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=HL7 EHR/PHR Standards=
 
=HL7 EHR/PHR Standards=
 
==System Functionality Standards==
 
==System Functionality Standards==
*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=269 HL7 Electronic Health Record System Functional Model (EHR-S FM) Release 2, April 2014 (also published as ISO 10781)]
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*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=528 HL7 Electronic Health Record System Functional Model (EHR-S FM) Release 2.1, Apr 2020 (will be advanced to ISO as ISO 10781)]
*[[media:EHRS_FM-Functional_Profiles-20190114.pdf|EHR-S FM Functional Profiles, revised 14 Jan 2019]]
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*[[media:EHRS_FM-Functional_Profiles-20200729.pdf|EHR-S FM Functional Profiles, revised 29 Jul 2020]]
*[[media:EHRS_FM-National_Initiatives-20180516.pdf|EHR-S FM Known National Initiatives, revised 16 May 2018]]
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*[[media:EHRS_FM-National_Initiatives-20200204.pdf|EHR-S FM Known National Initiatives, revised 4 Feb 2020]]
 
*[[media:LegacyVistA_To_HL7_EHR-FM.xlsx|US Department of Veterans Administration - VISTA Legacy EHR System Functions - Mapping to EHR-S FM Release 1.1]]
 
*[[media:LegacyVistA_To_HL7_EHR-FM.xlsx|US Department of Veterans Administration - VISTA Legacy EHR System Functions - Mapping to EHR-S FM Release 1.1]]
 
*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=88 HL7 Personal Health Record System Functional Model (PHR-S FM) Release 1, May 2014 (also published as ISO 16527)]
 
*[http://www.hl7.org/implement/standards/product_brief.cfm?product_id=88 HL7 Personal Health Record System Functional Model (PHR-S FM) Release 1, May 2014 (also published as ISO 16527)]
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=HL7 "Reducing Clinician Burden" (RCB) Project=
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=HL7 EHR Work Group - Reducing Clinician Burden Project=
 
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Note that the HL7 EHR WG Reducing Clinician Burden Project now has its own Wiki pagehttps://wiki.hl7.org/Reducing_Clinician_Burden
This project is now hosted on its own Wiki Pagehttp://bit.ly/reducing_burden
 
  
 
==HL7 RCB Project - Presentations==
 
==HL7 RCB Project - Presentations==
  
*[[media:Reducing_Clinician_Burden-Overview-20190617.pdf|DRAFT Reducing Clinician Burden Project Overview, dated 17 Jun 2019]]
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*[[media:Reducing_Clinician_Burden-Overview-20201102.pdf|DRAFT Reducing Clinician Burden Project Overview, updated 2 Nov 2020]]
 +
*[[media:Reducing_Clinician_Burden-US_Core_Data_for_Interoperability-20201026.pdf|Burden Reduction Opportunities in the World of US Core Data for Interoperability (USCDI)? Presentation for Discussion, Gary Dickinson, updated 26 Oct 2020]]
 +
*[[media:Burden_Reduction_OBRHI_9-21-2020.pdf|Interoperability and Burden Reduction - Emerging Opportunities for Collaborative Care, Denise St Clair PhD, US Centers for Medicare and Medicaid Services, Office of Burden Reduction and Health Informatics, presented 21 Sep 2020]]
 +
*[https://www.dropbox.com/s/bythlco0ss8j89g/RCB%20Opelka%202020.pdf?dl=0 Reducing Clinical Burden thru Knowledge Engineering - Curating Clinical Knowledge, Frank Opelka MD FACS, American College of Surgeons, presented 21 Sep 2020]
 +
*[https://www.dropbox.com/s/kcgqrfs8yhnxnew/Review%20of%20Problem%20Concept%20Maps%2C%20HL7%20EHR%20Work%20Group%2C...pdf?dl=0 Problem Concept Maps: An Ontology to Facilitate Auto-Summarization of Electronic Health Information, Joel Buchanan MD, University of Wisconsin/Madison, presented 21 Sep 2020]
 +
*[[media:POHR_and_reducing_clinician_burden_2020-08-17_wLinks.pdf|The Problem-Oriented Health Record (POHR) and a Pathway to Reducing Clinician Burden (with Links), Lincoln Weed, Chris Weed, presented 17 Aug 2020]]
 +
*[[media:POHR_and_reducing_clinician_burden_2020-08-17_wNotes.pdf|The Problem-Oriented Health Record (POHR) and a Pathway to Reducing Clinician Burden (with Notes), Lincoln Weed, Chris Weed, presented 17 Aug 2020]]
 +
*[[media:V3Diagnostic_Advanced_Payment_ModelsHL7.pdf|Payment Reform in the Era of Advanced Diagnostics, Artificial Intelligence and Machine Learning, James Sorace MD MS, presented 3 Aug 2020]]
 +
*[[media:HL7_RCB_Presentation-Mullins-20200720.pdf|Examining the Health IT Vendor’s Perspective - Lessons learned as a physician working for a health IT vendor, Ryan Mullins MD CPE, presented 20 Jul 2020]]
 +
*[https://confluence.hl7.org/download/attachments/39160937/20200518%20Da%20Vinci%20-%20RCB%20Presentation.pptx?version=1&modificationDate=1589915917527&api=v2 HL7 Da Vinci Project Overview (focused on Provider/Payer Exchange), Viet Nguyen MD, presented 18 May 2020]
 +
*[https://confluence.hl7.org/display/DVP/Da+Vinci+2020+Calendar HL7 Da Vinci Project Calendar, Viet Nguyen MD, presented 18 May 2020]
 +
*[[media:DQ_and_RCB_Complexity_Simplified_May_4_2020.pdf|Data Quality and Clinician Burden - Overview, Examples, and Basic Recommendations, Reed Gelzer MD, presented 4 May and 1 Jun 2020]]
 +
*[[media:EHR_WG_Update_20April2020.pdf|Exploring FHIR to Reduce Burden for Quality Measurement, Floyd Eisenberg MD PhD, presented 20 Apr 2020]]
 +
*[[media:HL7_Interactive_fhir_FINAL_14April2020_with_results-1.pdf|Exploring FHIR to Reduce Burden for Quality Measurement - Survey Results, Floyd Eisenberg MD PhD, presented 20 Apr 2020]]
 +
*[[media:Association_Between_EHR_Usability_and_Burnout_DS_20191118.pdf|Association between EHR Usability and Burnout, David Schlossman MD, presented 18 Nov 2019]]
 +
*[[media:HL7_EHR-S_FM_Usability_FP_Relationship_to_RCB_Project_DS_20191007.pdf|Increasing EHR System Usability Through Standards - As One Approach to Reducing Clinician Burden, David Schlossman MD, presented 7 Oct 2019]]
 
