CIC Monthly Call Minutes

CIC Monthly Call Minutes Thursday, April 23, 2009, 1:00 pm Eastern U.S. 60 minutes

Meeting Attendees: Bentley, Steve NHS [email protected] Brandt, Sam Siemens [email protected] Diamond, Ann ACOG Dickinson, Gary CentriHealth [email protected] Diehl, Mark CDPHP/ADA [email protected] Dove, James American College of Cardiology Eckerson, Kristi Emory [email protected] Heermann, Laura IHC [email protected] Jaffe, Charles HL7 [email protected] Kallem, Crystal** AHIMA [email protected] Kuhn, Thom ACP [email protected] Lincoln, Michael U.S. Dept. of Veterans Affairs [email protected] Lyle, Jay Ockham Information Services LLC [email protected] Maers, Greg Emergency Medicine, University of [email protected] NC Chapel Hill McClay, Jim UNMC [email protected] Nahm, Meredith Duke Translational Medicine [email protected] Institute Reeves, Dianne NCICB [email protected] Ryan, Sarah VA [email protected] Shakir, Abdul-Malik Shakir Consulting [email protected] Walden, Anita Duke Translational Medicine [email protected] Institute

I. Approval of March Conference Call Minutes: J. McClay motioned to approve, L. Heemann second, 0 abstentions, 0 against, motion passed. Minutes approved as written

II. Update on the Bridging the Chasm Meeting C. Jaffee reported that two others on the call spoke at the meeting. Both attendance and participation exceeded expectations 120 attendees representing 100 medical and health related specialty societies. There was remarkable senior-level participants and observers from important government agencies. Meeting presentations are posted on the HL7 web site, pending permission from speakers.

Outcomes from meeting were significant. Participants were eager to move forward with defining their clinical domains. No consensus on how or in what time frame, but unanimous agreement to move ahead. The meeting conveners (E. Hammond and C. Jaffe) Will follow up with a web cast for participants to maintain opportunity for engagement. Unfortunately, AMA could not attend. Will look to Office of National Coordinator and AMA to collaborate with the clinical professional societies to move this effort forward. Two leaders for the effort, Drs. James Dove and Nina Schwenk were identified. The meeting concluded with identified opportunities to move forward with other professional societies and standards groups. Kudos to S. Brandt and J. Dove for two presentations that were on target and widely recognized. J. Dove reported that it was a great meeting. He emphasized the importance of and clinician appreciation for banning of technical jargon. Clinicians are interested in the clinical definitions and want to look to others for the mechanics. S. Brandt reported that Ed Hammond stated at the meeting that HL7 possibly should not be the home of the effort. The consensus from the group was split. Some preferred more broadly based than HL7, other preferred to utilize HL7 infrastructure and connections with other standards efforts to prevent overlap. C. Jaffe reported that near term HL7 will take a leadership role and determine with the clinical professional societies how best to forward.

M. Nahm asked in near term is there anything that CIC needs to do to support the effort. C. Jaffe answered that will define as we move forward, i.e. engage others in making those decisions. Importantly, the clinicians were happy that there was not a method being sold or forced.

J. McClay asked, “was this an HL7 sponsored meeting? If so why do you need to get permission to share presentations?” C. Jaffe responded, “courtesy to the presenters”, and that within next 24 hours he expected to have permission from everyone to post. S. Brandt responded with the example that he had some images from the web that didn’t have copyright for, and needs to take those out prior to posting.

J. McClay asked, at what point did this effort transcend the CIC? C. Jaffe reminded the group that the meeting was never a CIC meeting. In the past, we have not had success getting clinicians to join the CIC and keeping presentations non-technical, thus, Ed convened the separate effort and meeting with AHRQ funding. In the meeting feedback, 1/3 of the participants responded that they were very relieved that the meeting was non-technical.

J. McClay remarked that this appears to step on toes of Office of the National Coordinator. C. Jaffe reported that at the meeting B. Humphreys endorsed the effort and explained that there was no overlap with NLM or Office of the National Coordinator efforts. B. Humphreys (NLM) and C. Friedman (ONC) were consulted in the meeting planning , were in support, and that this was not an overlap with those efforts. In addition, NQF welcomed the opportunity as transcending/larger than quality efforts and welcomed participation.

J. McClay asked, “was the organization to exist at executive level of medical professional societies”?. C. Jaffe said he was not sure, but reported that the groups valued the opportunity to convene with other medical specialties. Attendees noted that this was unique opportunity to convene to further the broader healthcare cause, and preferred not to break out into specialties. C. Jaffe emphasized that this was on reason why this was a milestone meeting.

A. Walden asked, “what about needs for example charters, budgets, business cases, etc. that participants may want to take back to their organizations?”. C. Jaffe responded that they would distribute high level materials on mission, vision and charter.

III. Project Updates a. Diabetes Data Strategy – Project Scope Statement This is the scope statement that was presented at the last CIC meeting. We have incorporated some elements based on comments from others’ review. This is a high level proof of concept project to map data needed for T1D DAM and map to the DCM and EHR Functional Profile. In addition, we have added a sub-component to compare process and methodology to the interoperability and lifecycle model. We anticipate this project will deliver a process and methodology that can be replicated to support domain definition and pathway to technical specifications for other therapeutic areas. CIC is a co-Sponsor. EHR is the sponsor and has approved. RCRIM has reviewed. Patient Care is reviewing and will take a vote.

