document structure to address versioning, expanded provenance, reconciliation, data governance and curation.
• ONC should consider creating a process to align consumer product and provider standards
• ONC should consider using BlueButton+ API approach to accommodate PGHD
• Trust Framework expanded for consumer/patient adoption in emerging technologies (BB+)
• ONC should ask the HITSC to prioritize consumer vocabularies to support wider consumer, patient and family engagement
HITSC Discussion
• The key discussion was an evaluation of the standards maturity and the level of adoption of the standards suggested for patient generated data. Recommendations included Direct for data transport, CCDA for content capture, LOINC/SNOMED for vocabulary capture, and Continua implementation guides for devices.
• As a followup the Consumer Technology Workgroup will list examples of CCDA templates that can be used to support patient generated data use cases.
• Continua will provide us a list of the named standards so that we can validate the maturity and adoption of Continua's recommendation.
• We will also ensure that the CCDA templates include the appropriate vocabularies that will enable incorporation of patient generated data into EHRs.
• http://geekdoctor.blogspot.com/2013_12_01_archive.html
04/19/2023 Office of the National Coordinator for Health Information Technology 48