PDMP & Health IT Integration All-Hands Meeting

1. PDMP & Health IT IntegrationAll-Hands Meeting May 27th, 2014

2. Meeting Etiquette From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute  NOTE: This meeting is being recorded and will be posted on the Meeting Artifacts Wiki page after the meeting • Remember: If you are not speaking keep your phone on mute • Do not put your phone on hold – if you need to take a call, hang up and dial in again when finished with your other call • Hold = Elevator Music = very frustrated speakers and participants • This meeting, like all of our meeting is being recorded • Another reason to keep your phone on mute when not speaking • Feel free to use the “Chat” feature for questions, comments or any items you would like the moderator or participants to know.

3. Agenda

4. General Announcements… • We hosted a Concert Series presentation “Prescription Drug Monitoring Programs and the PMIX Architecture” on May 21st at 3pm ET • The recording and slides can be found on the Past Meetingswikipage. • The Solution Planning Work Group meets Thursdays, 12:00 – 1:00 pm ET. • https://siframework1.webex.com/siframework1/onstage/g.php?t=a&d=667584401 • Dial In: 1-650-479-3208 • Access code: 667 584 401

5. General Announcements Continued Note: Please check the meeting schedule weekly to get the most up-to-date meeting information • To subscribe to our mailing list, simply complete the PDMP & Health IT Project Signup Form: http://wiki.siframework.org/PDMP+%26+Health+IT+Integration+Join+the+Initiative • To access current and archived meeting materials, visit the Project Meeting Artifacts section: http://wiki.siframework.org/PDMP+%26+Health+IT+Integration+Meeting+Artifacts • To join our weekly webinars, visit the PDMP & Health IT Integration initiative Homepage for the latest meeting information: http://wiki.siframework.org/PDMP+%26+Health+IT+Integration+Homepage

6. PDMP & Health IT IntegrationStandards and Harmonization May 27th, 2014

7. Review: Solution Planning Workgroup Session 5/22Current-State Transaction: Standards Landscape

8. HIE/Pharmacy Intermediary 2 5 2 7 4 Out of State PDMP In-State PDMP EHR or Pharmacy System Hub 1 8 8 3 7 6 3 Hub PMP/HITI User Stories with Alternate Workflows EHR or Ph. to In-State PMP: 1a: EHR to In-state PMP 1b: Ph. to In-state PMP 2a: EHR to In-state PMP via HIE 2b: Ph. to In-State PMP via HIE 3a: EHR to In-state PMP via Hub 3b: Ph. Intermediary to In-State PMP via Hub EHR or Ph. to Out-of-State PMP: 1a+4: EHR to out-of-state PMP via In-state PMP 1b+4: Ph.to out-of-state PMP via In-state PMP 2a+4: EHR to out-of-state PMP via HIE & In-state PMP 2b+4: Ph. to out-of-state PMP via Ph. Int& In-state PMP 2a+5: EHR to out-of-state PMP via HIE 2b+5: Ph. to out-of-state PMP via HIE 3a+4: EHR to out-of-state PMP via Hub & In-State PMP 3b+4: Ph. to out-of-state PMP via Hub & In-State PMP 1a+8: EHR to out-of-state PMP via In-State PMP & Hub 1b+8: Ph. to out-of-state PMP via In-State PMP & Hub 3a+6: EHR to out-of-state PMP via Hub 3b+6: Ph. To out-of-state PMP via Hub

9. Summary of Transactions

12. Summary of Current Standards Landscape • What we know: • Several states utilize the EHR  HIE  PDMP transaction • Some states that cannot make interstate connections might have no other option but to use this model • PMIX-NIEM is the standard used for the Hub to PDMP transaction • Translation from HL7 messaging to PMIX must occur prior to Hub to PDMP transaction • Thus, translations can occur from the EHR system to the HIE, the HIE to the Hub, the EHR system to the Hub, or the HIE to the PDMP • HL7 ADT is used as a trigger in several states • Currently, EHR systems and Pharmacy IT systems do not generally query the PDMP directly • ASAP Web Services standard was developed specifically for this purpose

13. Questions to be answered: Differences in pharmacy and clinician workflows / data systems and expectations in PDMP data transmitted? How do we define intermediaries and their relationships to Health IT systems? What components of PDMP report are extracted for decision support? Can EHR and Pharmacy IT systems handle the proposed standards (in the context of PDMP systems)? What standard(s) fit into message and workflow configuration per transaction type? Are transactions collapsible in terms of capability of leveraging same standard? Are all transactions necessary? What is the cost associated with the proposed solutions? How do we define an aggregator? (collection of response from different PDMPs back to recipient) Parking lot item: Differences in care settings - Ambulatory vs. Acute; In-hospital pharmacies vs. retail pharmacies. Are different standards needed for different EHR systems?