*[[media:Schlossman_AMDIS_RCB_Presentation_final.pdf|Reducing Clinician Burden Project - New Directions in Alleviating Clinical Workflow and Documentation Burdens - Association of Medical Directors of Information Systems (AMDIS) Presentation, David Schlossman MD, presented 20 Jun 2019]]
 
*[[media:Schlossman_AMDIS_RCB_Presentation_final.pdf|Reducing Clinician Burden Project - New Directions in Alleviating Clinical Workflow and Documentation Burdens - Association of Medical Directors of Information Systems (AMDIS) Presentation, David Schlossman MD, presented 20 Jun 2019]]
 
*[[media:HL7_EHR_S_and_Usability_DS_20190617.pdf|Update on HL7 EHR System Usability Functional Profile Project, HL7 Da Vinci Project, CMS Patients over Paperwork RFI, David Schlossman MD, presented 17 Jun 2019]]
 
*[[media:HL7_EHR_S_and_Usability_DS_20190617.pdf|Update on HL7 EHR System Usability Functional Profile Project, HL7 Da Vinci Project, CMS Patients over Paperwork RFI, David Schlossman MD, presented 17 Jun 2019]]
  
==HL7 RCB Project - Analysis Worksheet==
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==HL7 RCB Project - Analysis Worksheets==
*[[media:Reducing_Clinician_Burden_Analysis_Worksheet-20190617.xlsx|DRAFT Reducing Clinician Burden Analysis Worksheet, DRAFT IN PROGRESS - COMMENTS ARE WELCOME!!, dated 17 Jun 2019]]
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*[[media:Reducing_Clinician_Burden_Analysis_Worksheet-20201019.xlsx|DRAFT Reducing Clinician Burden Analysis Worksheet, updated 19 Oct 2020]]
 +
This version of the RCB Analysis Worksheet includes the ONC FINAL "Strategy on Reducing Burden Relating to the Use of Health IT and EHRs".  Each of the four ONC Initiatives(I), along with Strategies(S) and Recommendations(R) are inserted within the related RCB topic area and are identified as Ix.Sx.Rx.  NOTE also that all reference sources up through #122 have been reviewed and are incorporated in this version.  See "References" Tab.
 +
*[[media:Reducing_Clinician_Burden-Clinical_Documentation_Lifecycle-20201019.xlsx|DRAFT Clinical Documentation - Collect, Share, Use - Information Flow and Lifecycle Example - including Intersections with Clinician Burden and Safety Concerns, updated 19 Oct 2020]]
 +
This two tab worksheet shows:  1) typical end-to-end information flow of clinical documentation, starting at the point of origination of health record entry and ending at the point where record entry content is accessed/used for subsequent patient care, interventions and decision making;  2) the potential to segment health record entry into a segment supporting direct care and separate segment(s) for other uses/users of clinical documentation (including payors, public health, quality/performance entities, administration, finance, clinical registries...).
 +
*[[media:Reducing_Clinician_Burden-Cause_Matrix-20200615.pdf|DRAFT Reducing Clinician Burden - Cause Matrix, updated 15 Jun 2020]]
 +
This one page DRAFT outlines key causal factors for clinician burden and is offered for your review and comment.
 +
*[[media:IPS-Burden_Comments-20200330.pdf|RCB-related Comments on ISO DIS 27269 - International Patient Summary, published 30 Mar 2020]]
 +
These comments on the DRAFT International Patient Summary were prepared in correspondence with findings of the HL7 RCB Project and clinician burdens associated with patient summary creation, exchange and use, particularly with regard to aspects of information overload, data integrity, patient/provider identity matching, preservation of clinical data context, reconciliation of medications, medication allergies, all allergies, problems/diagnoses and more.