C. Kallem called for questions. None were voiced. Motion to approve: S. Brandt, second, M. Nahm. No further discussion. 0 against, 1 abstention (J. McClay hasn’t read the scope statement). The motion passed as written. b. EMS DAM – Project Scope Statement Abdul-Malik Shakir reported that he was bringing a new project to the CIC for consideration as the sponsoring work group. The overall purpose was to create a generic DAM for the clinical group’s existing National Emergency Medical Services Information System (NEMSIS). standard and to seek ballot. The project is looking for CIC to serve as the primary sponsor because the group is used to sharing knowledge and information with related working groups. The goal of the project is to develop a Domain Analysis Model (DAM) specific to emergency medical service in the pre-hospital setting. The DAM will be balloted as an informative document and used as a reference in subsequent projects to develop or evaluate ANSI approved specifications and standards within the pre-hospital emergency medical services domain. This project is the first in a series of planned activities intended to transform the uniform pre-hospital emergency medical services dataset as defined by the United States Department of Transportation National Highway Traffic Safety Administration (NHTSA) into an American National Standard.

The deliverable from this project is the EMS DAM, an HL7 informative specification consisting of Use Case specifications, Activity diagrams, Class diagrams, Vocabulary Specifications, and mappings to the HL7 RIM.

C. Kallem asked if they had talked with Pt. Care, Emergency Care and PhER, EHR. AMS reported that they were in process asking others.

J. McClay reported that this looked like a subset of the Emergency care DAM, and that he felt that the project should go through Pt. Care. J. McClay reported that they should be harmonized, that they had a first pass at setting up their DAM. AMS reported that his project would add the Emergency Care as a co-sponsor. J. McClay and K. Eckerson responded that the Scope will ultimately go before the DESD and that the two projects should work together. AMS asked if they were working with NEMSIS. J. McClay reported that NEMSIS was input to the Emergency Care DAM and that they should talk off line to support each other. AMS asked if the work was moving forward in a productive fashion. J. McClay and L. Heermann reported that the work was sporadic. AMS reported that his was a funded project that had specific goals, but agreed that they needed to understand how the projects relate and that the combined project should be under CIC, and that he could supply resources to move the combined project forward. G. Mesrs, PI of the NEMSIS project, reported that NEMSIS stops at the ED door but that they are part of healthcare and not specifically not part of DEEDS. The hope is that they would have a home in a broad work group, i.e. CIC. K. Eckerson stated that the sponsoring group should be a cross working group, i.e. one that helped to bridge interested HL7 working groups. AMS asked that CIC vote to adopt the project, with the addition of the DEEDS work. L. Heermann stated that the conversation with AMS project and DEEDS should happen first. K. Eckerson added that could we ask CIC to approve the intent to Sponsor the project. AMS asked for a conversation with Emergency care about their project to compare objectives. J. McClay agreed to schedule next week, 11:00 eastern to talk with Emergency Care. C. Kallem offered agenda time for joint dialog during the joint session with Pt. Care in Kyoto. AMS asked that CIC take a vote. L. Heermann asked, “What does home mean to your project?”. M. Nahm responded that home ment a forum for all clinical specialties where content was harmonized, and common methods and tools were available to promote consistency and reduce overlap. G. Mears reported that this funding must provide a location within HL7 where all areas can be represented and that CIC meets the requirement. In addition, they have funds and need a decision in order to apply the funds. AMS asked to secure the time on the CIC agenda for Kyoto. Decision: table the motion till discussion with Emergency Care, and will vote in Kyoto, subsequent to conversations with Emergency Care and Patient care groups.

c. Others None reported

IV. CIC Workgroup Mtg Agenda, May 2009 in Kyoto, Japan C. Kallem offered time for EMS discussion Q2 in Kyoto. AMS agreed. C. Kallem asked meeting participants to please email C. Kallem to add topics to the Kyoto or monthly CIC call agendas.

V. Upcoming Calls  May 28th at 2:00 pm ET US  June 25th at 2:00 pm ET US  July 23rd at 2:00 pm ET US

Supporting Documents: CIC Conference Call Minutes: March 2009 http://www.hl7.org/documentcenter/public/wg/cic/minutes/2009-03-CIC%20Call%20Minutes.doc

Diabetes Data Strategy PSS – 04.03.2009 http://www.hl7.org/documentcenter/public/wg/cic/Diabetes%20Data%20Strategy%20Project %20Scope%20Statement%20(2009-04-03).doc

EMS DAM PSS – 04.15.2009 http://www.hl7.org/documentcenter/public/wg/cic/HL7%20EMS%20Project%20Scope %20Statement.doc

Draft CIC Workgroup Meeting Agenda (updated) – May 2009 in Kyoto, Japan http://www.hl7.org/documentcenter/public/wg/cic/CIC%20Agenda_May %202009%20(DRAFT_2009.04.22).doc