Use Case and Requirements (UCR) Workgroup Transition of Care InitiativeFebruary 2, 2011

Office of Standards and Interoperability

Use Case and Requirements Workgroup Kick-off Agenda

» Kick-off Objectives» Workgroup Committed Members» S&I Support » Logistics» Charter/Scope of Initiative » Workgroup Objectives, Activities & Scope» How to Participate and Contribute (Wiki Navigation & Comment Process)» Next Steps

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 Workgroup Kick-off Objectives

» Introduction to your fellow committed community members and support team

» Active discussion and agreement upon the approach and scope for the Transition of Care initiative and first use case

» Understanding of key next steps and responsibilities as a participant of the Use Case and Requirements Workgroup

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Current List of Workgroup Committed Members Workgroup Committed Member Organization

David Kibbe AAFP, ASTM, CGC

John Williams OpenEMR, Health-ISP

Teresa M. Mota, R.N. Quality Partners of Rhode Island

Doug Pratt Siemens

Keith Boone IHE PCC

John Moehrke HL7 Security WG and IHE ITI

Brian Ahier Oregon HIE Planning Team

Steven Waldren AAFP

Greg Alexander ANI

Paul Edge Microsoft

Greg Smith KHIE (consultant team), KHIN

Eric Heflin Medicity, IHE ITI, NW-HIN

Fred Buhr, MSSW Metasteward LLC4

Workgroup ONC/S&I Support » Initiative Coordinator: Arien Malec, ONC S&I Framework» Community Workgroup Lead: TBD» S&I Framework Support Members  

S&I Framework Support MembersUse Case(Support Leads)

Amy BerkEd Larsen

Harmonization Rich Kernan

Implementation Specifications Rich Kernan

Reference Implementation Steve Cason, Andriy SelivonenkoJoan DuHaime, Chitra Ragu

Demos/Pilots Dave Colbert, Charles Ndunda, Anjali Gupte, Chitra Ragu

Certification & Testing Chris Brancato, Chad Clay

Tools Kevin Puscas

Architecture Dragon Bashyam, Marc Bernard

FHA Erik Pupo, Neal Richards

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Ground Rules

» Stakeholder participation in person or by phone; not by proxy

» Engage in Workgroup meetings in a professional manner, do not interrupt other Workgroup members when they are speaking

» Encourage Participation; bring forth subject matter expertise and knowledge relevant to the Initiative

» Actively Listen

» Present a United Front by Consensus

» Issues will be resolved in a timely manner within workgroups or offline and resolution of these issues are priority within the workgroups themselves

» Workgroup Minutes will be posted to the Wiki 48 hrs after each Workgroup

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Transition of CareInitiative Charter

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Transition of Care Initiative Charter /Scope

» Challenge: Meaningful Use Stage 1 and foreseen Stage 2 requires information to be exchanged in Transition of Care.

• Implementers confused on how to use the specifications to exchange required data

• Exchange of clinical summaries hampered by ambiguous common definitions of what data elements must be exchanged, how they must be encoded, and how those common semantic elements map to MU specified formats. (C32/CCD and CCR)

• Lack of a robust toolset to aid in development and validation of conformant templated clinical documents is a major impediment to the widespread adoption of standards.

Scope: Limited to Meaningful Use Stage 1 summary of care (Eligible Provider, Eligible Hospital, and Critical Access Hospital) requirements for transition of care and transition of care to consumer.

http://jira.siframework.org/wiki/display/SIF/Transition+of+Care+%28ToC%29+Initiative 8

Use Case and Requirements WorkgroupObjectives, Activities and Scope

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 Initial Workgroup Objectives

» Engage Stakeholders as Committed Members, Invited Experts, or Interested Parties in the creation of the Use Case for the Transition of Care Initiative

» Create a finalized Use Case that demonstrates value and supports the proposed goals and success criteria for the Transition of Care Initiative 

» Publish a finalized Use Case that contains necessary content, supported by artifacts, to enable Harmonization and subsequent S&I Framework efforts to occur

» Establish the Use Case and supporting artifacts in a reusable fashion to support future health information interchange Initiatives

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Operating Procedures and Conditions

» Use Case and Functional Requirements Workgroup will draft, review, and update the Use Cases

» Workgroup Meetings will occur on a weekly basis by conference call with face to face meetings to occur at the very end of the Discovery Phase

» Once realized, the final Use Case draft will be posted to the Wiki for public comment, which is another opportunity to engage additional Stakeholders

» The process for which to document comments and feedback is one that promotes transparency and collaboration; feedback and actions will be captured in a table so Stakeholders are able to trace their own comments through each action taken by the Workgroup Leads

» Public comments will be evaluated and dispositioned by the Use Case and Functional Requirements Workgroup with guidance from the Initiative Coordinator and ultimately ONC

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Use Case Outline

» Business Processes• Preface & Introduction• Overview & Scope of Use

Case • Background• Policy Issues• Regulatory Issues• Communities of Interest • Challenge Statement • Value Statement • User Story • Use Case Assumptions• Pre-Conditions• Post-Conditions • Issues & Obstacles• Data Set Considerations

» Use Case Diagrams• Actors & Roles • Use Case Diagram

» Business Scenarios• Activity Diagram• Base Flow of Scenario • Sequence Diagrams

» Functional Requirements • Information Interchange

Requirements • System Requirements

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Use Case Mapping

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Overview and Scope of Use Case

» Overview: • The Initiative, Elements in Transitions of Care, defines the electronic

communication and data elements necessary for clinical information exchange to support transfers of care between providers and between providers and patients.