 +
*[[media:HL7_EHR_WG-A_Perspective_on_History_and_the_Future-20200730.pdf|“A Perspective on the History and Progression of EHR System Functionality Standards, Certification and Adoption”, updated 30 Jul 2020]]
 +
This document is part of an initial dialogue between the HL7 RCB Project and the US Centers for Medicare and Medicaid Services (CMS) Office of Burden Reduction and Health Informatics and offers a timeline of HL7 EHR WG standards development activities from 2000 until the present.
 +
 
 +
==HL7 RCB Project - Reducing Clinician Burden "Comment Only" Ballot==
 +
*[[media:HL7_RCB_R1_O1_2020SEP.pdf|RCB Ballot Document - September 2020 Ballot Cycle - To Gain Insights/Input from the HL7 International Community on Workable Strategies for Clinician Burden Reduction]]
 +
*[[media:Reducing_Clinician_Burden-Ballot_Comments-20200914.xlsx|RCB Ballot Comments (from Participants)]]
 +
This ballot closed on Monday, 14 September 2020.
 +
 
 +
==HL7 RCB Project - White Paper==
 +
*[[media:RCB_Project_Clinical_Workflow_Paper_JMIR_Format_21Jan2020-Final.docx|DRAFT Reducing Clinician Burden by Improving Electronic Health Record Usability and Support for Clinical Workflow, David Schlossman MD PhD, Lisa Masson MD, James Tcheng MD, Luann Whittenburg RN PhD, Barry Newman MD, Gary Dickinson FHL7, released 1 Jun 2020]]
 +
This White Paper has been released for Project Team review and comment.
 +
 
 +
==Burden Reduction (and other) Initiatives in Response to the COVID-19 Pandemic==
 +
*[https://www.cms.gov/files/document/cms-waivers-and-covid-19-response.pdf (US) Centers for Medicare and Medicaid Services (CMS) - Waivers and COVID-19 Response, Online Presentation, 7 April 2020]
 +
*[https://www.cms.gov/newsroom/press-releases/cms-announces-relief-clinicians-providers-hospitals-and-facilities-participating-quality-reporting (US) CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19, posted 22 Mar 2020]
 +
*[https://www.cms.gov/newsroom/press-releases/trump-administration-makes-sweeping-regulatory-changes-help-us-healthcare-system-address-covid-19 (US) Trump Administration Makes Sweeping Regulatory Changes to Help U.S. Healthcare System Address COVID-19 Patient Surge, posted 30 Mar 2020]
 +
*[https://www.hcinnovationgroup.com/interoperability-hie/standards/article/21131620/hitac-brainstorms-ways-onc-can-help-frontline-providers-in-covid19-response (US) Health Information Technology Advisory Committee (HITAC) Brainstorms Ways ONC Can Help Front-Line Providers in COVID-19 Response, published 27 Mar 2020]
 +
*[https://www.fiercehealthcare.com/payer/humana-aims-to-ease-administrative-financial-burdens-providers-amid-covid-19-crisis?utm_medium=nl&utm_source=internal&mrkid=4643083&mkt_tok=eyJpIjoiWmpNME1HRmlPV1E0TkRBeiIsInQiOiJPVXlncCtyNWVqZWdvNFZwQUxxQlpPOWFlOUNwUExHeVZuR2hCV1E4clV4MVVuMXZVQUNQTzIySWpmbEN6N2pkYXhnUkMwSEg1a0V4TTNyaEw1YjE0bnFZdm02Y2Ewb1djeSszUTlKcytjbldJSU9JTVZRQVFsSm1wa1N3bVlBVyJ9 (US Health Plan) Humana easing administrative, financial burdens on providers amid COVID-19 crisis, published 2 Apr 2020]
 +
*[https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/coronavirus-disease-2019-covid-19/index.html (US) CMS - COVID-19 Disaster Response Toolkit, posted 7 April 2020]
 +
 
