Digital Bridge Governance Principles Transparency: Stakeholders - - PowerPoint PPT Presentation

• Transparency: Stakeholders will have

visibility into the governance body’s work and opportunities to provide input.

• Respect for Process: Governance body

members will adhere to an agreed upon decision-making process. Members will

• bserve delineated and agreed upon roles

and responsibilities.

• Outreach: The governance body can solicit
• pinions and presentations from

stakeholders to inform its decision-making.

• Utility: The governance body will prioritize

use of existing information technology standards and infrastructure as it pursues shared and realistic goals that benefit all parties.

• Representativeness: Governance body

members will represent their broader field and be responsive to the goals of the Digital Bridge partnership.

• Trust: Governance body members will

honor commitments made to the Digital Bridge effort.

Digital Bridge Governance Principles

FOR DISCUSSION USE ONLY – June 7th, 2018

Governance Body Meeting

Thursday, June 7th, 2018 12:00 – 1:30 PM ET This meeting will be recorded for note-taking purposes only

FOR DISCUSSION USE ONLY – June 7th, 2018

FOR DISCUSSION USE ONLY – June 7th, 2018

Meeting Agenda

Time Agenda Item 12:00 PM Call to Order 12:04 PM Agenda Review and Approval 12:05 PM Consent Agenda

• Workgroup Charge: eCR Implementation Workgroup
• Workgroup Charge: Evaluation Committee
• Digital Bridge Charter, version 2.3 - revised

12:10 PM eCR Implementation Update

• Progress overall, risks, and mitigations
• Houston site
• Funding risks and mitigations

12:40 PM New Workgroup: Pilot Participation Workgroup remaining Announcements – Charlie Ishikawa 1:30 PM Adjournment – Vivian Singletary

Purpose:

The purpose of this meeting is to work toward a common vision for exchanging actionable information between public health and health care.

Objectives:

By the end of this meeting, the governance body will: 1. Charge and form the following workgroups

1. Evaluation Committee 2. eCR Implementation Workgroup

2. Update and revise the Digital Bridge charter 3. Discuss progress of eCR implementation work and identify related governance body actions 4. Discuss purpose and charge for Pilot Participation Workgroup

Materials:

1. Consent Agenda

1. Charge | Evaluation Committee 2. Charge | eCR Implementation Workgroup 3. Charter | Digital Bridge Governance, ver. 2.3

2. Meeting slides

FOR DISCUSSION USE ONLY – June 7th, 2018

Consent Agenda | June 2018

John Lumpkin (Chair)

FOR DISCUSSION USE ONLY – June 7th, 2018

Governance Meeting Consent Agenda

Protocol

1. Pre-meeting:

a. Chair places items that are believed to be non-controversial or routine b. Items should be received with sufficient review time

2. Start of meeting:

a. Chair asks if any member wishes to move an item into regular discussion b. All items left on the consent agenda are documented as approved by governance body c. Any item removed will be discussed during the meeting

June 2018 Consent Agenda Items

• 1. Charge: Evaluation Committee
• 2. Charge: eCR Implementation

Workgroup

• 3. Charter revisions: Digital Bridge

Governance, ver. 2.3

FOR DISCUSSION USE ONLY – June 7th, 2018

eCR Implementation Update

Laura Conn (eCR Implementation Taskforce Co-Chair), Rob Brown (Digital Bridge PMO)

FOR DISCUSSION USE ONLY – June 7th, 2018

Apr 2018 May 2018 June 2018 July 2018

Digital Bridge Utah Site Digital Bridge & Utah Site

Digital Bridge Critical Path for Utah Site in Production DRAFT

Set up Onboarding Environment - APHL RR Development & Testing - APHL IMH RCTC UDOH Onboarding – CSTE/APHL Utah Site Go-Live Post-Production Support Execute Legal Agreements (Signed) Execute Help Desk Support Agreement Standards Team eICR Review Potential Gap for DSI Funding Beyond 6/30 APHL Confer

• ence

CSTE Confer

• ence

Today 6/7

Set up Production Environment - APHL IMH eICR End-to-End Testing – APHL/CSTE

FOR DISCUSSION USE ONLY – June 7th, 2018

IMH Onboarding - APHL

Utah Site Progress

• Utah Department of Health
• UDOH has completed two RCKMS training/
• nboarding sessions
• AIMS connectivity has been established with

additional tests occurring during end-to-end testing

• Ready to begin end-to-end testing
• Intermountain
• Intermountain has completed trigger code

mapping but is unable to pull all the required data for an eICR; as a result, hardcoding ServiceDeliveryLocationRoleType with a generic SNOMED code

