CCHIT Roundtables at HIMSS 09

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  • 1. Certification Commission for Healthcare Information Technology CCHIT Roundtables:  Interoperability 09 and Beyond  Open Source Forum Mark Leavitt, MD, PhD – Chairman Amit Trivedi – Certification Manager & Strategic Work Group Leader, Interoperability Dennis Wilson – Certification Technology Director Hyatt Regency McCormick Place Chicago, IL Apr 6, 2009
  • 2. Roundtable Sessions Session #1: 1:00 – 2:00pm CDT Interoperability 09 and Beyond Session #2: 2:00 – 3:00pm CDT Open Source Forum © 2009 | Slide 2 | Apr 6, 2009
  • 3. Agenda • 09 Interoperability Criteria • 09 Interoperability Testing • Laika EHR 2009 • Roadmap • Q&A © 2009 | Slide 3 | Apr 6, 2009
  • 4. 09 Interoperability Criteria 08 Criteria 09 Criteria • Registration, Medication, and • Registration, Medication, and Allergy modules Allergy modules CCD/C32 Import & Export • File/Display: Level 2 • File/Display: Level 2 • Generate/Format: Level 2 • Generate/Format: Level 3 Lab Result • Import HL7 2.5.1 (no changes from 08) ORU messages Import DICOM • Display image via (no changes from 08) WADO or C-Move protocol Image Display • NCPDP SCRIPT 8.1 eRX • New, Refill, Eligibility, (no changes from 08) Transactions Formulary, and Med Hx transactions • Advanced Interoperability • PIX or PDQ query XDS • XDS.a or XDS.b: Transactions • Provide & Register • Query + Retrieve © 2009 | Slide 4 | Apr 6, 2009
  • 5. CCD/C32 Coding Level 2 = “Structured Naratives” Level 3 = “Coded Vocabularies” Sections Requiring Coding:  Medications:  Product Code: NDC or RxNorm (use of NDF-RT or FDA UNII not required)  Allergy / Drug Sensitivity:  Product Code: RxNorm (meds), FDA UNII (food/substances) (use of NDF-RT codes not required)  Adverse Event Type: SNOMED CT  Severity Code: SNOMED CT  Conditions, Immunizations, Encounters, Procedures, Results, Vital Signs, Pregnancy © 2009 | Slide 5 | Apr 6, 2009
  • 6. Advanced Interoperability Advanced Criteria: •Required for incentives? •Distinguished from basic criteria © 2009 | Slide 6 | Apr 6, 2009
  • 7. 09 Interoperability Testing 09 Testing Procedures Laika test cases for Display/File and Generate/Format CCD/C32 •Checklists for Display verification Import & Export •Level 3 coding validated, code sets checked ORU messages dynamically generated with Lab Result Import conformance tools DICOM Images served by DICOM server Image Display eRX Transactions surescripts certification accepted Laika test cases for: XDS Provide & Register, Query/Retrieve, PIX Feed/Query, PDQ XDS Transactions •Checklists for queries •Comparison of transaction results in test servers © 2009 | Slide 7 | Apr 6, 2009
  • 8. Laika EHR 2009 XDS DICOM PDQ Registry XDS EHR
Under
Test Supplier for
Certification Repository PIX
Mgr Laika
2009 • Complete, ready to use, fully integrated AWS
Instance
of
Laika test environment 2009
Environment • Private virtual instances allocated for practice and final inspection testing © 2009 | Slide 8 | Apr 6, 2009