 +
*[https://www.logicahealth.org/covid-19-interoperability-project/ Logica COVID-19 Interoperability Project, posted 4 Apr 2020]
 +
*[https://covid-19-ig.logicahealth.org/?mc_cid=709e81f39c&mc_eid=10d45eb01b Logica COVID-19 FHIR Implementation Guide, posted 4 Apr 2020]
  
 
=="See What We Mean"==
 
=="See What We Mean"==
 
*[https://ehrseewhatwemean.org/ "See What We Mean" Video Clips, developed by Medstar Health - National Center for Human Factors in Healthcare - EHR Safety and Usability Team]
 
*[https://ehrseewhatwemean.org/ "See What We Mean" Video Clips, developed by Medstar Health - National Center for Human Factors in Healthcare - EHR Safety and Usability Team]
  
==HL7 RCB Project - Reducing Burden and Addressing Burnout - Success Stories==
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==HL7 RCB Project - Reducing Burden - Success Stories==
 
*[[media:Reducing_Clinician_Burden-Success_Story_Template-20190128.docx|DRAFT Reducing Clinician Burden - Success Story Template, updated 28 Jan 2019]]
 
*[[media:Reducing_Clinician_Burden-Success_Story_Template-20190128.docx|DRAFT Reducing Clinician Burden - Success Story Template, updated 28 Jan 2019]]
*[[media:RCB_Story_-_Duke_Heart_Procedures.docx|Duke University - Duke Heart Business Unit – Procedure Reporting, James Tcheng MD, posted 4 Feb 2019]]
+
*[[media:RCB_Story_-_Duke_Heart_Procedures.docx|Duke University - Duke Heart Business Unit – Procedure Reporting, James E Tcheng MD FACC FSCAI, 4 Feb 2019]]
*[[media:Greta_Branford-UMich-HIMSS_2019.pdf|University of Michigan - Burnout: How EHR Usability Improves Efficiency & Satisfaction, Greta Branford MD, presented 14 Feb 2019 (Posted with Permission)]]
+
*[[media:19_HL7_RCB_Duke-dist.pdf|Duke University - Reducing Clinician Burden - Cardiovascular Procedure Reporting at Duke, James E Tcheng MD FACC FSCAI, 18 Sep 2019 (Posted with Permission)]]
*[[media:Monica_Jones-SNOMED_Clinical_Forum-20190409a.pdf|National Health Service - Rotherham Foundation Trust (UK) - Benefits of SNOMED CT from a clinical perspective, The Rotherham experience, Monica Jones, presented 9 Apr 2019]]
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*[[media:UGM_2019_ProviderBurnoutandEd_final-resized.pdf|University of Michigan - "Home for Dinner" - Reducing After Hours Documentation with Focused Training, Greta Branford MD, Marie Baldwin MSHROD, 26 Aug 2019 (Posted with Permission)]]
*[[media:ClinAC128 Optimization in the Ambulatory Setting.pdf|University of Pennsylvania - Getting Time Back in Your Day!  Implementing a Multi-Faceted Approach to Optimizing Epic in the Ambulatory Setting, Jeff Tokazewski MD, Carole Rosen, Shane Thomas, May 2019 (Posted with Permission)]]
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*[[media:Monica_Jones-SNOMED_Clinical_Forum-20190409a.pdf|National Health Service - Rotherham Foundation Trust (UK) - Benefits of SNOMED CT from a clinical perspective, The Rotherham experience, Monica Jones, 9 Apr 2019 (Posted with Permission)]]
*[https://www.aha.org/system/files/media/file/2019/05/plf-well-being-playbook.pdf?utm_source=newsletter&utm_medium=email&utm_content=05162019%2Dat%2Dpub&utm_campaign=aha%2Dtoday American Hospital Association - Well-Being Playbook, A Guide for Hospital and Health System Leaders, May 2019]
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*[[media:HL7_-_CCA_Optimization_Presentation_7.15.19.pdf|University of Pennsylvania - Getting Time Back in Your Day!  Implementing a Multi-Faceted Approach to Optimizing Epic in the Ambulatory Setting, Jeff Tokazewski MD, Carole Rosen, Shane Thomas, 15 Jul 2019 (Posted with Permission)]]
 +
*[[media:AHA-well-being-playbook.pdf|American Hospital Association - Well-Being Playbook, A Guide for Hospital and Health System Leaders, May 2019]]
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*[[media:AHA-HL7_Burnout_Webinar-Arespacochaga-20190818.pdf|American Hospital Association - Well-Being Playbook Presentation, Elisa Arespacochaga, 19 Aug 2019 (Posted with Permission)]]
 +
*[[media:UGM040_Understanding_the_Impact_of_the_EHR_on_Physician_Wellness_and_Burnout.pdf|Stanford University/Stanford Health Care - Understanding the Impact of the EHR on Physician Burnout and Wellness, Christopher Sharp MD, Lindsay Stevens MD, 28 Aug 2019 (Posted with Permission)]]
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*[https://www.dropbox.com/s/vxz2gywht2d0r9p/amber%20sieja-univ%20colorado-hl7%20talk%20-%20sprint%20ehr%20optimization%20program-20191216.pdf?dl=0 SPRINT – An Organizational Strategy that Increases Satisfaction, Improves Teamwork and Reduces Burnout, Amber Sieja MD, University of Colorado School of Medicine, UCHealth (Posted with Permission)]
 +
 
