Outreach Plan
Working Draft
For comment and discussion
- CIC co-chairs
Outreach Plan Content
Introduction 2
Relevant Communities and a Plan for Reaching Each 2
Clinical Professional Societies & Associations 2
National Provider & Practice Management Organizations 4
Payers 4
Related Standards Organizations 4
Informatics Professional Societies 4
Informatics Academic Programs 5
Vendors 5
Fellow HL7 Working Groups 6
Secondary Data Use Stakeholders 6
Communication Mechanisms 8
CIC Public Web site 8
CIC Canned Content 8
Ambassador Program 8
Workshops and Information Sessions in Conjunction with other Meetings 8
Personalized CEO visit 9
Project Schedule 10
Strategic Priorities in Year 1 10
Resources needed 11
Outreach Program Management and Evaluation 12
Introduction
Clinical Content Standards cross all areas of healthcare, and will impact many different stakeholders. Thus, development of clinical content data standards requires outreach to and partnership with these stakeholders. The Clinical Interoperability Council (CIC) has been developed to steward the development of clinical content data standards. As such, outreach and communication is a key function of the CIC. We approached the outreach planning by first identifying communities of stakeholders. The communities have been classified by role within the larger healthcare context, as opposed to type of organization, or how that organization / community might interact with standards. Communication and outreach venues are identified for each community and are described in the plan below. Subsequent sections of the outreach plan address communication mechanism & tools, the outreach project plan & schedule, and necessary resources.
Relevant Communities and a Plan for Reaching Each
There are many stakeholders for something as far-reaching as clinical content standards. We have identified many and list them below according to their role in healthcare. We are initiating this endeavor starting with the clinical professional societies, as the clinical specialists are in the best position to outline the diagnosis and treatment process for patients in their specialty. As clinical specialties wish to move forward in the definition of the clinical content for their area, the full cadre of stakeholders will be sought. Potential types of stakeholders are listed alphabetically below.
Classification by Role
- Clinical Professional Societies
- EHR/PHR development and implementation industry
- Fellow HL7 Working Groups
- Informatics Academic Programs
- Informatics Professional Societies
- National provider organizations & Medical Group Management Associations (American Healthcare Assoc.)
- Oversight and Coordinating Organizations (NQF, CCHIT, ONC, HITSP, eHealth Initiative, Commonwealth Fund, Infoway, UK Department of Health)
- Payers (CMS, Insurance companies)
- Public Health Organizations
- Regional and National Healthcare Networks (RHIOs, Health Information Exchanges, IHE)
- Related standards organizations
- Secondary Data Use Stakeholders (Performance Measurement, Research, Accreditors)
Clinical Professional Societies & Associations:
Domain expertise is critical to knowledge representation. As such, the initial component of CIC outreach activities is communication with clinical professional societies. The CIC will seek formal agreements/memoranda of understanding (MOU) with all interested clinical professional societies. There are a large number of clinical professional societies and we will prioritize contact with umbrella societies, like AMA, and Council of Medical Specialties that have broad reach. In addition, we will prioritize contact where there is ongoing DAM work in CIC. In addition, many clinical professional societies have existing Informatics committees, and we plan to work directly with these established groups where they exist. The following venues will be used:
Personal contact with Society leadership: this will be accomplished through personal contact, presentations on Society Leadership calls, at Board meetings, and one-to one interaction with Society leadership. This communication will encompass 1) purpose of the CIC, 2) How standardized clinical content can help clinicians and specialties, 3) How the Society can support development of standardized clinical content, 4) Ways in which the Society can become involved in the HL7 CIC including offer of a mutual MOU agreement, 5) recruitment of Clinician Leadership for CIC. Chuck Jaffe, MD will take on leadership of this effort.
CIC Leadership chose societies where contact had been made, or where the society had existing connections to HL7. These were chosen as the first to receive a CEO visit.
