GCPR - Modeling Discussion

September 1999 HL7 MeetingAtlanta, Georgia

Discussion Group

•Dr. Mike Lincoln - VA•Dr. Tim Mayhew - IHS•Dr. Terry Clark - VA•Dr. Steve Brown - VA•Mr. Steve Wagner - VA•Mr. Marco Johnson - DoD•Ms. Nancy Orvis - DoD•Mr. Ken Rubin - VA/EDS•Mr. John Leslie - Litton/PRC• Capt Jim McCain - IHS

WHAT IS THE GCPR FRAMEWORK?

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GCPR Utility Service Concept

High-level Architecture Model

Data Management Model

Security Component

Ensure client/population information is available to authorized users only

Guiding legislation Federal Privacy Act Health Insurance Portability and Accountability Act,

1996

Common InformationModel/Data Representation

Identify and model common data elementsMaximize use of established data standardsFacilitate collaborative

development of additional standards by academic, industry and government agencies

Phase I - Development

Develop and maintain Reference Information Model (RIM) for clinical information domains. (ongoing activity)

Develop heritage/legacy system interfaces (agency unique activity, ongoing).

Establish security standards and authorities.

Design and develop the technical environment.

Proof-of-Concept Testing.Prototype Demonstration.

Phase I -Government Tasks/Responsibilities

Model Selection Select baseline information models Document adopted terminology models

Model Development Identify trigger/events and data elements by domain expert focus

groups Produce electronic format of model for hand-off

Model Maintenance Ongoing maintenance of information and terminology models

Heritage/Legacy System Interfaces Establish Common Security Standards

Identify and document common policies and methods. Ensure compliance with key regulations/laws.

5 Months 7 Months

Nov ‘99 - Mar ‘00 Apr ‘00 - Oct ‘00

6 Months

Nov ‘00 - Mar ‘01 Apr ‘01 …………………………………

Model (4 Likely Partitions)Outpatient Encounter NotesNarrative SummariesPhysical ExamsConsult Tracking

Framework Version 2

Build & Alpha V2 Refine & Beta V2 Deploy V2 …

May ‘00 - Oct ‘00

6 Months 5 Months 5 Months

Nov ‘00 - Mar ‘01 Apr ‘01 - Aug ‘01 Sep ‘01...

EXPECTED GCPR FRAMEWORK TIMELINE

Model (6 Partitions)•Problem Lists•Medication Profiles•Allergies•Imaging Results•Immunizations•Vital Signs

Model(5 Partitions)•Person (MPI)•Laboratory•Patient Record Architecture•Security•Continuity of Care

Framework Version 1

Build & Alpha V1 Refine & Beta V1 Deploy V1 ………………

Draft for Discussion Only

GCPR Modeling Discussion

GCPR GRM

GRM GoalsBrief HistoryRole of HL7Role of other Standards ModelsWhere we are

GCPR GRM -- The Present

Status of the GRMGaps in the modelIdentified collaboration opportunities

with HL7

GRM -- The Future

GRM = Domain Model + Computational

Cornerstone Deliverables GRM Product Description Document GRM Modeling Approach Document GRM Utilization Guide(s) HL7 “Rules of Engagement” Approach

GRM and HL7: Open Questions

1) When should we engage HL7?2) How should we engage HL7?3) What should be done informally vs

formally?4) Whom should be engaged?5) When does the Govt SIG become

involved?

GRM and HL7: Current CONOPS

Refine and extend the model Security Example (RIM) Language Example (RTM)

Forward and backward harmonizationPropose extensions but continue

working (e.g., cannot risk HL7 interdependency with project timelines)

Role of GRM Team and HL7

Symbiotic Outcomes(for GCPR)

Ability to leverage significant existing work (Utilization of RIM 3.0) Field-test HL7 Clinical Templates Tap into existing expertise and knowledgebase

(for HL7) Refine and contribute to areas of the RIM 3.0 model (i.e. security) Gained experience in applying the model both to large provider

environment and via current technology Terminology refinement and detail definition Creation of HL7 Clinical Templates Greater involvement in SIGS and Technical Committees

Others?

Next Steps...