 +
==HL7 RCB Project - Survey and Responses==
 +
*[[media:Reducing_Clinician_Burden-Survey_Responses-20190819.docx|RCB Project Survey and Responses, dated 19 Aug 2019]]
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*[[media:ACS-CMS_Mango_v3.0-Opelka-201906.pdf|"The Value Expression" Presentation to CMS, Frank Opelka MD, Medical Director, American College of Surgeons, Quality and Health Policy, published Jun 2019 (Posted with Permission)]]
  
 
==HL7 RCB Project - Focus Team Drafts==
 
==HL7 RCB Project - Focus Team Drafts==
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*[[media:Data_Quality_interest_group_report_for_March_4_RCB_Meeting.docx|DRAFT Team Report - Data Quality - Reed Gelzer MD, Lead, updated 4 Mar 2019]]
 
*[[media:Data_Quality_interest_group_report_for_March_4_RCB_Meeting.docx|DRAFT Team Report - Data Quality - Reed Gelzer MD, Lead, updated 4 Mar 2019]]
  
==US Office of National Coordinator for Health Information Technology (ONC) DRAFT "Strategy on Reducing Burden"==
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==US Office of National Coordinator for Health Information Technology (ONC) Strategy for Reducing Burden==
*[https://www.healthit.gov/topic/usability-and-provider-burden/strategy-reducing-burden-relating-use-health-it-and-ehrs ONC DRAFT "Strategy on Reducing Burden Relating to the Use of Health IT and EHRs", including Findings, Strategies and Recommendations, published 28 Nov 2018, comment period closed 28 Jan 2019]
+
*[https://www.healthit.gov/topic/2020-2025-federal-health-it-strategic-plan ONC DRAFT Federal Health IT Strategic Plan, 2020-2025 - published 15 Jan 2020]
*[https://healthit.gov/burdencomments Summary of Public Comments for Draft Strategy, published 26 Mar 2019]
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*[https://www.healthit.gov/topic/usability-and-provider-burden/strategy-reducing-burden-relating-use-health-it-and-ehrs ONC FINAL "Strategy on Reducing Burden Relating to the Use of Health IT and EHRs", including Findings, Strategies and Recommendations, published 21 Feb 2020]
*[[media:HL7_Response_Letter_ONC_Reducing_Burden_Strategy_FINAL.docx|HL7 Comments on ONC Draft Strategy, compiled by HL7 Policy Advisory Committee, submitted 28 Jan 2019]]
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*[https://healthit.gov/burdencomments Summary of Public Comments on ONC DRAFT Strategy, published 26 Mar 2019]
*[[media:CentriHealth-Comments_on_ONC_DRAFT_Burden_Reduction_Strategy.pdf|CentriHealth (UnitedHealth Group) Comments on ONC Draft Strategy, submitted 28 Jan 2019]]
+
*[[media:HL7_Response_Letter_ONC_Reducing_Burden_Strategy_FINAL.docx|HL7 Comments on ONC DRAFT Strategy, compiled by HL7 Policy Advisory Committee, submitted 28 Jan 2019]]
 +
*[[media:CentriHealth-Comments_on_ONC_DRAFT_Burden_Reduction_Strategy.pdf|CentriHealth Comments on ONC DRAFT Strategy, submitted 28 Jan 2019]]
 +
*[https://www.urban.org/policy-centers/health-policy-center/projects/electronic-health-record-reporting-program ONC/Urban Institute - Health Policy Center - DRAFT Electronic Health Record Reporting Program, published Jun 2020]
 +
*[[media:Ehr_draft_voluntary_user-reported_criteria-GLD-20200810.pdf|EHR Standards Consulting - Comments on the ONC/Urban Institute DRAFT Electronic Health Record Reporting Program, submitted 10 Aug 2020]]
 +
 
