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Cross-Paradigm Interoperability Implementation Guide for Immunizations (“X Paradigm”)

Cross-Paradigm Interoperability Implementation Guide for Immunizations (“X Paradigm”). Common Information Model First Cut May 2012. Project Scope.

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Cross-Paradigm Interoperability Implementation Guide for Immunizations (“X Paradigm”)

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  1. Cross-Paradigm Interoperability Implementation Guide for Immunizations(“X Paradigm”) Common Information Model First Cut May 2012

  2. Project Scope “This implementation guide will explore the Service-Aware Interoperability Framework (SAIF) methodology to show how various HL7, IHE and OMG immunization-related artifacts can be deployed to satisfy immunization interoperability use cases. “ • This presentation gives work so far on just the Common Information Model section

  3. Project Work Space • Wiki http://hssp.wikispaces.com/Cross+Paradigm+Interoperability+Implementation+Guide+for+Immunization • Artefacts • Identified standards documents to use and found links • Download spreadsheet from wiki

  4. Common Information Model • First pass • V2 • IHE Immunization Content • Consolidated CDA • After • Immunization DAM. • EHR FIM • POIZ • …

  5. Version 2 • 2.3.1 – since early 90s • 2.5.1 – recent • Very established in the U.S. • Meaningful Use standard Stage I

  6. Background of Immunization Content • Background of Immunization Content • First drafts included V2 messaging models • Mapped V2 data elements and NVAC elements to CareRecord and POIZ – see (outdated) wiki workspace • http://wiki.ihe.net/index.php?title=Immunization_Registry_Content&diff=20082&oldid=20081 • Convinced in public comment phase to go with XDS solution only – i.e. CDA model • 4 Connectathons/Interoperability Showcases • Voted into Final Text

  7. IHE Immunization Content Could no longer find our data elements! http://www.ihe.net/Technical_Framework/upload/IHE_PCC_Suppl_Immunization_Content_Rev2-2_TI_2011-09-09.pdf

  8. Understanding Templates

  9. Chasing the cascade of template IDs • See spreadsheet at: http://hssp.wikispaces.com/Platform+Independent+Model+--+Common+Information+Model

  10. Consolidated CDA • Formed to resolve many HL7/IHE templates involved in Transfer of Care • Out-of-cycle ballot created to include MU Stage II NPRM elements • PHER project to add immunization elements

  11. Consolidated CDA Templates • Continuity of Care Document (CCD) • Consultation Notes • Discharge Summary • Imaging Integration, and DICOM Diagnostic Imaging Reports • History and Physical • Operative Note • Progress Note • Procedure Note • Unstructured Documents • Immunization Content/PH not included

  12. Templates and data elements • See http://hssp.wikispaces.com/Platform+Independent+Model+--+Common+Information+Model

  13. Lessons So Far • CDA is designed to promote semantic interoperability • ResponsibleParty example • Promote inheritance • Facilitate integration of patient information • Their human-readable forms promote much easier access by non-technical users

  14. Lessons So Far • CDA solutions are a very deep technical dive • Template IDs are “magic numbers” and not easy to chase • Without additional tools, their specifications do not facilitate easy access by non-technical domain expertise

  15. Returning to Common Information Model • Need to determine model • RIM? • Finish the cross-reference • Based upon templates and not individual data elements? • Explore recent efforts • FHIR, Template registry, Green CDA, ??? • Vet, vet, vet • Ideas?

  16. Need for implementation guide • There a document specifically showing public health or other non-CDA experts how to interpret the immunization CDA-related specs is needed

  17. Discussion • Track Patient Care projects and present to PC • Track CDA R3 vs R2 • Include NVAC data elements in list of artefacts • Old version? • Look closely at use cases for what different players such as ACOs want out of them • AIRA functions • Map EHR public health functions into EHR functions • This project may inform FHIR and/or vice versa

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