EHR Interoperability WG

The HL7 Electronic Health Record (EHR) Interoperability Work Group is an activity of the HL7 EHR Work Group.

All are welcome to join and contribute to weekly teleconference sessions - as noted by topic area below. Please subscribe to the HL7 EHR Interoperability listserver for meeting announcements, agendas and updates on current work.

Note: DRAFT documents may be incomplete and are posted for Team review and discourse. Please take care to note their draft (tentative) status if referencing or sharing with others.

Co-Facilitators

• Gary.Dickinson@ehr-standards.com
• Stephen.Hufnagel.HL7@gmail.com

Record Entry Lifecycle Event Metadata using FHIR (Fast Health Interoperable Resources)

Leads: Gary Dickinson, Reed Gelzer, MD, Diana Warner

• This team meets each Friday at 11AM ET (8AM PT). GoToMeeting link: https://www3.gotomeeting.com/join/650909605 Dial-in: 1-312-878-3080 Code: 650-909-605
• Fast Health Interoperable Resources (FHIR) Main Page
• Current FHIR Resource Index
• DRAFT EHR-S FM Record Lifecycle Events on FHIR Overview Presentation, Gary Dickinson, 23 Jun 2014
• DRAFT Record Entry Lifecycle Event Metadata using FHIR Project Scope Statement, 13 Jun 2014
• FHIR Provenance and EHR Record Lifecycle/Lifespan, Kathleen Connor, messages from 1 and 11 May 2014
• DRAFT EHRS FM R2 Record Lifecycle (RI.1) and Audit (TI.2) Metadata Requirements, Gary Dickinson, 1 Jun 2014
• DRAFT EHRS FM R2 Record Lifecycle Events (RI.1.1) to FHIR Mapping, Gary Dickinson, 27 Jun 2014

Record Lifecycle, Provenance and Vocabulary Discussion

Leads: Kathleen Connor, Gary Dickinson, Reed Gelzer, MD, Steve Hufnagel, Diana Proud-Madruga, Tony Weida

• Weekly EHR Interop Teleconference: Each Tuesday at 2PM ET (11AM PT). GoToMeeting: https://www3.gotomeeting.com/join/798931918 Dial-in: 1-770-657-9270 Code: 510269
• (GoToMeeting facilities provided courtesy of Dr. Michael Brody.)
• 2014-06-10 EHR Interop Teleconference: Methodology for Action / Operation Taxonomy by Tony Weida, [1]
• 2014-06-10 EHR Interop Teleconference: Verb Harmonization Matrix, Definitions and Notes
• 2014-06-03 EHR Interop Teleconference: EHRS FM Verbs vs. Record Lifecycle Events vs. Security Verbs

REFERENCES

• Way with Verbs, Diana Proud-Madruga, linked 27 May 2014
• EHR Action Verbs and Security Operations, Tony Weida, presented 7 May 2014 to HL7 EHR WG meeting in Phoenix
• Mind Map of HL7 Security and Privacy Ontology, Diana Proud-Madruga, presented 7 May 2014 to HL7 EHR WG meeting in Phoenix
• EHRS FM Verbs vs. Record Lifecycle Events vs. Security Verbs, Steve Hufnagel, presented 7 May 2014 to HL7 EHR WG meeting in Phoenix
• EHRS FM Release 2 Verb Hierarchy
• HL7 Electronic Health Record Lifecycle Model - Draft Standard for Trial Use, published Jan 2008
• Lifecycle Events in ISO/HL7 Standards, revised 26 Jun 2014
• EHRS FM Functions – Relationship to Record Lifecycle Events and Audit Triggers, revised 23 April 2014
• EHRS FM Record Infrastructure - Record Lifecycle Events (RI.1.1.x) with Corresponding Metadata Requirements (RI.1.1.x.1) - Worksheet, revised 25 Feb 2013
• EHRS FM Record Lifecycle Events - Opportunity for Standards Convergence?, revised 30 May 2013

Meaningful Use Functional Profile (of ISO/HL7 10781 EHR-S FM Release 2)

Leads: Gora Datta, Gary Dickinson

• List of EHR System Functional Profiles (of ISO/HL7 10781 EHR System Functional Model), revised 2 Jun 2014
• Meaningful Use Functional Profile - Overview - 28 Mar 2014
• Meaningful Use Functional Profile - Test Procedure Analysis - Final - Ready for Comment Only Ballot, revised 28 Mar 2014
• Guidance Document on How to Build the ONC/NIST MU to HL7 EHRS FM Profile, revised 1 Aug 2013
• Meaningful Use Stage 1 (2011), EHR Certification Criteria, 45 Test Procedures
• Meaningful Use Stage 2 (2014), EHR Certification Criteria, 50 Test Procedures
• EHR-S FM MU FP Presentation to CDC on 10 Sep 2013
• Meaningful Use - Demographics, Julie Richards (Atlanta), presented 6 May 2013
• DRAFT Crosswalk - US Meaningful Use Stage 2 Certification Criteria (as proposed for 2014 on) and ISO/HL7 10781 EHR System Functional Model Release 2 Functions and Conformance Criteria, revised 7 May 2012