 +
==US Department of Health and Human Services (HHS) Patients over Paperwork Initiative==
 +
*[https://www.govinfo.gov/content/pkg/FR-2019-09-30/pdf/2019-20736.pdf FINAL RULE - Medicare and Medicaid Programs; Regulatory Provisions To Promote Program Efficiency, Transparency, and Burden Reduction..., 20 Sep 2019]
 +
 
 +
==More RCB Perspectives and Resources==
 +
*[https://www.youtube.com/watch?v=xB_tSFJsjsw Video - An EHR State of Mind, Zubin Damania MD, posted 19 Oct 2015]
 +
*[https://www.youtube.com/watch?v=tpu5qcqspGA Video - Professional Satisfaction – Saturday Night Belongs to Epic, Christine Sinsky MD, VP/American Medical Association, posted 27 Jan 2016]
 +
*[https://www.youtube.com/watch?v=LMdxi7Hky-s&feature=youtu.be Video - Professional Satisfaction – EHR Should Make Our Lives Delightful, Christine Sinsky MD, VP/American Medical Association, posted 27 Jan 2016]
 +
*[https://www.youtube.com/watch?v=POZvCRdNbI8 Video - Creating Joy in Medical Practice - An Interview, Christine Sinsky MD, VP/American Medical Association, posted 25 Jan 2018]
 +
*[https://www.youtube.com/watch?v=dmIe4idZE6U Video - Strategies to Address Burnout Must be Practical and Local, Christine Sinsky MD, VP/American Medical Association, posted 25 Jan 2018]
 +
*[https://www.youtube.com/watch?v=FIFnY5mzXF0 Video - AMDIS/HIMSS Physician Executive Symposium - An Interview, Christine Sinsky MD, VP/American Medical Association, posted 28 March 2018]
 +
*[https://edhub.ama-assn.org/steps-forward/module/2702761 American Medical Association - Education Hub - Electronic Health Record Optimization: Strategies for Thriving - Strategies to help health care organizations maximize the benefits and minimize the burdens of the EHR, published 30 Aug 2018]
 +
*[https://www.youtube.com/watch?v=CCZlFE_R5yg Video - Freeing physicians to do their jobs - 2019 EHR National Symposium - Stanford Medicine, posted 28 Oct 2019]
 +
*[https://www.statista.com/topics/2099/stress-and-burnout/ Statista - Stress and burnout - Statistics & Facts, John Elflein, published 16 Aug 2019]
 +
*[https://www.youtube.com/watch?time_continue=120&v=NMa1tomIM7c&feature=emb_logo World Health Organization - Safe Health Workers, Safe Patients?, posted 16 Sep 2020]
  
 
==HL7 RCB Project - Reference Sources==
 
==HL7 RCB Project - Reference Sources==
RCB Reference Sources (and related links) are available at the RCB Wiki:  http://bit.ly/reducing_burden
+
RCB Reference Sources (and related links) are available at the RCB Wiki:  https://wiki.hl7.org/Reducing_Clinician_Burden
  
  
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=US Office of National Coordinator (ONC), 21st Century Cures Act: Interoperability, Information Blocking...=
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=US Office of National Coordinator (ONC) - 21st Century Cures Act: Interoperability, Information Blocking...=
*[https://www.federalregister.gov/documents/2019/03/04/2019-02224/21st-century-cures-act-interoperability-information-blocking-and-the-onc-health-it-certification US Office of National Coordinator for Health Information Technology - 21st Century Cures Act - Notice of Proposed Rule-Making (NPRM): Interoperability, Information Blocking, and the ONC Health IT Certification Program, published 4 Mar 2019]
+
*[https://www.govinfo.gov/content/pkg/FR-2020-05-01/pdf/2020-07419.pdf US Office of National Coordinator for Health Information Technology - 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program, published 1 May 2020]
 +
*[https://www.healthit.gov/cures/sites/default/files/cures/2020-03/HighlightedRegulatoryDates.pdf ONC 21st Century Cures Act - Interoperability, Information Blocking... - Implementation Timeline, published 1 May 2020]
 +
*[https://www.healthit.gov/cures/sites/default/files/cures/2020-04/Enforcement_Discretion.pdf ONC 21st Century Cures Act - Interoperability, Information Blocking... - Enforcement Discretion Dates and Timelines, published 1 May 2020]
 
*[[media:HL7_Response_Letter_TEFCA_2_06.14.19_FINAL.pdf|HL7 Response Letter, HL7 Policy Advisory Committee, published 3 Jun 2019]]
 
