HL7 Project Scope Statement s8

Health Level Seven®, International

2013 Project Scope Statement

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1. Project Name and ID

Ordering Service Interface Specification Project Project ID:

2. Sponsoring Group(s) / Project Team

Primary Sponsor/Work Group (1 Mandatory) Orders and Observations Co-sponsor Work Group(s) Clinical Decision Support, SOA

Project Team: Project facilitator (1 Mandatory) Emory Fry, MD Craig Parker, MD; Davide Sottara, PhD, Other interested parties and their roles Pharmacy, Patient Care Multi-disciplinary project team (recommended) Modeling facilitator Publishing facilitator Vocabulary facilitator Domain expert rep Business requirement analyst Conformance facilitator (for IG projects) Other facilitators (SOA, SAIF) CDS: Ken Kawamoto, MD; O&O: Lorraine Constable

Implementers (2 Mandatory for DSTU projects): Cognitive Medical Systems, Inc. Intermountain Healthcare

3. Project Definition

3.a. Project Scope

The proposed Ordering Service is intended to complement existing SOA services and the SAIF Behavioral Framework (BF) for HL7. It will provide a Service Functional Model (SFM) for ordering pharmacy, laboratory, radiology, consult and nutritional services individually or part of an order set. The Ordering Service is intended to support interactive applications utilized by healthcare providers, and service-to- service interactions as might be required by a Clinical Decision Support system. The interface specification will be developed using the HSSP SFM development process, described at http://hssp.wikispaces.com/HSSPApproach, and will be documented in the HSSP wiki http://hssp.wikispaces.com/file/detail/Ordering.

Pre-existing HL7 conceptual work in topics such as Composite Orders, Laboratory Orders, Nutrition, Medication, or FHIR Order and Prescription resources will be incorporated to help document the necessary definitions, descriptions, graphics, and data models that are relevant. The responsible HL7 working groups for each domain will be consulted and their input incorporated as appropriate. In keeping with the approach used by the above referenced projects, the Ordering Service will distinguish between the order itself and the item requested. The Service Interface Specification will provide functional, semantic, and conformance profiles.

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2013 Project Scope Statement

Some usage scenarios: a) A CPOE system that provides extensive drug-drug, drug-allergy, and drug- disease decision support utilizes the interface to place a weight-adjusted Amoxicillin order for a paediatric patient. b) An EMR utilizes the interface to allow a community provider to refer a patient for an orthopaedic consult at the regional medical center. c) A hospitalist orders a low-carbohydrate, diabetic diet for a patient using a dedicated nutrition system. d) A Clinical Decision Support system analyses a patient’s clinical data and determines that their annual HgA1c is over due. The system places an unsigned order for the test and then notifies the Primary Care provider that their signature is required.

Exclusion: The consequences of an order are not necessarily enacted by the initial recipient, but may only be realized after a complex, multi-step workflow. The semantics and management of orders that can be delegated or transferred is out of scope.

3.b. Project Need A generalized service is needed to provide a standardized way to instantiate orders and thus initiate clinical workflows. The Ordering Service will provide a key integration component between systems involved in the distributed delivery and coordination of clinical care. Clinical Decision Support systems will benefit significantly. By being able to place unsigned, evidence-based orders requiring only a provider’s final signature, CDS tools will help overcome unnecessary behavioural or educational barriers to desired clinical practice. As appropriate, fully automated ordering and/or triggering of desirable workflow will reduce unnecessary approval delays, improve efficiency, and help reduce the task burden placed on providers and other care professionals.

3.c. Success Criteria An Order Service Interface Specification is successfully balloted and published.

3.d. Project Objectives / Deliverables / Target Dates Target Date Project Initiation 2013 May Service Requirements Specification 2013 July Initial Specification 2013 November Ballot for Comment 2014 January DSTU Ballot 2014 May DSTU Reconciled and Published 2014 Sept Normative Ballot 2016 Sept Normative Reconciled and Published 2017 Jan

3.e. Project Requirements As a crosscutting functional service, participation from several WG/Communities is required.

3.f. Project Risks As a crosscutting functional service, participation from several Risk Description WG/Communities is required.