ID / Organization Name / URL6 / American Academy of Family Physicians (AAFP) / http://www.aafp.org/
10 / American Academy of Ophthalmology (AAO) / http://www.aao.org/
15 / American Academy of Pediatrics (AAP) / http://www.aap.org/
51 / American College of Cardiology (ACC) / http://www.acc.org/
52 / American College of Chest Physicians / http://www.chestnet.org/
54 / American College of Emergency Physicians (ACEP) / http://www.acep.org/
58 / American College of Obstetricians & Gynecologists (ACOG) / http://www.acog.org/
61 / American College of Physicians (ACP) / http://www.acponline.org/
64 / American College of Radiology (ACR) / http://www.acr.org/
66 / American College of Surgeons (ACS) / http://www.facs.org/
68 / American Gastroenterological Association / http://www.gastro.org/
69 / American Geriatrics Society / http://www.americangeriatrics.org/
71 / American Medical Association / http://www.ama-assn.org/
74 / American Nurses Association / http://www.nursingworld.org/
78 / American Psychiatric Association (APA) / http://www.psych.org/
101 / American Thoracic Society / http://www.thoracic.org/
102 / American Urological Association (AUA) / http://www.auanet.org/
105 / College of American Pathologists / http://www.cap.org/
123 / Royal College of Pediatrics and Child Health / http://www.rcpch.ac.uk/
Council of Medical Specialties (24 Society members) / http://www.cmss.org/
American Diabetes Association (ADA) / http://www.diabetes.org/
American Association of Clinical Endocrinologists / http:// www.aace.com
The CIC will continue to update and maintain the list of health-related professional societies. This list will be used to manage and track outreach to health-related professional societies.
Broader communication to Professional Society Membership: This will encompass content for Society newsletters, Scholarly works in specialty journals, and presentations at society meetings. All communication will direct interested parties to a CIC web site where they can register interest. We will need to initiate an ambassador program to leverage all CIC members to take part in this task.
Clinicians and Standards website: The CIC web site should serve multiple communities of interest (navigation by interest). The site should enable individual clinicians to register their interest, find out about meetings, and learn how to document domain content. The site should have parallel information for Clinical Professional Society Leadership.
National Provider & Practice Management Organizations
Will use an approach similar to the Clinical Professional societies.
Payers
Will directly approach CMS, and international payers. Will identify an association of Payers if one exists and approach the sector through their professional organization. Additional work needs to be done here to more fully develop appropriate outreach.
Regional and National Healthcare Networks
The National Governors Association's (NGA) State Alliance for e-Health may be a good central point of contact for RHIOs and Health Information Exchanges. The main site is http://www.nga.org/portal/site/nga Such an organization could facilitate outreach to Regional and National Healthcare Networks. Additional work needs to be done here to more fully develop appropriate outreach.
Public Health Organizations
Public Health Organizations may be most easily reached through the related clinician association, through the CDC directly, or through PHIN conferences. Additional work needs to be done here to more fully develop appropriate outreach.
Related Standards Organizations
Outreach here will concentrate on strengthening communication with standards organizations with whom HL7 has ongoing relationships. For example, the Clinical Data Interchange Standards Consortium (CDISC) is considering future work on therapeutic specific data elements for research. This and similar activities in quality improvement and other primary and secondary data use areas is of interest to the CIC. The CIC will want to assure that efforts on related activities are informed by each other and well coordinated. As such, CIC will establish a liaison and MOU with related standards organizations. Reciprocal presentations and attendance at planning meetings will be encouraged.
Related Standards Organizations include: (please add, I am certain I have missed many)
Clinical Data Interchange Standards Consortium (CDISC)
OpenEHR
Informatics Professional Societies
Informatics Professional Societies are crucial to communication with and engagement of informaticists in our work. Outreach to informatics professional societies, like medical professional societies should occur at the Leadership level as well as the membership level.
Leadership outreach includes 1) Personal contact and Board presentations, 2) Invitation to create an MOU for CIC related work, 3) Reciprocal web links, 4) Sponsorship opportunities for Informatics Residencies.
Support for Societies in communicating CIC information to their membership include 1) Press kit, 2) Monthly syndicated content for News letters, 3) Supplemental issues of Society Journals on CIC related content, 4) Ambassador presentations at Society Conferences and publications in Society Journals.
Key Informatics Professional Societies include: (I may have missed some, please add)
American Health Informatics Association (AHIMA)
American Medical Informatics Association (AMIA)
International Medical Informatics Association (IMIA)
Alliance for Nursing Informatics (ANI)
Association of Medical Directors of Information Systems (AMDIS)
Society for Clinical Data Management (SCDM) and their European counterpart, Association for Clinical Data Management (ACDM)
Informatics Academic Programs
Involvement of informatics academic programs in the CIC has many advantages, including ability to collaborate in the education of knowledge representation and methodology, opportunity for testing new methodologies, engagement of students and faculty in preceptorship opportunities for masters and PhD students. Although such a program should be approached at a broader level within HL7, creation of a “HL7 Informatics Residency” program, would benefit the CIC as well as academic programs. This would necessitate collaborative seeking of sponsorship for one year residencies and student travel to HL7 meetings. Participation in clinical content representation through CIC would provide considerable experience for students, and expand our ability to educate rising informaticists about HL7. Such outreach entails formulation of an HL7 Residency program, and communication with Informatics degree granting programs and potential sponsors. We will recommend this to the HL7 Board.