14. Data Element Analysis

15. Implementation Guide – Data Elements and Attributes

16. Data Requirements Analysis - PDMP & HITI Use Case

17. Data Requirements Analysis - PDMP & HITI Use Case

18. Consolidated Standard Data Set– PDMP & HITI Use Case

19. Standard Data Set– MITRE WG Recommendation

20. Next Steps • Review: Minimum Dataset Requirements • Next Solution Planning WG meeting is Thursday, May 29 from 12:00pm – 1:00pm ET • Next All Hands meeting is Tuesday, June 3 from 12:00pm - 1:00pm ET • Reminder: All PDMP & HIT Integration Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Harmonization materials, Use Case, Project Charter and general information will be posted on the PDMP Wiki page • http://wiki.siframework.org/PDMP+%26+Health+IT+Integration+Homepage

21. Contact Information • For questions, please feel free to contact your support leads: • Initiative Coordinators: • Johnathan Coleman jc@securityrs.com • Sherry Green sgreen@namsdl.org • ONC Leads: • Mera Choi mera.choi@hhs.gov • Jennifer Frazier Jennifer.Frazier@hhs.gov • Helen Caton-Peters Helen.Caton-Peters@hhs.gov • SAMHSA Leads • Jinhee Lee Jinhee.Lee@samhsa.hhs.gov • Kate Tipping Kate.Tipping@samhsa.hhs.gov • Support Team: • Project Management: • Jamie Parker jamie.parker@esacinc.com • Ali Khan Ali.Khan@esacinc.com (Support) • Use Case Development: • Ahsin Azim Ahsin.Azim@accenturefederal.com • Presha Patel presha.patel@accenture.com • Standards Development Support: • Alex Lowitt alexander.s.lowitt@accenturefederal.com • Harmonization Support: • Divya Raghavachari divya.raghavachari@accenturefederal.com • Atanu Sen atanu.sen@accenture.com • Implementation Guide Development: • Rita Torkzadehrtorkzadeh@jbsinternational.com • Vijay Shah vshah@jbsinternational.com • Vocabulary and Terminology Subject Matter Expert: • Mark Roche mrochemd@gmail.com

22. Appendix

23. Current In-State EHR Workflow (Direct) Transaction 1a PMIX? EHR System In-State PDMP PMIX? Legend Request Response

24. Current In-State EHR Workflow (HIE) Transaction 2a HL7 A04 NCPDP SCRIPT with PMIX Wrappers Third Party Software HL7 QRY^T12 HL7 ADT feeds NCPDP SCRIPT (Med History) HL7 QRY^T12 EHR System HIE In-State PDMP HL7 OBX XML Report NCPDP SCRIPT (Med History) HL7 DOC^T12 - CCD XML Response NCPDP SCRIPT with PMIX Wrapper HL7 DOC^T12 Legend Request Response

25. Current In-State Pharmacy Workflow (Direct) Transaction 1b Pharmacy IT System In-State PDMP Legend Request Response

26. Current In-State Pharmacy Workflow (Pharmacy Int. / Switch) Transaction 2b NCPDP SCRIPT (Medication History) ? Pharmacy System Pharmacy Intermediary/ Switch In-State PDMP NCPDP SCRIPT (Medication History) ? Legend Request Response

27. Current In-State EHR Workflow (Hub) Transaction 3a – Not Effective Workflow? Currently Active? In-State PDMP EHR System PMIX ? PDMP Hub ? ? Legend Request Response

28. Current Interstate EHR Workflow Transaction 2a + 7a + 6 EHR System HIE In-State PDMP Third Party Software PMIX-NIEM NCPDP SCRIPT (Medication History) PMIX-NIEM XML PMIX-NIEM XML PMIX-NIEM Out-of-State PDMP PDMP Hub PMIX-NIEM Legend Request Response