electronic Long-Term Services & Supports (eLTSS) InitiativeAll-Hands Workgroup Meeting

August 27, 2015

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Meeting Etiquette

• Remember: If you are not speaking, please 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 o Hold = Elevator Music = frustrated speakers and

participants• This meeting is being recorded

o Another reason to keep your phone on mute when not speaking

• Use the “Chat” feature for questions, comments and items you would like the moderator or other participants to know.o Send comments to All Panelists so they can be

addressed publically in the chat, or discussed in the meeting (as appropriate).

o Please DO NOT use the Q&A—only the presenter sees Q&A, not necessarily the person facilitating the discussion

From S&I Framework to Participants:Hi everyone: remember to keep your phone on mute

All Panelists

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Agenda

Topic Presenter Timeframe

Welcome AnnouncementseLTSS Roadmap

Lynette Elliott 10 mins

eLTSS Wiki Updates and Walk-Through Lynette Elliott 10 mins

eLTSS Pilot Guidance: Standards 101 Grant Kovich 40 mins

Announcements

• Accessibility & Usability in Health Information Technology (HIT): User-Driven Research and Actionable Strategies Responsive to People with Disabilities, Older Adults, and Caregivers– What: This two-day event will explore the advancement of the

accessible HIT agenda from a compliance-focused paradigm toward one that is user-driven and responsive to human-centered experiences and contributes to improved health and wellness for individual disabilities, older adults, and caregivers.

– When: Thursday and Friday, September 17 - 18, 2015– Where: U.S. Department of Education, Potomac Center Plaza,

10th Floor Auditorium, 550 12th Street SW Washington, D.C. – To register: http://icdr.acl.gov/AHIT/index.html

• NOTE: Space is limited. Please register right away.

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Announcements, cont’d…

• National Association of States United for Aging and Disabilities (NASUAD) “National Home and Community Based Services (HCBS) Conference”– What: The conference always sees a strong presence from U.S.

Health and Human Services ranging from the Administration for Community Living including AoA, Office of Disability and IADD to CMS, HRSA, SAMHSA, Office of Developmental Disabilities, and other federal agencies.

– When: August 31 – September 3, 2015 (Note: eLTSS and S&I specific workshops are Sept. 2 from 4:30-5:30pm ET)

– Where: Washington Hilton ~ Washington, D.C. – To register:

https://www.hcbsconference.org/ehome/index.php?eventid=113072&

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Announcements, cont’d…

• mHealth Summit– What: The 2015 mHealth Summit explores what is new in

mobile, telehealth and connected health—from the impact on healthcare delivery, clinical care and patient/consumer engagement to new technologies, research, investment activities, policy and shifts in the business environment.

– When: December 8 – December 11, 2015 – Where: Gaylord National Resort and Convention Center ~

Washington, D.C. – To register: http://www.mhealthsummit.org/registration

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eLTSS Initiative Timeline

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Phase 1 Pilots &Testing …

Pilot Guide DevelopmentUse Case &Functional

RequirementsPre-Discovery

DEC 14 JUNJAN FEB MAY JUL AUG SEP OCT NOV

Kick Off11/06/14

Evaluation...

ContentWork Stream

eLTSS All-Hands Work Group

Use Case 1. eLTSS Use Case

eLTSS Plan Content SWG1. eLTSS Plan Domains & Data

Elements

Pilot Guide Development 1. Candidate Standards & Technologies2. Three-tiered implementation

Approach3. Functional Requirements Matrix4. Pilot Guide (Phase 1)

MAR APR DEC 15 JAN 16

Pilot Execution

Goals for the eLTSS Initiative

• Identify key assessment domains and associated data elements to include in an electronic Long-term Services & Supports (eLTSS) plan

• Create a structured, longitudinal, person-centered eLTSS plan that can be exchanged electronically across and between community-based information systems, clinical care systems and personal health record systems.

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eLTSS Artifacts

• Final published Project Charter is located here: http://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29+Charter

• eLTSS Glossary posted here: http://wiki.siframework.org/eLTSS+Glossary– The eLTSS Glossary is a working document containing eLTSS-relevant

terms, abbreviations and definitions as defined by stakeholders– We are looking for your feedback and comments

• Discussion Thread available• Submit any change requests via the Change Request Form located on

the wiki• Final published Use Case document is located here:

– http://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29+Use+Case

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eLTSS Wiki Updates

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eLTSS Wiki: Navigation

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eLTSS Wiki: Navigation, cont’d.

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eLTSS Wiki: Navigation, cont’d.

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eLTSS Wiki: Functional Requirements and Pilot Guide Development Pagehttp://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29+Pilot+Guidance

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eLTSS Wiki: Pilots Page

http://wiki.siframework.org/electronic+Long-Term+Services+and+Supports+%28eLTSS%29+Pilots

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eLTSS Pilot Guidance: Standards 101

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Pilot Guide Development Workflow

Environmental Scan

• Conduct outreach to LTSS-related projects to research technical solutions in real-world implementations

• Engage technical resources to assist in development of Pilot Guide

• Create Candidate Technologies and Standards List

• Environmental Scan Spreadsheet• Candidate Technologies and

Standards List

Three-Tiered Approach

• Develop tiered approach with engagement from community for piloting technical solutions

• Advance tiers progressively• Map tiers to Technical

framework within FRM

• Three-Tiered Implementation Approach

Functional Requirements Matrix

• Present requirements via FRM• Define details for transactions

from user stories within the Use Case

• Map tiers to Technical framework within FRM

• Map exemplar technical solutions and standards to functional requirements

• Map Corresponding Initiative Requirements to functional requirements

• FRM

Activ

ities

Out

put

Pilot Guide

What is a Standard?