*[[media:HL7_Response_Letter_TEFCA_2_06.14.19_FINAL.pdf|HL7 Response Letter, HL7 Policy Advisory Committee, published 3 Jun 2019]]
*[[media:CentriHealth-Comments_on_ONC_NPRM-20190603.pdf|Comments on ONC NPRM - 21st Century Cures Act: Interoperability, Information Blocking, et al, Gary Dickinson, CentriHealth,, published 3 Jun 2019]]
+
*[[media:CentriHealth-Comments_on_ONC_NPRM-20190603.pdf|Comments on ONC NPRM - 21st Century Cures Act: Interoperability, Information Blocking, et al, Gary Dickinson, CentriHealth, published 3 Jun 2019]]
  
  
=US Office of National Coordinator (ONC), Technical Interoperability Forum, 15-16 August 2017=
+
=US Office of National Coordinator (ONC) - Interoperability Standards Advisory (ISA)=
*[https://oncprojectracking.healthit.gov/wiki/pages/viewpage.action?pageId=35127443 Agendas, Panel Presentations, Discussions and Input]
+
*[https://www.healthit.gov/isa/isa-publications ISA Editions 2015-2020]
  
  
=US Office of National Coordinator (ONC), Interoperability Forum, 6-8 August 2018=
+
=US Office of National Coordinator (ONC) - Interoperability Forums=
*[https://www.healthit.gov/news/events/oncs-2nd-interoperability-forum Agendas, Panel Presentations, Discussions and Videos]
+
*[https://oncprojectracking.healthit.gov/wiki/pages/viewpage.action?pageId=35127443 1st: 15-16 Aug 2017]
 +
*[https://www.healthit.gov/news/events/oncs-2nd-interoperability-forum 2nd: 6-8 Aug 2018]
 +
*[https://www.healthit.gov/news/events/oncs-3rd-interoperability-forum 3rd: 21-22 Aug 2019]
  
  
=US Office of National Coordinator (ONC), "Record to Rely On" Workshop, 29 November 2016=
+
=US Office of National Coordinator (ONC) - "Record to Rely On" Workshop, 29 November 2016=
 
==Leads:  Mark Knee JD, Elise Sweeney Anthony JD, Mike Lipinski JD==
 
==Leads:  Mark Knee JD, Elise Sweeney Anthony JD, Mike Lipinski JD==
 
*[[media:ONC-EHR_as_Record_to_Rely_On-Slides-20161129.pdf|Truth (Authenticity) as Evidence for Trust (Assurance), slide set developed/presented by Gary Dickinson, dated 29 Nov 2016]]
 
*[[media:ONC-EHR_as_Record_to_Rely_On-Slides-20161129.pdf|Truth (Authenticity) as Evidence for Trust (Assurance), slide set developed/presented by Gary Dickinson, dated 29 Nov 2016]]
Line 94: Line 167:
  
  
=US Office of National Coordinator - Interoperability Standards Advisory (ISA)=
+
=US Centers for Medicare and Medicaid Services (CMS) - Interoperability and Patient Access...=
*[https://www.healthit.gov/isa/sites/isa/files/inline-files/2019ISAReferenceEdition.pdf ISA 2019 Edition]
+
*[https://www.govinfo.gov/content/pkg/FR-2020-05-01/pdf/2020-05050.pdf Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability and Patient Access for Medicare Advantage Organization and Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans on the Federally- Facilitated Exchanges, and Health Care Providers, published 1 May 2020]
*[https://www.healthit.gov/isa/sites/default/files/2018%20ISA%20Reference%20Edition.pdf ISA 2018 Edition]
 
*[https://www.healthit.gov/standards-advisory ISA 2017 Edition]
 
  
  

Latest revision as of 16:14, 2 November 2020

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

Please subscribe to the HL7 EHR Interoperability listserver for meeting announcements, agendas and updates regarding 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.


Contents

HL7 EHR/PHR Standards

System Functionality Standards

Record Interoperability Standards


HL7 EHR Work Group - Reducing Clinician Burden Project

Note that the HL7 EHR WG Reducing Clinician Burden Project now has its own Wiki page: https://wiki.hl7.org/Reducing_Clinician_Burden

HL7 RCB Project - Presentations

HL7 RCB Project - Analysis Worksheets

This version of the RCB Analysis Worksheet includes the ONC FINAL "Strategy on Reducing Burden Relating to the Use of Health IT and EHRs". Each of the four ONC Initiatives(I), along with Strategies(S) and Recommendations(R) are inserted within the related RCB topic area and are identified as Ix.Sx.Rx. NOTE also that all reference sources up through #122 have been reviewed and are incorporated in this version. See "References" Tab.

This two tab worksheet shows: 1) typical end-to-end information flow of clinical documentation, starting at the point of origination of health record entry and ending at the point where record entry content is accessed/used for subsequent patient care, interventions and decision making; 2) the potential to segment health record entry into a segment supporting direct care and separate segment(s) for other uses/users of clinical documentation (including payors, public health, quality/performance entities, administration, finance, clinical registries...).