ISO/HL7 10781:2017 EHR-S FIM Release-3 2014-Planning

Gary Dickinson, co-chair and Steve Hufnagel PhD, project-facilitator

EHR-S FIM is EHR System Function-and-Information Model, release-3 planned for '2017 joint ISO/HL7-International ballot

• Release 3 - EHR-WG_Jan-2014_TSC-Presentation
• Release 3 - Jan 2014 Immunization-Management Prototype-Report for San Antonio WG Presentation
• Release 3 - Dec 2013 Immunization-Management Prototype Requirements-Specifications, Use-Cases, Information Models and Scenarios
• Release 3 - Dec 2013 EHR-S FIM Summary Report
• Release 3 - Dec 2013 EHR-S FIM Summary Presentation
• Release 3 - Dec 2013 EHR and PHR System Reference Model, presented l7-Dec-2013
• Release 3 - Nov 2013 EHR-S FIM Summary Report
• Release 3 - Nov 2013 EHR-S FIM Summary Presentation
• Release 3 - Nov 2013 CP.6.2 Immunization-Management Interoperability-Specification Prototype
• Release 3 - Oct 2013 EHR-S FIM Summary Report
• Release 3 - Oct 2013 EHR-S FIM Summary Presentation
• Release 3 - Jul 2013 Analysis of Immunization Administration (CP.6.2) Conformance Criteria, Gary Dickinson, revised 28 July 2013
• Release 3 - Jun 2013 EHR-S FIM Overview and Objectives, Steve Hufnagel, revised 4 June 2013

EHR-S and PHR-S FIM, Release-3 2012 Prototype

Steve Hufnagel, Facilitator and Gary Dickinson, co-chair

PURPOSE

- add conceptual information and data model for each Release 2.0 EHR-S FM function
- make the EHR-S FM easier  to use for architects, analysts and engineers
- verify and validate EHR-S FM Release 2.0
- DSTU demonstration for Service Aware Interoperability Framework (SAIF) 
- Support specific profiles (e.g., WG project DAMS, DIMS, DCMS).

REFERENCE DOCUMENTS

• EHRS FIM (for EHR-S FM R2.1), Immunization Example, revised 8 Nov 2011
• File:HL7 Project Scope Statement for EHR-S FIM 2012-1-3.doc
• File:EHR-S FIM Request for PSS co-sponsorship 2012-01-02-E.pptx
• File:ISO 13940 Continuity-of-Care Concepts Jan-11.pptx
• UML: You can download the current Sparx EA EAP file for the models at: https://www.dropbox.com/s/vzilknooyzv9c5f/EHR-S%20FIM.eap

IMMUNIZATION MAGAGEMENT PROTOTYPE

• Executive Summary for EHR-S FIM Immunization Management Capability and its Function and Information Models, 9-Feb-12 (Original), 15-Mar-12 (Last Update)
• CP.1.2_Manage_Allergy,_Intolerance_and_Adverse_Reaction_List, 23-Jan-12 (Original), 24-Feb-12 (Last Update)‎
• CP.1.3_Manage_Medication_List, 23-Jan-12 (Original), 24-Feb-12 (Last Update)
• CP.1.6 Manage Immunization List, 14-Jan-12 (Original), 24-Feb-12 (Last Update)
• CP.3.3 Manage Clinical Documents and Notes, 14-Jan-12 (Original), 24-Feb-12 (Last Update)
• CP 6.2 Manage Immunization Administration, 5-Dec-11 (Original), 28-Feb-12 (Last Update)
• CPS.1.7.2 Manage Patient Advance Directives, 20-Jan-12 (Original), 24-Feb-12 (Last Update)
• CPS.3.9 Clinical Decision Support System Guidelines Updates, 27-Jan-12 (Original), 24-Feb-12 (Last Update)
• CPS.9.4_Standard_Report_Generation, 27-Jan-12 (Original), 24-Feb-12 (Last Update)
• AS.4.1_Manage_Registry_Communication, 27-Jan-12 (Original), 24-Feb-12 (Last Update)

ORDERS MAGAGEMENT PROTOTYPE

• Executive Summary for EHR-S FIM Orders Management Capability and its Function and Information Models, 18-Apr-12 (Original), 5-Jul-12 (Last Update)

RESULTS MAGAGEMENT PROTOTYPE

• Executive Summary for EHR-S FIM Orders Management Capability and its Function and Information Models, 29-May-12 (Original), 5-Jul-12 (Last Update)

RECORDS INFRASTRUCTURE (RI) PROTOTYPE

• RI.1.1.3 Translate Record Entry Content, 13-Mar-12 (Original), 23-Aug-12 (Last Update)

US ONC Standards and Interoperability Framework

2011-2014 Use Case Initiatives - Transitions of Care, Lab Results, Provider Directory, Digital Certificate...

