360Exchange (360X) Project

10/25/12

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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– Consensus around keeping it simple and then allowing individual pilots to

innovate• Baseline for everyone in 360X to ensure fundamental interoperability

– MUS1 / MUS2 requirements for structured content– Inclusion of additional content types – Inclusion of referral ID

– 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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• Next steps– Crafting implementation guidance per existing consensus decisions

• Includes recommendation to use enhanced MDN IG for quality of service

– Combining w/ content/payload workgroup• Provides for better alignment to address points of intersection / overlap

360X Transport Workgroup

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• Reviewing final draft of 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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• 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• Enhanced Direct MDN functions for QoS