This one page DRAFT outlines key causal factors for clinician burden and is offered for your review and comment.

These comments on the DRAFT International Patient Summary were prepared in correspondence with findings of the HL7 RCB Project and clinician burdens associated with patient summary creation, exchange and use, particularly with regard to aspects of information overload, data integrity, patient/provider identity matching, preservation of clinical data context, reconciliation of medications, medication allergies, all allergies, problems/diagnoses and more.

This document is part of an initial dialogue between the HL7 RCB Project and the US Centers for Medicare and Medicaid Services (CMS) Office of Burden Reduction and Health Informatics and offers a timeline of HL7 EHR WG standards development activities from 2000 until the present.

HL7 RCB Project - Reducing Clinician Burden "Comment Only" Ballot

This ballot closed on Monday, 14 September 2020.

HL7 RCB Project - White Paper

This White Paper has been released for Project Team review and comment.

Burden Reduction (and other) Initiatives in Response to the COVID-19 Pandemic

"See What We Mean"

HL7 RCB Project - Reducing Burden - Success Stories

HL7 RCB Project - Survey and Responses

HL7 RCB Project - Focus Team Drafts

US Office of National Coordinator for Health Information Technology (ONC) Strategy for Reducing Burden

US Department of Health and Human Services (HHS) Patients over Paperwork Initiative

More RCB Perspectives and Resources

HL7 RCB Project - Reference Sources

RCB Reference Sources (and related links) are available at the RCB Wiki: https://wiki.hl7.org/Reducing_Clinician_Burden


US Office of National Coordinator (ONC), Trusted Exchange Framework/Common Agreement (TEFCA)


US Office of National Coordinator (ONC) - 21st Century Cures Act: Interoperability, Information Blocking...


US Office of National Coordinator (ONC) - Interoperability Standards Advisory (ISA)


US Office of National Coordinator (ONC) - Interoperability Forums


US Office of National Coordinator (ONC) - "Record to Rely On" Workshop, 29 November 2016

Leads: Mark Knee JD, Elise Sweeney Anthony JD, Mike Lipinski JD


US Centers for Medicare and Medicaid Services (CMS) - Interoperability and Patient Access...


HL7 FHIR Standard Release 4

FHIR EHR-S Record Lifecycle Event Implementation Guide

FHIR AuditEvent and Provenance Profiles

FHIR Five W's Pattern (Who, What, When, Where, Why)

FHIR Implementer's Safety Check List


Interoperability Assessment


Blockchain for Health/Healthcare (Public Journal)


International Patient Summary (INTERPAS/IPS)


PUBLICATION PACKAGE - Meaningful Use 2015 Edition Functional Profile

Leads: Gary Dickinson, Anneke Goossen, Michael Van Der Zel


Meaningful Use 2015 Edition Functional Profile (of ISO/HL7 10781 EHR-S FM Release 2)

Leads: Gary Dickinson, Mark Janczewski MD, Anneke Goossen

Meaningful Use 2014 Edition Functional Profile (of ISO/HL7 10781 EHR-S FM Release 2)

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


EHR as Legal Record Project

HL7 EHR and Records Management-Evidentiary Support (RM-ES) WGs

Leads: Gary Dickinson, Reed Gelzer MD, Diana Warner


Record Entry Lifecycle Event Metadata using FHIR (Fast Health Interoperable Resources) - Project Now Complete

Lead: Gary Dickinson


Record Lifecycle, Provenance and Vocabulary Alignment - Project Now Complete

Record Lifecycle, Security, Privacy, and Provenance Vocabulary Alignment

Leads: Reed Gelzer, MD, Diana Proud-Madruga

REFERENCES


US ONC Standards and Interoperability Framework

2011-2016 Use Case Initiatives - Transitions of Care, Lab Results, Provider Directory, Digital Certificate, et al.

Cross Initiative Work Group - S&I Simplification


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


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

IMMUNIZATION MAGAGEMENT PROTOTYPE

ORDERS MAGAGEMENT PROTOTYPE

RESULTS MAGAGEMENT PROTOTYPE

RECORDS INFRASTRUCTURE (RI) PROTOTYPE


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


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


US HITECH Act - EHR Incentive Program - Stage 3 - Final Regulations (2015 Edition)


US ONC Final 10 Year Interoperability Roadmap


US ONC Advance Notice of Proposed Rulemaking

Metadata Standards to Support Nationwide Electronic Health Information Exchange


ISO 16223 - Standards Convergence to Promote EHR Interoperability


Key Reference Documents


2009 ANSI HITSP Foundations Framework Simplification Strategy