How to Participate in the HL7 Ballot: CDA Consolidation Project

1. How to Participate in the HL7 Ballot: CDA Consolidation Project Hosted by: Health Story ProjectApril 13, 2011

2. Webinar Purpose • Summarize the HL7/IHE Health Story Consolidation Project • Encourage participation in HL7 CDA Consolidation ballot by providing ballot instructions • Raise awareness of Health Story and the collaboration with HL7 and IHE

3. Presenters LioraAlschuler CEO Lantana Consulting Group HL7 Structured Documents Work Group Co-chair Executive Committee Member Health Story Project Brett Marquard Senior Interoperability Consultant Lantana Consulting Group Project Lead IHE/HL7 Health Story Consolidation Project Joy Kuhl Principal Optimal Accords, LLC Executive Director Health Story Project

4. Agenda Review • Project Background: Health Story, HL7, IHE • Project Background: Consolidation Project • HL7 Ballot Participation • Q&A

5. PROJECT BACKGROUND:Health Story, HL7, IHE

6. Health Story Project • Non profit, industry alliance • Founded 2007 • Associate Charter Agreement: HL7 • Sponsor HL7 standards for flow of information between narrative and EMR systems • Member organizations provide direction • www.healthstory.com

7. Health Story Project Members Founding Members Promoters Contributors Aprima Software - Scribe Healthcare Technologies All Type - Arrendale Associates - BayScribe - Chase Transcriptions DictateIT, Ltd - Dispersive Medical - Documentation Services Group eMTS - Healthline, Inc. - InterFix - MedEDocs - MD-IT New England Medical Transcription - Phoenix Medcom Physicians Medical Group of Santa Cruz County - Sten-Tel, Inc. - Webmedx Participants

8. Health Story Project • A physician’s practical • need for fast and easy • methods of creating • clinical documentation The enterprise need for structured and coded information capture Computer image courtesy of M*Modal

9. Health Story Project Completed HL7 Implementation Guides • History & Physical • Consultation • Operative Report • DICOM Imaging Reports • Discharge Summary • Procedure Note • CDA with Unstructured Body • Progress Note • Consolidated Implementation Guides • Meaningful Use requirements (in ballot) • Full CCD/entries (current work) www.healthstory.com

10. Health Level Seven (HL7) • Standards Development Organization • ANSI Accredited • International Affiliates: approximately 30 countries • Home for development, balloting of CDA, CCD • Also standards for messaging, services, context management, functional profiles • Meets in person 3 times per year and frequently by teleconference • Participation is open to all • Review of standards is open to all • Implementation of standards falls under licensing agreement • www.hl7.org

11. Integrating the Healthcare Enterprise (IHE) • Standards profiling organization • Builds upon existing standards • Works with HL7, DICOM, other specifications • Developing profiles for CDA through Patient Care Coordination • Issues implementation specifications called “IHE Profiles” • Hosts annual Connectathon for vendor system testing • www.ihe.net

12. PROJECT BACKGROUND:Consolidation Project

13. Consolidation Project • HL7 Consult Note • HL7 Diagnostic Imaging Report • HL7 Discharge Summary • HL7 History and Physical • HL7 Operative Note • HL7 Procedure Note • HL7 Unstructured Documents • HL7 Progress Notes • HL7Continuity of Care Document • HITSP/C84 Consult and History & Physical Note Document • HITSP/C32 - Summary Documents Using HL7 CCD • HITSP/C48 Referral and Discharge Summary Document constructs • HITSP/C62 Scanned document One master implementation guide Health Story supported guides in blue

14. Consolidation Project Goals • Update and harmonize C32 while addressing known issues (ambiguity, gaps, etc.) • initially, those issues identified by ONC and required for Meaningful Use (open technical issues from HITSP, etc.) • next, those reused in Health Story • finally, if time allows, full set of CCD/C32 templates • Proof of concept for model-driven, structured tools supporting easy to use developer documentation • Rapid demonstration of templated CDA as a data element centric paradigm for health information exchange