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A standard is a technical “building block” that enables the construction and use of resources within information technology

• Standards help to establish and enable products and assist in the development of services and markets

• Standards are necessary to advance technical interactions and enable interoperability of data across various systems

• Standards are vetted through a Standards Development Organization (SDO)– Responsible for developing, coordinating, producing and publishing

technical standards to address the needs of developers and adopters

ONC has provided best available standards and implementation specifications through the 2015 Standards Interoperability Advisory

• http://www.healthit.gov/standards-advisory

Categories of Standards

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Standards can be broken down into five distinct categories based on their purpose and proposed use:

Applicability to Functional Requirements Matrix

• Purpose: Identify whether technical solutions and standards support specific eLTSS functional requirements– Not a comprehensive list of all available technical

solutions/standards• Two categories of exemplar technical solutions and standards

will be provided to the eLTSS Community via the eLTSS Pilot Guide– Concert Series Presentations: Products and associated technical

frameworks/standards that were publically shared with the eLTSS Community as part of a Concert Series Presentation

– Environmental Scan: Products and associated technical frameworks/standards found through independent research and vendor engagement through partnerships and industry conferences

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Concert Series Presentations

• Purpose: organizations were invited to present on an existing project or initiative that is related to the eLTSS scope of work– Presentations provided technical guidance and potential solutions to

inform the eLTSS Initiative functional requirements

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Solution Name Contact Name Contact Email Presentation Link

FEi Systems (State of Maryland) Nish Thakker Nish.thakker@feisystems.com FEi Systems Concert Series Slides

The Imagine Project Debra Albert Debra.albert@dodd.ohio.gov The Imagine Project Concert Series Slides

PeerPlace Eric Frey efrey@peerplace.com PeerPlace Concert Series Slides

Care At Hand Dr. Andrey Ostrovsky Andrey@careathand.com Care At Hand Concert Series Slides

CORHIO Kelly Wilson Kelly.Wilson@state.co.us CORHIO Concert Series Slides

Kno2 Dane Meuler dmeuler@inofile.com Kno2 Concert Series Slides

Harmony Information Systems John Byer jbyer@harmonyis.com Harmony Concert Series Slides

Right Care Now Dr. Susan Abend sabend@rightcarenowproject.org Right Care Now Concert Series Slides

Environmental Scan

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Candidate Technologies and Standards List

Prior S&I Candidate Standards Lists

Engagement with LTSS Providers and

Vendors at Conferences

Concert Series Presenters

Purpose: Engage LTSS-based solution providers to understand technical framework and best practices for solution planning• Casting very wide net; some

products may be full-fledged or have a single LTSS element

• Extract technical framework, standards, and data models from solutions for Tiered Approach and Pilot Guide

• Vendors engaged include 3M, Accenture, The Advisory Board Company, and NTT Data among others

Functional Requirements Matrix Example

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Use Case Activity Tier Exemplar Technical

Solutions/Frameworks

Exemplar Standards/TechnologiesRelevant

SDOs/VendorsVocab & Code Set

Content & Structure

Transport & Security Cross Category

Create Plan Tier II

Kno2 C-CDA;HL7v2.0

Direct;Equifax Level 3 Assurance;Two-Factor Authentication;SSL

Microsoft Azure HL7;IETF;Microsoft (MS)

3M ClinTrac Care Planning Manager

ICD-10;ISO 639-2;SNOMED-CT;CPT;HCPCS;CVX;LOINC;RxNorm

SAP Crystal Reports;InterQual

CDC;ISO;IHTSDO;CPT-4;CMS;LOINC;NIH;SAP;McKesson

Example Activity and Exemplar Technical Solutions/Frameworks from FRM:

Next Steps

Over the next few weeks, the eLTSS Internal Team will introduce the Exemplar Technical Solutions/Frameworks and associated Exemplar Standards• These presentations will help to assist in the

“matchmaking process” between committed vendors and TEFT states in preparation for the Pilots Phase

• If you are interested in piloting, please express your interest using the Pilot Interest Survey form:– http://

wiki.siframework.org/electronic+Long+Term+Services+and+Supports+Pilot+Interest+Survey

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Comments/Discussion

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Questions?Comments?

eLTSS Initiative: Project Team Leads• ONC Leadership

– Mera Choi (mera.choi@hhs.gov)– Elizabeth Palena-Hall (elizabeth.palenahall@hhs.gov) – Patricia Greim (Patricia.Greim@hhs.gov)

• CMS Leadership– Kerry Lida (Kerry.Lida@cms.hhs.gov)

• Community Leadership– Andrey Ostrovsky (andrey@careathand.com)– Mary Sowers (msowers@nasddds.org)– Terry O’Malley (tomalley@mgh.harvard.edu)

• Initiative Coordinator– Evelyn Gallego-Haag (evelyn.gallego@siframework.org)

• Project Management – Lynette Elliott (lynette.elliott@esacinc.com)

• Use Case & Functional Requirements Development– Becky Angeles (becky.angeles@esacinc.com)

• Pilot Guide Development– Grant Kovich (grant.kovich@accenture.com) – Atanu Sen (atanu.sen@accenture.com)

• Pilots Management– Jamie Parker (jamie.parker@esacinc.com)

• Standards and Technologies Identification– Angelique Cortez (angelique.j.cortez@accenture.com)

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