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

• 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.)

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

Leads: Gary Dickinson, Lloyd McKenzie

• This team meets each Friday at 11AM ET (8AM PT). GoToMeeting link: https://www3.gotomeeting.com/join/650909605 Dial-in: 1-215-383-1013 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, Gary Dickinson, 9 Jun 2015
• DRAFT EHR-S FM Record Lifecycle Events on FHIR - Implementation Guide Front Matter, Gary Dickinson, 18 Mar 2015
• FHIR W5 Report, FHIR Management Group, 3 Apr 2015
• DRAFT EHR-S FM Record Lifecycle Event Metadata Requirements on FHIR WORKSHEET, Gary Dickinson, 27 Feb 2015
• DRAFT EHR-S FM Record Lifecycle Events on FHIR - Resource Analysis WORKSHEET, Gary Dickinson, 27 Feb 2015
• DRAFT EHR-S FM Record Lifecycle Events on FHIR - Code/Value Set Analysis WORKSHEET, Gary Dickinson, 27 Feb 2015
• DRAFT EHR-S FM Record Lifecycle Events on FHIR - USE CASE WORKSHEET, Gary Dickinson, 29 Aug 2014
• DRAFT S&I Data Provenance System Event Matrix, Gary Dickinson, 7 May 2015
• Introduction to ISO/HL7 Standards for EHR Record Lifecycle and Lifespan, Gary Dickinson, presented 26 Jun 2014 to S&I Data Provenance Community Teleconference
• EHR Record Lifecycle Events and Data Provenance Across S&I Initiatives, Gary Dickinson, 2 July 2014
• S&I Data Provenance Examples - User Stories with Record Lifecycle & Provenance Events, Gary Dickinson, 18 Aug 2014
• Record Entry Lifecycle Event Metadata using FHIR Project Scope Statement, 22 Jul 2014
• Patient, Provider, Community Pharmacy Perspectives - Presentation, Version 11, Julia Chan, work in progress
• Patient, Provider, Community Pharmacy Perspectives - Scenario Worksheet, Julia Chan, work in progress
• FHIR Resources - States and State Transitions - 1 min Video - Julia Chan, work in progress
• FHIR Financial Domain - Resource/Attribute States and Statuses - Julia Chan

Record Lifecycle, Provenance and Vocabulary Alignment

Leads: Reed Gelzer, MD, Diana Proud-Madruga

• 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

• Project Scope Statement for Vocabulary Alignment Project, revised 22 Jul 2014, as approved by Security WG
• 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
• 2014-06-10 EHRS-FM vs. Record Lifecycle vs Security Verb Harmonization Matrix & Definitions.xlsx
• 2014-09-02-P EHR Verb Categorization by Record Entry Events.docx

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

Leads: Gary Dickinson, Diana Warner, Hetty Kahn, Anneke Goosen

• List of EHR System Functional Profiles (of ISO/HL7 10781 EHR System Functional Model), revised 17 Sep 2014
• Meaningful Use Functional Profile - Overview - 28 Jul 2014
• Meaningful Use Functional Profile - Test Procedure Analysis Worksheet - Ready for Informative Ballot, revised 14 Jul 2014
• Meaningful Use Stage 1 (2011), EHR Certification Criteria, 45 Test Procedures
• Meaningful Use Stage 2 (2014), EHR Certification Criteria, 50 Test Procedures
• 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

US ONC Standards and Interoperability Framework

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

• Link to ONC S&I Framework Initiative Wiki Pages

Cross Initiative Work Group - S&I Simplification

• Link to ONC S&I Simplification (cross-initiative Work Group) Wiki Page
• Link to ONC S&I Simplification Reference Materials Wiki Page
• S&I Simplification Overview, published 8 Aug 2014
• DRAFT Simplification Core Matrix, Version 3.2, published 27 Nov 2014

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 - Analysis of Immunization Administration (CP.6.2) Conformance Criteria, Gary Dickinson, revised 20 Feb 2015
• 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 - 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 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, courtesy of the late Robin Raiford, published 2 Aug 2010
• HITECH White Board Story - Stage 1, Version 2, courtesy of the late 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, courtesy of the late Robin Raiford (Advisory Board), published 10 Feb 2014
• Quick Guide Comparison―Stage 1 to Stage 2 Objectives and Measures, courtesy of the late 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

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

• ISO 21089 - Trusted End-to-End Information - Overview Presentation to S&I Data Provenance (DPROV) Community, Gary Dickinson, published 20 Nov 2014
• 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

• "Comments on ONC Interoperability Roadmap", Gary Dickinson, CentriHealth, 3 Apr 2015
• "Comments on MU3 NPRM for System Certification", Gary Dickinson, CentriHealth, 29 May 2015
• "Truth, Trust, Fitness for Use (Purpose)", Gary Dickinson, CentriHealth, 10 Mar 2015
• "Achieving Interoperability and Safe Exchange of Health Information/Records - How Meaningful Use Stage 2 Falls Short", Gary Dickinson, CentriHealth, 26 Aug 2013
• EU/US eHealth Cooperation Initiative - "Interoperability", Gary Dickinson, CentriHealth, 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)