15. Consolidation Project Scope • HL7 Project Scope Statement • Success criteria • Publication as DSTU in time for recognition under the next stage of Meaningful Use • Subsequent adoption across the industry • Development of related International Guides should follow • Note: revisions to source specifications not required by consolidation are out of scope

16. Key Participants Approximately 140 volunteers participating in weekly calls and offline work

17. HL7 Ballot Participation

18. HL7 ballot website http://www.hl7.org/ctl.cfm?action=ballots.home HL7 v3 ballot instructions http://www.hl7.org/v3ballot/html/help/backbone/backbone.htm#bbballo refers mostly to the HTML ballots; CRS2 is a ZIP file Current ballot open: now to May 9, 2011 Must join the ballot pool by May 2, 2011 HL7 Balloting: www.hl7.org

19. Getting to the ballot site from hl7.org

20. Ballot Desktop If have member login & cookie, will be logged in:

21. HL7 Ballot Website HL7 members must be logged in

22. Non Member Participation

23. From the desktop, join the Ballot Pool You will first see a list of the available ballots: Select “Join Ballot Pools:”

24. Select the ballots you’d like to join: Joining the Ballot Pool The final sign-up day for the Consolidation Project is May 2, 2011 Ballot Name: “HL7 Implementation Guides for CDA Release 2: IHE Health Story Consolidation, Release 1 (US Realm)”

25. HL7 Ballot Participation Process Your ballot pools: The ballot package The ballot response spreadsheets

26. Review the Ballot • Prose document • Sample files • Display stylesheet

27. Determine your vote • Affirmative • May provide comments, but not necessary to do so • Brief comments can be entered on the ballot submission page • Extensive comments must use the ballot spreadsheet • If any line item comment is negative, overall vote must be negative • Negative • Must provide comments explaining reason for negative • May reference another person’s ballot as reason for negative • Brief comment can be entered on the ballot submission page • Extensive comments must use the ballot spreadsheet • Abstain: use ballot submission page only

28. Find the Comment XLS

29. Submitter tab • Your information • Your vote

30. Ballot tab • Key fields

31. Line item vote types • Negative – major or minor • Affirmative Suggestion, Typo, Question, Comment

32. Resolution • Balloter fills out first column; rest done by WG

33. Resolution: addressing comments • Indicate who is the “go to” person for reconciling comments

34. Collaborating on ballot responses • Review ballot • Consolidate comments into single spreadsheet • There is an HL7 “macro” that can do this • Contact Liora if you would like a copy of it • Submit as single organization • Indicate who is the “go to” for reconciliation

35. Voting Casting the overall vote Attaching the spreadsheet Select the “Vote” tab:

36. Voting

37. Ballot reconciliation: Discuss resolution; reach consensus; record decisions At the working group meeting (May 16-20) On conference calls Thurs 10-12am ET; Tuesday 11-12:30am ET Request withdrawal of negatives Work Group decides: Incorporate changes and publish or Incorporate changes and go back to ballot After the Ballot Closes

38. So, why participate in the ballot? • Your ballot is the most powerful voice in HL7 • Every comment addressed • Every negative reconciled: use of “non-persuasive” very rare • This is the process that shapes national standards • Voting affirmative • Fast and easy to do • Shows support for the effort • Voting negative • Takes time • Adds tremendous value

39. In summary

40. Actionable Next Steps Participate in the Ballot • Sign Up for Ballot Pool: Due May 2 • Review Ballot Documents and Submit Ballot and Comments: Due May 9

41. Actionable Next Steps Participate in the Consolidation Project ONC sponsored calls resume Tuesday, April 19 HL7 SDWG meets Thursdays, 10-12 ET Support adoption through Health Story, IHE and HL7

42. Questions? Liora Alschuler Chief Executive Officer Lantana Consulting Group t: 802.785.2623 c: 619.847.8800 Brett Marquard Sr. Interoperability Consultant Lantana Consulting Group t/c: 413.549.6886 www.lantanagroup.com Joy Kuhl Health Story Project t: 818.308.7063 joy@optimalaccords.com