PDMP & Health IT Integration All-Hands Meeting

1. PDMP & Health IT IntegrationAll-Hands Meeting January 14th, 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 will be rescheduling our February 18th, 2014 meeting • Options • Thursday February 20th– same time (12-1????)

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. S&I FrameworkPrescription Drug Monitoring Program & Health IT Integration Initiative Use Case & Functional Requirements January 14, 2014 6

7. Use Case OutlineTailored for each Initiative • 10.0 Scenario: Workflow • 10.1 User Story 1, 2, x, … • 10.2 Activity Diagram • 10.2.1 Base Flow • 10.2.2 Alternate Flow (if needed) • 10.3 Functional Requirements • 10.3.1 Information Interchange Requirements • 10.3.2 System Requirements • 10.4 Sequence Diagram • 11.0 Dataset Requirements • 12.0 Risks, Issues and Obstacles • Appendices • Privacy and Security Considerations • Related Use Cases • Previous Work Efforts • References • 1.0 Preface and Introduction • 2.0 Initiative Overview • 2.1 Initiative Challenge Statement** • 3.0 Use Case Scope • 3.1 Background** • 3.2 In Scope • 3.2 Out of Scope • 3.3 Communities of Interest (Stakeholders)** • 4.0 Value Statement** • 5.0 Use Case Assumptions • 6.0 Pre-Conditions • 7.0 Post Conditions • 8.0 Actors and Roles • 9.0 Use Case Diagram ** Leverage content from Charter

8. PDMP & HIT Integration InitiativeProposed Use Case & Functional Requirements Development Timeline

9. Section Review Click the icon to open the Word Document Note- Below sections will be reviewed within the separate Use Case word document: • Discuss and review the following sections: • Definitions • Scope Items • Assumptions • Context Diagram • Introduce and review the following sections: • Draft User Stories

10. PDMP & HIT Integration – Definitions To be reviewed in Word Document Definitions Healthcare Professional- A medical practitioner or provider of care who has legal authorization to access prescription drug data for patients at the point of care to make informed clinical decisions and appropriate treatment recommendations This may include: Prescribers, dispensers, nurses, etc. Health IT System – An information system that is used by a Healthcare Professional to collect and store patient information including demographics, medicine, etc. (i.e. EHR, HIE, Pharmacy System)

11. PDMP & HIT Integration – In and Out of Scope To be reviewed in Word Document Out of Scope • Defining the trigger event for how the PDMP is queried or initiated by the user (e.g., hyperlink while ordering, pressing a button, automatic trigger, etc.)** • Addressing delegation of rights to individuals not legally authorized to prescribe medications (this is an implementation specific decision and may vary by implementation and pilot sites)** • Third party access - (this is an implementation specific decision and may vary by implementation, pilot sites and state statues and law)** • Reporting patient prescription information from dispensers to state PDMP • Policy-based decisions on how PDMPs are managed, accessed, and updated that vary from state to state • Timeliness of PDMP: Currency of Data • Storing query response from PDMP • Health IT system’s structure of display for the query response In Scope • Connecting PDMPs to Health IT systems using existing standards; (technical mechanism for actual exchange of data)** • If standards do not exist, identifying the gap in the current standards and working with the Standards Organizations (SDOs) to address the gaps** (Refers to harmonization activity) • Improving effective and efficient access to PDMP data by Healthcare Professionals** • Health IT system has ability to view query response from PDMP • Healthcare Professional querying PDMP for a known patient through a Health IT system • Healthcare Professional querying a state PDMP connected to the same hub as the state they are located in • Safety notifications/ automated alerts from PDMP • Define standard set of data elements used to submit queries each time • Define system /technical requirements for Healthcare Professionals to be able to access patient information already stored in a PDMP • Accessing a PDMP through a Health IT system (i.e. EHR system) instead of another portal • Define system/technical requirements that allow applications to access data in a consistent manner across the local Health IT system • Method of extraction **Leveraged from Charter

12. PDMP & HIT Integration – Use Case Assumptions To be reviewed in Word Document Health IT system is capable of querying a PDMP All Healthcare Professionals have appropriate legal authority based on state regulations to request and receive information from state PDMP Healthcare Professionals accessing the PDMP follow state guidelines as appropriate, including any privacy and security requirements as required by each individual state PDMP authority The PDMP returns high positive matches to the Healthcare Professional1 The Healthcare Professional accesses information that already exists within the PDMP at the time of querying 1Question for Community: What are the responses you receive when querying a PDMP? 12

13. Generic Scenario & Context Diagram To be reviewed in Word Document PDMP & HIT Integration Use Case Scope Pre-Step: Healthcare Professional logs into Health IT System 1. Sends query to state PDMP Interstate Hub Healthcare Professional receives requested information 2. PDMP sends query response AND/OR PDMP & HIT Integration Use Case Scope Pre-Step: Healthcare Professional logs into Health IT System 1. Sends query to state PDMP Healthcare Professional receives requested information 2. PDMP sends query response

14. User Story 1: A legally authorized provider queries PDMP before writing a prescription for a patient To be reviewed in Word Document Trigger: Patient needs medication for chronic back pain Use Case Scope 1. Healthcare Professional logs into Health IT System 2. Sends query to state PDMP to check if patient has been prescribed narcotics/controlled substance in past X weeks 3. PDMP sends query response 4. Healthcare Professional makes an informed decision to prescribe medication based on information received Draft User Story: A patient arrives at the doctor’s office for chronic back pain. The Healthcare Professional logs into his Health IT system and enters his credentials. After diagnosis, the Healthcare Professional sends a query to the State PDMP through his Health IT system to see if the patient had been prescribed a controlled substance in the past X weeks. The PDMP processes the request and identifies the appropriate response to send back to the requestor. After receiving the query response from the PDMP, the Healthcare Professional makes an informed decision of whether or not to prescribe the medication or modify the dosage based on the information received.

15. User Story 2: Pharmacist queries PDMP prior to dispensing opioids to a patient To be reviewed in Word Document Trigger: Patient arrives at pharmacy and drops off prescription to be filled Use Case Scope 1. Pharmacist logs into Pharmacy Dispensing System 2. Sends query to state PDMP to check if patient has received narcotics/controlled substance in past X weeks 3. PDMP sends query response 4. Pharmacist makes an informed decision to dispense medication based on information received Draft User Story: A patient arrives at the pharmacy to have his prescription filled. The pharmacist logs into the Pharmacy Dispensing system, and she enters her credentials. After, she sends a query to the State PDMP through her Pharmacy Dispensing system to see if the patient had filled a prescription for a controlled substance in the past X weeks. The PDMP processes the request and identifies the appropriate response to send back to the requestor. After receiving the query response from the PDMP, the pharmacist makes an informed decision of whether or not to dispense the medication based on the information received.

16. Next Steps • Review:User Stories, In/Out of Scope, Assumptions, and Scenario sections • Next Meeting is Tuesday, January 21 from 12:00pm - 1:00pm EST • Reminder: All PDMP & HIT Integration Announcements, Meeting Schedules, Agendas, Minutes, Reference 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

17. 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 • Vocabulary and Terminology Subject Matter Expert: • Mark Roche mrochemd@gmail.com