CDA Implementation Guide Consolidation Project

Project Launch

Meeting Minutes

January 4, 2011, 11:00 AM EST - 12:30 PM EST

Phone Number: 770-657-9270 Participant Passcode: 310940

GoToMeeting: https://www.livemeeting.com/cc/dt/join?id=CDAconsolidation&role=attend

Attendees

name / organization / email / 1/4 / 1/11 / 1/18 / 1/25
Amram Ewoo / ONC/Deloitte / / ü
Amy Berk / ONC/Accenture / / ü
Beth King, CDR / Partners HealthCare / / ü
Bob Dolin / ONC/Lantana Group / / ü
Bob Yencha / ONC/Lantana Group / / ü
Brett Marquard / ONC/Lantana Group / / ü
Catherine Chronaki / FORTH-Institute of Computer Science / / ü
Chirag Bhatt / FEI / / ü
Chris Karr / (Only Dialed-In) / ü
Chris Melo / Philips Healthcare / / ü
Crystal Kallem / AHIMA / / ü
Dave Carlson / VA / / ü
David Heaney / McKesson / / ü
David Parker / DoD/Evolvent / / ü
D. Maris / DoD / / ü
Gay Giannone / ONC/Lantana Group / / ü
George Power / Canada Health Infoway / / ü
Harry Solomon / GE Healthcare / / ü
Isaac Vetter / Epic / / ü
Janet Campbell / Epic / / ü
Jas Singh / ONC/Deloitte / / ü
Jillian Wanner / ONC/Deloitte / / ü
John Donnelly / IntePro Solutions / / ü
Kate Hamilton / ONC/Lantana Group / / ü
Katya Kroupnik / Booz Allen Hamilton / / ü
Larry Sampson / HealthPartners / / ü
Laura Bryan / MedEDocs / / ü
Lawrence McKnight / Siemens / / ü
Liora Alschuler / ONC/Lantana Group / / ü
Lisa Spellman / HIMSS & IHE / / ü
Louann ?? / (Only Dialed-In) / ü
Marie Swall / VA / / ü
Marty Prahl / SSA / / ü
Mike Lomangino / SSA / / ü
Mike Nusbaum / MH Nusbaum & Associates Ltd. / / ü
Omar Bouhaddou / VA / / ü
Peter N Gilbert / Wayne State / / ü
Rich Kernan / ONC/Deloitte / / ü
Rick Geimer / ONC/Lantana Group / / ü
Rita Altamore / WA DoH / / ü
Sandy Stewart / Kaiser Permanente / (Only Dialed-In) / ü
Sarah Squire / ONC/Deloitte / / ü
Sean Muir / VA / / ü
Siva Kandaswamy / Verizon / / ü
Thomson Kuhn / ACP / / ü
Tom Davidson / SSA / / ü
Tyler Luke / IPO / / ü
Virginia Riehl / / ü

Minutes

  1. Agenda review: Accepted
  2. Project Overview (Liora Alschuler)

a.  Consolidation Project Scope

  1. Discussion:
  2. Liora introduced the CDA Implementation Guide Consolidation Project as a collaboration between HL7, IHE and the Health Story Project to harmonize and consolidate existing CDA templates. The resulting library of CDA templates forms the basis for extensible interoperability.
  3. The project will first address data elements required for Stage 1 Meaningful Use, and then review any additional templates required by the eight Health Story Project implementation guides
  4. It is desirable to review and harmonize all CDA templates referenced by C32, however, the minimum scope of the project is as above.
  5. Decision: Adjust Project Scope criteria to include a recommendation for sustainability and extensibility of the project to cover harmonization of templates not covered by the initial scope.

