OSEHRA Immunization Work Group Meeting Minutes

Date: Thursday, May 1, 2014 Time: 4:00 PM EST

WebEx: 1-650-479-3207 & Online Meeting Access Code: 660 146 910

Meeting Lead: Nancy Anthracite Facilitator/Scribe: Liz Badt/Jacquie Marian

Attendees:

X Nancy Anthracite President, CMO & Director, WorldVistA X Keith Magoon VA VIMM Project Manager Dennis Peterson VA VLER Health Project Manager

X Michael Montali VA Developer Competency Manager Peter Li OSEHRA CISSP Director, Engineering X Rob Silverman VA Immunization SME Mike Henderson OSEHRA Director Open Source Product Management Brian Morgan Chris Rhodes Director, Open Source VHA X George Lilly VistA Expertise Network & CIO, WorldVistA Dennis Kemp VIMM PMO Project Manager Cameron Schlehuber Randy Nickel Director of Interfaces & Technical Services Group, Medsphere Bill Malcom Jay Heroux James Proctor VIMM PMO Agile Release Manager X Sridevi Uppalapati VIMM PMO Support Project Manager Helena Gilbert VIMM PMO Technical Writer Jacquie Marian VIMM PMO Business Analyst Sam Habiel Director of Technology, VistA Expertise Network Linda Hebert VA Immunization SME

1 X – Present. O – Excused absence. Blank – no report.

Discussion:

Topic: Update on Immunization Project Presenter: Rob Silverman Discussion: o Expecting a Sprint 2 document available soon and be provided for comments o Development is moving along; we are having good interactions. Starting to see the benefit of populating a standard file and distribute. Worked on a modest, but not 100% complete set of CVX codes that will be proposed to nationally distribute from the central account. o Rob is trying to find out who else needs to weigh in on whether ICE is the go forward application . Keith mentioned he has a team working on an Analysis of Alternatives, which ICE is one of the ones being considered. We will also have Cost Benefit Analysis and TCO and all the business documentation that is needed for the business to make a rational decision based on metrics. Trying to portray what is out there that meets the requirements of the business for immunizations. 1st draft is due in 2 weeks. . Nancy mentioned she hoped that open source is going to be high on the list of acceptable applications.  Keith stated the application needs to meet all the requirements of the business and wants an open source solution.  Project developers will do the 2nd developer review, create the necessary APIs and RPCs, and SQA will do the SQA testing . Results will be supplied to Keith and then he will provide to the business to select the application to go forward with. . In discussing with Rob, Keith is going with the strategy that the PWS will only be for Project Support and not for development. Keith has received commitment from the Resource Manager that he will have MUMPs developers for as long as needed for this project, which is the next 2 ½ years. o Topic: ICE information Presenter: Nancy Anthracite/George Lilly

2 Discussion: o Nancy loaded ICE – footprint between that and Tomcat is under 100 MB . Can put it on the same machine as VistA . Keith stated we could use local server, virtual server, or a cloud . Nancy felt you would want it local to keep response time quick . 130 VistA instances that have 30 clinics off the instance; Keith has network engineers to review the resources to determine the best configuration . Rob stated there would be 130 production servers and would need to have 130 testing servers that would access along with development accounts. Experience with MOCHA it was determined that the productions accounts could only access the production instances and test accounts could only access the test server instances. . Nancy had a document that describes what the message needs to look like and had a sample message within the document as well. . SOAP message goes out with this envelope, which is an XML message that contains the patient information along with the illnesses that would make them immune to some things they might need a vaccine for and what vaccines they received. It then gets encoded with base 64 and sent up to the server and sends back via XML that is base 64 encoded. . George displayed the message that went out and the message that is received (stored in a MUMPs ^TMP global)  Young man with hepatitis and a bunch of vaccines and it returned recommended vaccines for him  The only information that is absolutely necessary is DOB and Sex  Evaluation Rule looks like English but it’s not, it is a Drools Rule. (George read off the rule that appear to be logic statements). George mentioned it is a very concise language and not very tolerant of syntax except of what it accepts.  Supporting data was also provided. Vaccine group was selected and displayed (500). It has code numbers, CVX codes, display Names of vaccines. Vaccine 33 was then displayed, which appears to be the CVX code of 33. Vaccine series HepBChildAdult was displayed  Relationships and logic built into the use of the tables. Need to understand how these tables relate to each other in order to determine how the rules are applied  ICE also has the CAT and the Test Suite and Nancy stated they have not gotten it up yet.  Unique ID has to be sent with the message, but the data is not stored on the server  Curl Language is a way of sending something out from a command line without having a browser; VistA may have to send out using Curl. George stated it is a standard SOAP interface and a SOAP message can be formed in VistA and send it out and would not need Curl at all.

3 . Nancy stated she did not know what is in the IHS forecasting code, how much of that is going to be useable to help make use of this server. . Rules themselves importable into VistA?  Sample rules and sample?  Immunizations with all the military service; it would get too complex and a big job to parse with Reminders  Recommendation is best to have VistA handle the message creation for sending and receiving and have an outside server to do the evaluations; Nancy stated Patrick still needs to review the information o Nancy wrote to Howard Hays to get the latest forecasting code and sure he will provide it to us o Nancy mentioned waiting to see what Patrick Redington thinks about bringing the rules into VistA for the Reminders package. He will be on a call tomorrow dealing with the Reminders. o George displayed results of what VPR sends for a particular patient to see if there was enough data being formulated by VPR to use to create message to send to ICE. . Keith asked for links to the test procedures and test data for immunizations for meaningful use stage 1 testing so he can include in his requirements and the MTP . Rob stated that once this project has finished adding the files/fields, then the VPR will need updated to extract this information. However, there is a discussion of who will be responsible to update the VPR. o Nancy asked if anyone installed VueCentric and was able to access the RPMS server . Instructions to get to roll and scroll to manage immunizations were also provided by Nancy . Nancy will talk to someone to see if they could get a GUI for VistA instance o Patch 260 had some non-printing characters and has some HL7 tables and messaging

Topic: Presenter: Discussion:  Topic: Presenter:

Discussion:

4 Action Items:

Assigned To Date Due Date Action Item Disposition/Status Assigned Find out during Sprint Rob Silverman 4/17/2014 4/22/2014 Planning meeting regarding 0242 whether it has user facing functionality

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