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Without participation, service generalization/effectiveness will be Impact Description suboptimal. Probability: High Medium Low Severity: High Medium Low Mitigation Plan Active communication/”marketing” from O&O, CDS, and SOA.

3.g. Project Dependencies This project is intended to interface closely with the O&O Composite Order, Lab Order, FHIR, and SAIF modeling efforts.

3.h. Project Document Repository Location http://hssp.wikispaces.com/ orders

3.i. Backwards Compatibility Are the items being produced by this project backward compatible? Yes No Don’t Know N/A

4. Products Non Product Project- (Educ. Marketing, Elec. Services, etc.) V3 Documents - Knowledge Arden Syntax V3 Foundation – RIM Clinical Context Object Workgroup (CCOW) V3 Foundation – Vocab Domains & Value Sets Domain Analysis Model (DAM) V3 Messages - Administrative Electronic Health Record (EHR) V3 Messages - Clinical Functional Profile V3 Messages - Departmental V2 Messages – Administrative V3 Messages - Infrastructure V2 Messages - Clinical V3 Rules - GELLO V2 Messages - Departmental V3 Services – Java Services (ITS Work Group) V2 Messages – Infrastructure V3 Services – Web Services V3 Documents – Administrative (e.g. SPL) - New Product Definition - V3 Documents – Clinical (e.g. CDA) - New/Modified HL7 Policy/Procedure/Process -

5. Project Intent (check all that apply)

Create new standard Supplement to a current standard Revise current standard (see text box below) Implementation Guide (IG) will be created/modified Reaffirmation of a standard Project is adopting/endorsing an externally developed IG New/Modified HL7 Policy/Procedure/Process (specify external organization in Sec. 6 below) Withdraw an Informative Document Externally developed IG is to be Adopted N/A (Project not directly related to an HL7 Standard) Externally developed IG is to be Endorsed

5.a. Ballot Type (check all that apply) Comment Only Normative (no DSTU) Informative Joint Ballot (with other SDOs or HL7 Work Groups) DSTU to Normative N/A (project won’t go through ballot)

5.b. Joint Copyright Check this box if you will be pursuing a joint copyright. Note that when this box is checked, a Joint Copyright Letter of Agreement must be submitted to the TSC in order for the PSS to receive TSC approval. Joint Copyrighted Material will be produced

6. Project Approval Dates

Sponsoring Group Approval Date OO Approval Date CCYY-MM-DD 09c5ce86bc0e6778d1bc0f0f6128aa08.doc 2013 Release Page 3 of 4

2013 Project Scope Statement

Steering Division Approval Date SD Approval Date CCYY-MM-DD PBS Metrics Reviewed? (required for SD Approval) Yes No Technical Steering Committee Approval Date TSC Approval Date CCYY-MM-DD Joint Copyright Letter of Agreement received? (req'd for Joint Copyrighted material) Yes No

7. External Project Collaboration

Although no direct coordination is required, final outcome needs to be clearly communicated to other profilers basing their work on V3 messages/services.

7.a. Stakeholders / Vendors / Providers

Stakeholders Vendors Providers Clinical and Public Health Laboratories Pharmaceutical Clinical and Public Health Laboratories Immunization Registries EHR, PHR Emergency Services Quality Reporting Agencies Equipment Local and State Departments of Health Regulatory Agency Health Care IT Medical Imaging Service Standards Development Organizations Clinical Decision Support Healthcare Institutions (hospitals, long term (SDOs) Systems care, home care, mental health) Payors Lab Other (specify in text box below) Other (specify in text box below) HIS N/A N/A Other (specify below) N/A

7.b. Synchronization With Other SDOs / Profilers

Check all SDO / Profilers which your project deliverable(s) are associated with. ASC X12 CHA LOINC AHIP DICOM NCPDP ASTM GS1 NAACCR BioPharma Association (SAFE) IEEE Object Management Group (OMG) CEN/TC 251 IHE The Health Story Project CHCF IHTSDO WEDI CLSI ISO Other (specify below)

8. Realm

Universal Realm Specific Check here if this standard balloted or was previously approved as realm specific standard

9. Strategic Initiative Reference – For PMO/TSC Use Only

This section used only for Strategic Initiative Projects. 1. HL7 Recognition 2. HL7 Internal Processes 3. HL7 Implementation

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