b.  Consolidation Project Goals

  1. Update and harmonize C32, within the scope defined above, while addressing known issues
  2. Rapid demonstration of templated CDA as a data element-centric paradigm for health information exchange
  3. Harmonize HL7 and IHE templates (those lying within the project scope; in future, will use this project as a prototype, paradigm, for future work)
  4. Provide a real world demonstration of model-driven standards development using MDHT and the CDC/NCI Template Database (Tdb)
  5. Resolve the ‘peel the onion’ problem: deliver a single, implementation-ready, implementer-friendly package with full samples and validation test suites

c.  Tooling support

  1. Discussion: Model-Driven Health Tools (MDHT)
  2. MDHT, under the Open-Health Tools (OHT) project, will produce formal models and associated documentation as well as complete Java libraries to read and write XML instances
  3. MDHT will also produce a validation test suite, which is useful for the ongoing template development and template maintenance
  4. Discussion: Template Database (Tds)
  5. Will be released under Apache v2 license later this month
  6. Will be source of template formalism (conformance statements) and Schematron validation rules
  7. See notes on demonstration below.

d.  Project Outcomes: Discussion:

  1. Emphasized that new content or new clinical requirements, will not be considered. This project is a maintenance project on existing CDA-based templates.
  2. The project will: (1) reconcile discrepancies; (2) disambiguate current templates; (3) update to meet regulatory requirements; and (4) adopt consistent publication format/style.

e.  Key Participants: Key participants include:

  1. ONC’s Standards and Interoperability framework and the contractors supporting the S&I Framework (CGI, Deloitte, Harris, Lantana Consulting Group, OHT)
  2. HL7, IHE and Health Story as core, organizational collaborators;
  3. All interested parties, either through membership/participation in the SDOs or individually
  4. Wiki Review (Brett Marquard)

a.  Reviewed Wiki structure, including primary goals, broader group of support

b.  Identified associated HITSP and HL7/Health Story documents (links provided on Wiki). IHE links will be added soon.

c.  Introduced areas for community participation: Discussion:

i.  Currently the team is categorizing known issues (submitted to HL7/IHE listservs and consolidated by NIST)

ii.  Brett Marquard proposed a format for capturing header conformance (Consolidation tracker will be posted to the Wiki)

  1. Need to develop format for capturing section conformance. The format wil be supported by the Health Story/EHRA analysis of CDA Based Documents – see wiki
  2. Need to develop format for capturing entry conformance

d.  Identified the need for samples

e.  Reviewed Project Deliverables: Discussion:

i.  Publish a Draft Standard for Trial Use (DSTU), including: implementation guide; full set of sample files; style sheet

ii.  Validation Test Suites

1.  Exploration of the greenCDA schemas, given the shorter learning curve for greenCDA which abstracts away the RIM semantics of HL7, will strive to include these in deliverables (tooling dependency)

2.  Minimum: Schematron validation rules automatically output from tools (Tdb or Tdb & MDHT)

3.  Template exchange formalism: developing a formalism that can be exchanged between tools will be another validation that the expression is platform independent, complete and precise

  1. The Dept. of Veteran Affairs (VA) expressed their hope that there are fully populated sample files, which include the optional sections as well. Request was made for a style sheet that can render all the entries from sample files, however, that is feasible only for “closed” templates. The templates used for these types of clinical documents, including summaries, are “open” templates. The display will render all human-readable content, but is not a method for validation of entries (see above for the test suites that will be developed).
  2. Template Database Demonstration (Bob Dolin)

a.  The Template Database was initially developed for the Centers for Disease Control and Prevention (CDC)

b.  This tool manages and detects relationships between the included templates. There are two types of relationships: implied and containment. It was designed to manage a large number of templates.

c.  Discoverability can be done through metadata, however, he has found that in most cases, query against the template structures/properties is of much greater utility.

d.  The tool also has a data entry interface and can support multiple users. It is not a design environment like MDHT.

e.  The Tdb has been used to output conformance statements (templates) incorporated into many implementation guides including those for Public Health Case Reporting (PHCR) and Healthcare Associated Infections (HAI). It has output the corresponding Schematron validation rules.

f.  The Tdb is one tool to consider for management and publication of the consolidated templates. The current implementation uses mySQL as the back-end and Access for multi-user data entry.

1/4 Action Items

·  (Brett) Post Kick-off materials to the Wiki

·  (Liora) Adjust Project Scope criteria to include a recommendation for sustainability and extensibility of the project

Recommended reading for next meeting:

·  http://jira.niemhealth.org/wiki/display/SIF/CDA+-+Comparison+of+CCR+and+CDA-Based+Documents