  • 9. Testing Endpoints Laika Interface https://<hostname>.compute-1.amazonaws.com XDS.a Registry https://<hostname>.compute-1.amazonaws.com:9080/axis2/services/xdsregistrya XDS.a Repository https://<hostname>.compute-1.amazonaws.com:9080/axis2/services/xdsrepositorya XDS.b Registry https://<hostname>.compute-1.amazonaws.com:9080/axis2/services/xdsregistryb XDS.b Repository https://<hostname>.compute-1.amazonaws.com:9080/axis2/services/xdsrepositoryb XDS tools https://<hostname>.compute-1.amazonaws.com:9080/xdstools PIX Mgr mllp://<hostname>.compute-1.amazonaws.com:3600 PDQ Supplier mllp://<hostname>.compute-1.amazonaws.com:3601 ATNA Log (BSD syslog)://<hostname>.compute-1.amazonaws.com:5140 WADO http://<hostname>.compute-1.amazonaws.com/wado?requestType=WADO … Additional configuration parameters: • Patient Identifier Assigning Authority Domains OID • Document Source sourceId OID • Digital certificates • XDS metadata code set © 2009 | Slide 9 | Apr 6, 2009
  • 10. Laika Components Source Generator: custom CCD/C32 Import & Export Validation: NIST schematron, UMLS vocabularies DICOM DICOM server: dcm4chee Image Display XDS NIST Registry/Repository PIX Manager Open Health Tools OpenPIXPDQ PDQ Supplier Interface Engine Mirth HL7 Interface Engine © 2009 | Slide 10 | Apr 6, 2009
  • 11. Laika Test Case Types CCD/C32: • Display & File • Generate & Format PIX/PDQ: • PIX Feed • PIX Query • PDQ Query XDS: • Query & Retrieve Document • Provide & Register Document © 2009 | Slide 11 | Apr 6, 2009
  • 12. Laika Example Test Case XDS [ITI‐19]
Node
Authentication Registry XDS EHR
Under
Test Repository for
Certification [ITI‐14]
XDS.a
Register
Document or [ITI‐41]
XDS.b
Provide
&
Register
Document
Set‐b Laika
2009 [ITI‐20]
Record
Audit
Event Instance
of Laika
2009 Environment © 2009 | Slide 12 | Apr 6, 2009
  • 13. Laika Example Test Case Assign test case from view of patients in XDS Registry © 2009 | Slide 13 | Apr 6, 2009
  • 14. Laika Example Test Case • Provide XDS metadata attributes expected from Provide & Register transaction • Values not supplied are ignored © 2009 | Slide 14 | Apr 6, 2009
  • 15. Laika Example Test Case Executing test case triggers compare of expected versus actual values in XDS Registry © 2009 | Slide 15 | Apr 6, 2009
  • 16. Laika Example Test Case ATNA log browser enables inspection of required entries © 2009 | Slide 16 | Apr 6, 2009
  • 17. Laika Example Test Case Checklists support inspection of query transactions © 2009 | Slide 17 | Apr 6, 2009
  • 18. Project Contributors • MITRE Corporation • CitiusTech • OpenSourcery http://laika.sourceforge.net/  Contributors welcome! © 2009 | Slide 18 | Apr 6, 2009
  • 19. Looking Ahead © 2009 | Slide 19 | Apr 6, 2009
  • 20. Criteria Roadmap: 10, 11+ Additional CDA document types for quality reporting and data exchanges: • HITSP C48 – Encounter Document • HITSP C34 - Patient Level Quality Data Message • HITSP C37 – Lab Report Document • HITSP C38 - Patient Level Quality Data Document • HITSP C78 – Immunization Document © 2009 | Slide 20 | Apr 6, 2009
  • 21. Criteria Roadmap: 10, 11+ Further requirements around XDS transactions: • Document Replacement and Addendum • XDS-I (Cross Enterprise Image Information Sharing integration profile) • PIX Update Notifications • XCA – (Cross Community Access) HIE to HIE gateways © 2009 | Slide 21 | Apr 6, 2009
  • 22. Criteria Roadmap: 10, 11+ CCD/C32 Discrete Data Processing: • Display of data captured from external sources • Compare and selective update clinical list items • “Round trip” creation of CCD elements previously imported © 2009 | Slide 22 | Apr 6, 2009
  • 23. Thank you! Q&A For more information: www.cchit.org
  • 24. Roundtable Sessions Session #1: 1:00 – 2:00pm CDT Interoperability 09 and Beyond Session #2: 2:00 – 3:00pm CDT Open Source Forum © 2009 | Slide 24 | Apr 6, 2009