» In Scope: • Clinical Summary information and its minimal data set (s) for the

Transitions of Care to include the transfer of care and the exchange of clinical information between providers and between providers and their patients

» Out of Scope: • The comprehensive EHR• Financial Information will not be sent • Queries will not be performed• Discharge Instructions

http://jira.siframework.org/wiki/display/SIF/ToC+-+Use+Case+and+Supporting+Artifact14

Use Case and Requirements WorkgroupHow to Contribute

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Navigating the Wiki

This menu can be used to access the contents of the ToC UCR Workgroup, as well as general information about the S&I Framework and other Initiatives.

This table will list the artifacts that are open for Comments, the artifacts up for Consensus , and the deadlines for both.

These artifacts are hyperlinked to enable easy access to the content that is up for comments.

Navigating the Wiki (continued)

This table lists the Workgroup

Participants of the Transition of Care

Initiative – Use Case and

Requirements Workgroup

The “Related Links” section is another way to access

various material relevant to the Transition of Care UCR

Workgroup

Gathering Comments Using the Wiki

» The Review and Comments Log within Wiki will be used to:  

• Gather feedback from Committed Members, Invited Experts and Other Interested Parties.

• Document the actions taken by the Workgroup Lead(s) and/or Initiative Coordinator in relation to the comment

• Understand how each comment adds value to the final product

• Account for each suggestion, promoting teamwork and a positive environment for those who have dedicated their time to participating in the separate Initiative

http://jira.siframework.org/wiki/display/REPOPOC/ToC+-+UCR+Workgroup+Charter+Comments+Page

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How to add information within the Review Log:

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1) Click “Edit” at the top right hand corner within the Comments Page of interest

How to add information within the Review Log (Continued):

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2) Populate cells Columns 1-5 (in the next available row) within Table 1 3) Click “Save” in the top right corner of the page:

How to Trace Actions Taken Within the Review Log:

4) Scroll down the Comments Page until you arrive at Table 2 (shown above)5) Navigate to the row within Table 2 which is assigned the same number as the row in Table 1 where you left your comments.

• Example: If you left your comment in Row 1 of the first table, the actions taken on your comment will be listed in Row 1 of the table shown above. 21

Next Steps

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Next Steps » Identification of Subgroup to review Existing/Related Use Cases » Please complete prior to the next Workgroup (Wednesday, 2/9 at 3pm ET)

• Review and Comment:– Preface and Introduction – Overview and Scope – Challenge Statement – Value Statement

• Review Only:– User Story – Use Case Assumptions – Pre-Conditions– Post-Conditions– Actors/Roles– Use Case Diagram

http://jira.siframework.org/wiki/display/SIF/ToC+-+Use+Case+and+Supporting+Artifacts

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Questions

» For any questions, please feel free to contact the UCR WG Support Leads:

• Ed Larsen; e.larsen@ix.netcom.com

• Amy Berk; amy.d.berk@accenture.com

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Appendix

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Related/Existing Use Cases Sub-team Assignment; Review Related and Existing Use Cases » AHIC

• Consultations and Transfers of Care • Consumer Empowerment; Consumer Access to Clinical Information• Common Data Transport • Clinical Notes Detail • Personalized Healthcare

» NHIN Direct Project • Primary care provider refers patient to specialist including summary care

record• Direct Primary care provider refers patient to hospital including summary

care record• Direct Specialist sends summary care information back to referring provider• Direct Hospital sends discharge information to referring provider

http://jira.siframework.org/wiki/display/REPOPOC/ToC+UCR+Background+and+Reference+Materials 26

Workgroup Timeline » The Transition of Care Use Case and Requirements Workgroup will meet weekly:

Date Time (1 hr) Workgroup Session Wednesday, February 2, 2011 3pm ET. Conference Call

Wednesday, February 9, 2011 3pm ET. Conference Call

Wednesday, February 16, 2011 3pm ET. Conference Call

Wednesday, February 23, 2011 3pm ET. Conference Call

Wednesday, March 2, 2011 3pm ET. Conference Call

Wednesday, March 16, 2011 3pm ET. Conference Call

Wednesday, March 23, 2011 3pm ET. Conference Call

Wednesday, March 23-March 30, 2011 3pm ET. Face-to-Face Meetings (TENTATIVE)

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