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

S&I FrameworkPrescription Drug Monitoring Program Initiative

PDMP-to-EHR Data Format StandardDriving To Consensus – Assessment of Four Candidate Data Formats

First Topic - Review

Page 3

• Reach consensus on data format standard for exchanging patient information between PDMP and provider EHR systems

• 11 February:– Consensus on Data Elements to support the Use

Case– Consensus on the four candidate data format

standards– Initiated discussion of attributes to be used for

assessment

Data Format Standard – Community Discussion

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• Google Groups Discussions:– Continued discussion of assessment attributes

• Ten attributes proposed, grouped by qualitative level of importance to the Use Case

• Three rankings suggested for each

• For Today (25 February):– Brief overview of the assessment process– Share assessment of the four standards– Develop consensus recommendation for the data

format standard

PDMP Data Format Evaluation

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• The Use Case– A provider logs into an EHR system for a patient encounter– Patient presents with pain treatable with a controlled substance– EHR automatically queries the PDMP using patient identification– PDMP presents Provider with existing patient prescription information – Provider can make informed decisions about treatment options

• Overview of the strategy for evaluating the proposed standards– List the standards under consideration– Establish the criteria for the evaluation, and the appropriate weighting

for the Use Case

• Assess each standard and make a recommendation

Standards for Consideration

6

Based on PDMP S&I Framework Community WebEx meetings and discussions managed over Google Groups threads, the following standards have been identified by the community for evaluation:

• ASAP Web Service• NCPDP Script (Medication History Request and Response

messages)• PMIX PDMP Schemas (based on NIEM)• Consolidated CDA

Attributes for Standard Assessment

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Attribute Relative Scale Weighted Value

Availability of an XML format Very important 3

Ease of adoption and integration by EHRs/HIEs– includes technical complexity

Very important 3

Speed of adoption into the EHR/HIE Ecosystem– how widely used is it, plus others

Very important 3

Wide use of the XML version of the format Important 2

Suitability for the PDMP-to-EHR Patient Encounter Use Case– coverage of necessary data elements

Important 2

Separation of transport and content Important 2

Ease of adoption and integration by PDMPs Less important 1

Speed of adoption into the PDMP Ecosystem Less important 1

Available at no cost Less important 1

Accredited standards body Less important 1

Assessment Raw Score

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• Each of the attributes proposed as an assessment criterion can be found in shortened version in the left column labels in the following table.

• Each standard was applied a raw score according to the following:

Raw Score Description Raw Score

Standard meets 3

Standard partially meets 2

Standard does not meet 1

Assessment Table

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Criterion Weight ASAP NCPDP PMIX/NIEM CCDA

RawScore

Score x Weight

RawScore

Score x Weight

RawScore

Score x Weight

RawScore

Score x Weight

XML Spec 3 3 9 3 9 3 9 3 9EHR Ease 3 1 3 3 9 1 3 3 9EHR Speed 3 1 3 3 9 1 3 2 6XML Use 2 1 2 2 4 1 2 2 4Suitability 2 3 6 2 4 3 6 2 4Separation 2 1 2 3 6 3 6 3 6PDMP Ease 1 1 1 2 2 2 2 1 1PDMP Speed 1 2 2 2 2 1 1 1 1Cost 1 1 1 1 1 3 3 2 2Accredited 1 1 1 3 3 1 1 3 3

TOTALS 30 49 36 45

Consensus on Data Standard

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• NCPDP and CCDA rank highest, with NDPDP edging out CCDA

• Do we have consensus around NCPDP as the data standard that best addresses our Use Case?

PDMP S&I at HIMSS

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PDMP: Technical Framework for Interoperability WHEN: Wednesday, March 6th TIME: 11:00 AM – 12:00 PM CTLOCATION: HIMSS13 Conference, New Orleans, LA MITRE Government VIP Room #213

MITRE will convene representatives from the S&I Initiative, the EHR vendor community, and other interested parties to explore the recommendations from the Standards & Interoperability Framework Initiative. There will be a demonstration featuring an open source reference implementation for integrating PDMPs with electronic health record systems. The goal of this forum is to allow participants to connect and summarize the outcomes of the effort to enable interoperability between HIE/EHR and PDMP vendors.

Also at HIMSS…

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PDMP: An Introduction to Using Health IT to Combat Prescription Drug AbuseWHEN: Monday, March 4th TIME: 2:00 – 3:00 PM CTLOCATION: HIMSS13 Conference, New Orleans, LA MITRE Government VIP Room #213

This session will share an overview of the effort to enhance access to prescription drug monitoring programs (PDMP). The goal is to educate, raise awareness and build connections between key stakeholders who have not been involved in the project work to date. Sharing information to date will provide stakeholders with the initial framework to pursue PDMP initiatives.

PDMP: Pilot Impact, In Their Own WordsWHEN: Tuesday, March 5th TIME: 4:00 – 5:00 PM CTLOCATION: HIMSS13 Conference, New Orleans, LA MITRE Government VIP Room #213

The PDMP project is conducting multiple pilots to rapidly test the feasibility of using health IT to enhance PDMP access and affect clinical decision making. This session will present a deeper dive into the design and outcomes of four FY13 pilots showcasing the workflow, ease of use, and added technical value of presenting PDMP data in EHR and pharmacy systems. The goal of this session is to have multiple pilot participants share specific information about their pilot designs and outcomes.

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Backup

Jan 28 Meeting: Scoping – the Use Case

• The primary use case centers on getting initial PDMP information to EHRs

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Not all data elements can be regarded the same

• Some elements may not be recorded in the PDMP (variations across states, for example)

• Some elements may be more important for this use case than others

PDMP S&I Community Focus/Scope

Page 15

Pharmacy

PMPi / RxCheck PDMP

Other State PDMPs

NCPDP Script

PDMP

Por

tal

Switches

NCPDP Telecom

ASAP

Pharmacy Benefits Mgmt

Provider

EHR System

NIEM-PMP NIEM-PMP

Provider

EHR System

Provider

EHR SystemData Out

Needs for standards (data format and content; transport and security protocols)

WG Recommended Set of Data – the “Complete” List

■ The Work Groups defined a standard set of data that should be available to support clinical decision making

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Patient Prescriber Dispenser Prescription

First nameLast nameStreet addressCityStateZIP codeDate of birthIdentification (ID) qualifier and/or patient identifier (situational)Gender code (situational)Species code (situational)Phone number (situational)

First nameLast nameStreet addressCityStateZIP code Phone number (situational)Drug Enforcement Agency (DEA) number (situational)

Pharmacy or dispensing prescriber nameStreet addressCityStateZIP codePhone number (situational)DEA number (situational)National Council for Prescription Drug Programs (NCPDP)/National Association of Boards of Pharmacy (NABP) Provider ID (situational)National Provider Identifier (NPI) (situational)

Name of drugStrengthFormQuantity dispensedDays’ supply dispensedDate prescription filledDate writtenRefills authorizedRefill numberRefill status to indicate a full or partial refillPrescription number

Full list recommendation: section 2.2.1.1 page 16-17