EHR/PHR Development Industry
Software developers, vendors and implementers are key stakeholders and CIC participants. Adoption of standard clinical content will largely hinge on implementation within vended systems, and support for such implementations. It is critical that general and specialty EHRs are included in the CIC standards development process, and that their information needs are met. While it is impossible for us to contact each organization personally, it is feasible to support and maintain navigation and content on the CIC site to facilitate their involvement and access to information.
Specific outreach to software developers, vendors, implementers and related trade associations will likely increase visibility and interaction. Outreach to vendor associations, like medical and informatics professional societies should occur at the Leadership level as well as the membership level.
Leadership outreach includes 1) Personal contact and Board presentations, 2) Invitation to create an MOU for CIC related work, 3) Reciprocal web links, 4) Sponsorship opportunities for Informatics Residencies.
Support for Associations in communicating CIC information to their membership include 1) Press kit, 2) Monthly syndicated content for News letters, 3) Supplemental issues of Society Journals on CIC related content, 4) Ambassador presentations at Conferences, and 5) navigation path to relevant content for individuals.
Key Vendor Associations include:
Healthcare Information and Management Systems Society (HIMSS)
Electronic Health Record Vendors Association EHRVA
Fellow HL7 Working Groups
Part of working within HL7 is to actively engage and inform fellow HL7 Working Groups, and to collaboratively align efforts. This is a significant component of the CIC effort and will remain an ongoing process.
CIC will continue to maintain the area on the HL7 wiki and website. In addition, CIC leadership and members will be in attendance at planned collaborative meetings with our fellow working groups throughout the HL7 working group meetings. Teleconferences will be utilized to coordinate work between meetings.
The CIC Infrastructure project is a significant collaborative effort to collaboratively forge processes within HL7 to define clinical content and route it to the appropriate HL7 working group for creation of technical specifications. This project entails specification of clinical content so that it will be most useful to working groups as well as defining the hand-off point, hand-off process, and version control.
Secondary Data Use Stakeholders
Secondary Data Use Stakeholders are key participants in the clinical content definition process. In fact, to obtain ultimate value from standardization of clinical content, the content must support secondary data uses. These include, but are not limited to performance measurement and quality improvement, Public Health & Surveillance, and Research. Secondary data users span both the public and private sectors. As part of the clinical content standardization process, the CIC will seek to identify, contact and engage relevant stakeholders for each clinical project. An example of the stakeholders for two ongoing Clinical Domain Analysis Model projects are shown in Table 1.
Table 1: Stakeholders for Two Ongoing Clinical DAM Projects
Cardiovascular Stakeholders / Tuberculosis StakeholdersCardiovascular professional Societies
American College of Cardiology
American Heart Association
European Society of Cardiology
Society of Thoracic Surgeons / Tuberculosis professional Societies
International Union Against Tuberculosis and Lung Disease (IUATLD)
National TB Controllers Assoc.
The Royal Netherlands Tuberculosis Assoc. (KNVC)
Industry and Foundation Participants
Merck
Pfizer
Eli-Lilly / Industry and foundation Participants
Foundation for Innovative New Diagnostics (FIND),
Global Alliance for TB Drug Development
Aereas Global TB Vaccine Foundation
Brighton Collaboration
Global Alliance for TB Drug Development
Sequella Inc.
Standards Development Organizations
CDISC
Health Level Seven / Standards Development Organizations
CDISC
Health Level Seven
Government Organizations
NIH-NCRR
NIH-NHLBI
NIH-NCI
The Food and Drug Administration (FDA), Cardio-renal Division / Government Organizations
NIH-NCRR
NIH-NHLBI
NIH-NCI
The Food and Drug Administration (FDA)
Center for Disease Control and Prevention (CDC)
Other Participants
World Health Organization (WHO) Stop TB Partnership
Tuberculosis Clinical Trials Consortium
Communication Mechanisms
Accomplishing outreach to our large constituent community requires a cadre of communication mechanisms and tools. No one tool, method or person can accomplish the outreach job alone. We propose the following communication mechanisms.