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EU-US eHealth/Health IT Cooperation InitiativeInteroperability of EHR

Work Group

January 8, 2014

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Agenda

Topic Time Allotted General Announcements 5 minutesWhere Are We Now? 10 minutesC-CDA CCD to epSoS PS Mapping Overview from Mark Roche, MD 40 minutes

Harmonization, Next Steps and Questions 5 minutes

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Meeting Times

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Washington, DC

10:00am (ET)London

3:00pm/15:00 (GMT)Germany

4:00pm/16:00 (CET)Athens

5:00pm/ 17:00 (EET)

Interoperability of EHR Work Group meets

everyWednesday

General Announcements• To join our weekly webinars, visit the EU-US eHealth

Collaboration Wiki Homepage for the latest meeting information: http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative

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• To subscribe to our mailing list, simply complete the EU-US MOU Project Signup Form: http://wiki.siframework.org/EU-US+MOU+Roadmap+Project+Sign+Up

• To submit a brief biography of yourself (150 words or less), review the criteria listed at http://wiki.siframework.org/Interoperability+of+EHR+Work+Group#Work Group Members and e-mail your bio and photo (optional) to Gayathri Jayawardena at gayathri.jayawardena@esacinc.com• To access current and archived meeting

materials, visit the Project Meeting Artifacts section: http://wiki.siframework.org/Project+Meeting+Artifacts

Where Are We Now?

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USE CASE ACCEPTANCEAs discussed on our last call, we have updated the Accepted Use Case with editorial comments and have changed the “patient summary” wording to “clinical summary”.

4 additional affirmative votes and comments

Please see the updated use case on the wiki for review of the changes.

LAUNCH OF HARMONIZATION PHASE

Use Case Development Harmonization Implementation

Guide Pilot & Testing

• Continuity of Care Document (CCD)– CDA R2 NE (May 2005)– HL7 IG: CDA R2 C-CDA R1.1

(July 2012)• CCD template

• epSoS Patient Summary (PS) Form– CDA R2 NE (May 2005)– HL7 IG: CDA R2-CCD (April 1,

2007)– epSoS IG:

• Appendix II epsos_revised_data-set_25april2013.pdf

US EU

• In Scope:– Semantic Interoperability– Syntactic Interoperability

Standards for: Clinical Summary Document

Standards and Harmonization• Out of Scope:

– Transport– Privacy & Security

Sources: US http://www.hl7.org/implement/standards/product_brief.cfm?product_id=258 EU http://www.epsos.eu/

Phases of Harmonization

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<clinicalDocument>(Clinical Summary Form)

<header> (document ID, author, patient ID…)

<component> [Body]

<section> [Procedures]

<entry> (Colonoscopy)<procedureCode><procedureDate><…>

<entry> [Gastroscopy]<entry> [CABG]…

<section> [Current Medications]

<section>…

<entry> [ASA]<entry> [Warfarin]<entry> [CABG]

<entry>

Phase 1• Section level mapping

between epSOS and CCD

Phase 2• Header’ Data Element

mapping

Phase 3• Sections’ Data Element

mapping

Phase 4• Value Set mapping

Completed

Remaining

Data

Gra

nula

rity

and

Com

plex

ity

Mapping Review/Validation:Resources and Process• All harmonization/mapping work is done on Google spreadsheet:

– Link: https://docs.google.com/spreadsheet/ccc?key=0AiAfdYPeAnM-dG1mczY3dXN4WEl5eEpYVE5fV0pFWUE&usp=drive_web#gid=11

– Access: anyone with link– Privileges:

• “View and Comment” – everyone with link (the one above)• “Edit” – selected

– EU: one designated XML/epSoS PS subject matter expert– US: Mark Roche (for now)

» Above may be reviewed/updated as project continues

• Review Process:– Review/validate mapping outcomes after each phase with community– Review points:

• Mapping completeness• Mapping accuracy• Mapping gaps

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Review Resources

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• Implementation Guides (IG)• Examples:

– PDF– XML

Review: Phase 1, Section-level mapping–> Available on Google Spreadsheet

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1. Are all Sections listed?2. Are section names correct?3. Are section LOINCs and OIDs correct?4. Are requirements (R,R2,O) correct?

5. Is mapping complete (section-level)?6. Is mapping accurate (correct)?7. Are there mapping gaps?8. Is mapping clear and unambiguous?9. What is missing?

Review: Phase 2, Header’ Data Element mapping–> In process of being transferred to Google Spreadsheet. Availability will be announced.

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1. Are template names and OIDs correct?2. Are all Header Data Elements (DE) listed?3. Are DE names correct?4. Are X-Path Statements correct?5. Are requirements (R,R2,O) correct?6. Are Data Types correct?6. Is mapping complete (within header)?7. Is mapping accurate (correct)?8. Are there mapping gaps (sth. Exists in epSoS PS but not in C-CDA CCD

and vice verse)?9. Is mapping clear and unambiguous?10. What is missing?

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Google Spreadsheet Demo

• All harmonization/mapping work is done on Google spreadsheet:– Link:

https://docs.google.com/spreadsheet/ccc?key=0AiAfdYPeAnM-dG1mczY3dXN4WEl5eEpYVE5fV0pFWUE&usp=drive_web#gid=11

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EMERGE Demo

• What is EMERGE?– EMERGE is a web based application that provides synthetic

(dummy) clinical data for ~700 patients– Clinical Data is available in HTML format (human-readable)– Clinical Data is also available in XML format (machine-readable)

• XML format is compliant with C-CDA R1.1 CCD standard

• Why was EMERGE developed?– To provide EHR vendors in US with examples that will help

them more easily understand C-CDA CCD Implementation Guide (IG) and thus configure EHR to comply with provisions of Meaningful Use Stage 2.

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Standards and Harmonization• Continue Semantic and Syntactic

Harmonization Work• Work towards having demo for

Athens conference in May 2014

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Preparing for our Next Meeting

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• We will be meeting next week Wednedsay Jan 15th, 10:00 am ET, 5:00 pm EET

• Review materials posted onto Wikipage and e-mail the Use Case Development team with any questions

• http://wiki.siframework.org/Interoperability+of+EHR+Work+Group

Interoperability of EHR Project Support Team

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• US Point of Contacts– Mera Choi, Mera.Choi@hhs.gov– Jamie Parker, jamie.parker@esacinc.com– Gayathri Jayawardena, gayathri.jayawardena@esacinc.com– Amanda Merrill, amanda.merrill@accenturefederal.com– Mark Roche, mrochemd@gmail.com – Virginia Riehl, virginia.riehl@verizon.net

• EU Point of Contacts – Benoit Abeloos, Benoit.ABELOOS@ec.europa.eu – Frank Cunningham, frank.cunningham@ec.europa.eu– Catherine Chronaki, chronaki@gmail.com

Questions

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Initiative Resources • EU-US Wiki Homepage

– http://wiki.siframework.org/EU-US+eHealth+Cooperation+Initiative

• Join the Initiative– http://

wiki.siframework.org/EU-US+MOU+Roadmap+Project+Sign+Up

• EU-US Initiative Reference Materials– http://

wiki.siframework.org/EU-US+MOU+Roadmap+Project+Reference+Materials

• Interoperability of EHR Homepage– http://wiki.siframework.org/Interoperability+of+EHR+Wo

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