• Link to ONC S&I Framework Initiative Wiki Pages

Cross Initiative Work Group - S&I Simplification

• Link to ONC S&I Framework Cross Initiative Use Case Simplification Wiki Page
• S&I Simplification Overview, published 7 May 2013
• DRAFT Simplification Core Matrix, Version 2.5, published 10 June 2013

US HITECH Act - EHR Incentive Program - Stage 1 - Final Regulations (2011 on)

• Meaningful Use - CMS Stage 1 - Electronic Health Record Incentive Program - Final, published 28 Jul 2010
• Meaningful Use - CMS Stage 1 - Measures, published 28 Jul 2010
• Meaningful Use - ONC Stage 1 - Standards, Implementation Specifications and Certification Criteria, published 28 Jul 2010
• Meaningful Use - ONC Stage 1 - Certification Program - Final, published 7 Jan 2011
• HITECH White Board Story - Stage 1, Version 1, Robin Raiford, published 2 Aug 2010
• HITECH White Board Story - Stage 1, Version 2, Robin Raiford, published 5 Jun 2011

US HITECH Act - EHR Incentive Program - Stage 2 - Final Regulations (2014 on)

• Meaningful Use - CMS Stage 2 - Electronic Health Record Incentive Program - Final, Bookmarked Version courtesy of Robin Raiford (Advisory Board), Rule published 4 Sep 2012
• Meaningful Use - ONC Stage 2 - Standards, Implementation Specifications and Certification Criteria - Final, Bookmarked Version courtesy of Robin Raiford (Advisory Board), Rule published 4 Sep 2012
• HITECH White Board Story - Stage 2, Version 1, Robin Raiford (Advisory Board), published 10 Feb 2014
• Quick Guide Comparison―Stage 1 to Stage 2 Objectives and Measures, courtesy of Robin Raiford (Advisory Board), published 7 Sep 2012

US ONC Advance Notice of Proposed Rulemaking

Metadata Standards to Support Nationwide Electronic Health Information Exchange

• 45 CFR Part 170 RIN 0991-AB78, as proposed, Federal Register publication date 9 Aug 2011

Clinical Information Modeling Initiative

• CIMI Initial Public Release, Stan Huff, MD, dated 14 December 2011
• CIMI - Seeking Clarity (Questions and Issues), Gary Dickinson, revised 8 January 2012

ISO 16223 - Standards Convergence to Promote EHR Interoperability

• DRAFT Standards Convergence Slide Set, revised 5 October 2009 ("Standards Convergence" accepted as Preliminary Work Item by ISO TC215, April 2010)
• DRAFT EHR Source Journal, Supplement to Standards Convergence Work Item, revised 3 Dec 2009

HL7 EHR/PHR Standards

System Functionality Standards

• Electronic Health Record (EHR) System Functional Model, Normative HL7/ANSI Standard, published Mar 2007 (5 MB)
• Personal Health Record (PHR) System Functional Model, Draft Standard for Trial Use, published Dec 2008 (3.6MB)

Record Interoperability Standards

• EHR Interoperability Model, Draft Standard for Trial Use, published Mar 2007
• EHR Lifecycle Model DSTU, published Feb 2008
• Implementation Guide for CDA Release 2: Reference Profile for EHR Interoperability DSTU, published Feb 2008

Key Reference Documents

• "Achieving Interoperability and Safe Exchange of Health Information/Records - How Meaningful Use Stage 2 Falls Short", Gary Dickinson, CentriHealth, revised 26 Aug 2013
• EU/US eHealth Cooperation Initiative - "Interoperability", Gary Dickinson, CentriHealth, revised 17 Feb 2014
• "Interoperability Framework Overview", Presentation to HIT Standards Committee, Doug Fridsma, MD, PhD, 24 Mar 2010
• "Coming to Terms" White Paper on Interoperability, Pat Gibbons ( Mayo Clinic) et al, published Mar 2007
• "Integrating Standards to Achieve Semantic Interoperability", NHS Connecting for Health (UK), Dr. Ken Lunn, Director of NHS Data Standards and HL7 Board Member, Presentation to HL7/OMG Service Oriented Architecture Conference, Apr 2008
• EHR WG Document Library

2009 ANSI HITSP Foundations Framework Simplification Strategy

• HITSP - Simplification Strategy Slide Set
• HITSP - 2006 Biosurveillance Example (Includes references from Slide Set)
• HITSP - Use Case Template (for additional ONC/AHIC or other Use Cases)