360Exchange (360X) Project

10/11/12

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• Reminders / announcements

• Mission / scope review

• Workgroup updates

• Implementation sites

Agenda

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• This meeting is being recorded. If you don’t wish to be recorded, please hang up now.

• If you’re not speaking, please mute your line.

• Please don’t put us on hold (though dance breaks are fun).

Reminders / Announcements

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As quickly as possible using proposed MU Stage 2 standards, enable providers to exchange patient information for referrals from their EHR workflow, regardless of the EHR systems and/or HISP services used (i.e., allowing information to move point-to-point between unaffiliated organizations, differing EHRs, and differing HISPs) and with at least the same quality of workflow integration providers currently experience when referring between homogeneous EHR systems.

Mission

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• It’s not to demonstrate that it’s possible – We already know it’s technically possible

• It’s to ensure that it’s clinically relevant and useful– It must be ‘good’ for real-world providers

• It’s to ensure that it’s rapidly and widely deployable– If it’s ‘good’ but unavailable, it’s actually not good

• Whenever possible reduce friction, add lubricant– Implies applying a high standard for adding ‘requirements’

Mission, cont’d

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• 360X is not a standards-making body

• 360X is a workgroup for implementing existing standards in combination to advance ‘real-world’ interoperability

• 360X will not re-litigate conversations around the normative specifications for existing standards in this forum – The existing standards are the standards…

• 360X’s findings / observations / experimentation may inform other standards-making processes– Help to refine existing standards– Lead to the creation of new standards

About standards…

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• Key issues– Use of one (or more) trust frameworks?

• This is a hurdle the community wants to get over…

– Distribution of trust anchors / trust bundles• Obvious benefit in using a common approach and learning from trying it…

– Need for enhanced quality of service?• Should 360X use MDN enhancement implementation guidance?

360X Transport Workgroup

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• Currently drafting / reviewing / editing implementation guidance for this functionality

• In 360X, limited PD scope to:– Internal PD query– External PD query– Query for address– Use of HPD+ minimum data set

360X Provider Directory Workgroup

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• Key issues– What’s the minimum bar for 360X content?

• MUS1 / MUS2 requirements• Additional structured content (not required in MUS1/S2)• Additional unstructured content (images, PDFs, conversations, etc.)• Administrative / workflow content for referral management• Required/optional metadata?

– Consensus seems to be building around keeping it simple and then allowing individual pilots to innovate• Baseline for everyone in 360X to ensure fundamental interoperability• Allow individual groups to try alternative approaches for optional content to gain first-

hand experience by experimenting with different approaches– Incorporate lessons learned into subsequent implementation guides– Provide feedback to relevant standards-making bodies

360X Content Workgroup

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• Composition of teams– Minimum: 2 providers, 2 EHR vendors, and 1 HISP

• If one HISP, must demonstrate interop with another community• Ideal: >2 providers, >=2 EHR vendors, and >=2 HISPs

– Once you assemble a team ……. • Let us know: participants (names/role), coordinator • Send to 360Exchange@statehieresources.org

– Want to go to the dance but don’t have a partner?• Let us know too… we’ll start assembling a list on the wiki and playing

matchmaker

Forming Pilot TeamsNow is the time…….

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Baseline (mandatory) as currently proposed:• DIRECT-Enabled

– Conforming to the Applicability Statement v1.1• HISP/STA to HISP/STA trust certificate exchange • EHR workflow/solution enabled for referral process • Able to exchange baseline payload (MU1 and MU2) criteria

– CCD/CDR or consolidated CDA• Ability to view payload – (data consumption is optional)• Ready to begin implementation NOW or near term (within next 3 months)

Minimum Bar for Participation

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Are you an Over Achiever?

Additional functionality for EXTRA credit• Enhanced referral management functions• Additional content types• Provider directory query• C-CDA consumption• Automated trust bundle exchange