• NwHIN XDR connectivity has been established
• There will be difficulty triggering off lab orders

due to the limited ability to map local codes; analysis forthcoming

• Intermountain has submitted edits on the draft

pilot participation and business associate agreements

✔

Jan 2018 Feb 2018 Mar 2018 Apr 2018 May 2018 June 2018 July 2018 Aug 2018 Sept 2018 Oct 2018 Nov 2018 Dec 2018

Utah Site Production

Digital Bridge eCR Implementation Timeline - 2018 DRAFT

California Site Production Michigan Site Production Kansas Site Production New York City Site Production

RR Development & Testing Complete Production Environment Onboarding Environment

AIMS & RCKMS Milestones

Potential funding gap for DSI beginning July 1, 2018. Earliest potential new federal funding for RCKMS is October 1, 2018. Assumption of full funding for APHL during this time.

Utah Site Connectivity/Onboarding/Testing California Site Connectivity/Onboarding/Testing Michigan Site Connectivity/Onboarding/Testing New York City Site Connectivity/Onboarding/Testing Kansas Site Connectivity/Onboarding/Testing

Cerner corporate eICR product complete Today 6/7 FOR DISCUSSION USE ONLY – June 7th, 2018

Jan 2019 Feb 2019 Mar 2019 Apr 2019 May 2019 June 2019 July 2019 Aug 2019 Sept 2019 Oct 2019 Nov 2019 Dec 2019

Digital Bridge eCR Implementation Timeline - 2019 DRAFT

Massachusetts Site Connectivity/Onboarding/Testing Massachusetts Site Production New York State Site Production New York State Site Connectivity/Onboarding/Testing

Potential funding gap for DSI beginning July 1, 2018. Earliest potential new federal funding for RCKMS is October 1, 2018. Assumption of full funding for APHL during this time.

Potential Interested Implementation Sites:

• Delaware
• Illinois
• Iowa
• Kentucky
• Maryland
• Minnesota
• North Carolina
• North Dakota
• Pennsylvania
• Tennessee
• Wisconsin

Timeline to be Determined:

• Houston

Key Site Considerations

• Utah
• Intermountain has completed trigger code mapping but

is unable to pull all the required data for an eICR; as a result, hardcoding ServiceDeliveryLocationRoleType with a generic SNOMED code

• There will be difficulty triggering off lab orders due to the

limited ability to map local codes; analysis forthcoming.

• Public health is ready to begin onboarding and testing.
• Intermountain has submitted edits on the draft pilot

participation and business associate agreements.

• Michigan
• Local health department selection still in progress for

implementation of NetSmart’s MyInsight vendor software;

• MiHIN has submitted edits on the draft pilot

participation and business associate agreements.

• California
• Public health completing Rhapsody implementation and

expect to be ready by August/September.

• Kansas
• Lawrence Memorial Hospital is planning to wait for

Cerner corporate eICR product (August 2018).

• New York City
• Public health is completing Rhapsody

implementation; expects to be ready for a December 2018 implementation.

• Analysis on potential HIE approach with Bronx RHIO.
• IFH provider timeline is uncertain.
• Massachusetts
• Considering partners to participate in early 2019,

pending project approval.

• New York State
• Public health is waiting on NYC to complete

development for reuse.

• Upstate provider may benefit from waiting (second

half of 2018 or 2019).

• Houston
• Timeline pending.

FOR DISCUSSION USE ONLY – June 7th, 2018

Digital Bridge Dependencies

Development

• Onboarding environment -

Complete

• Production environment -

Complete

• Reportability Response (RR)

Development – mid-June 2018

Legal/Process

• Funding beyond July 2018
• Potential funding gap for DSI

beginning July 1, 2018 (i.e., funding is uncertain for AIMS and RCKMS). Earliest potential new federal funding for RCKMS is October 1, 2018.

• Signed legal agreements for DSI and sites
• Agreements for DSI post-production help

desk

• APHL Annual Conference: June 2 – June 5
• CSTE Annual Conference: June 10 – June

15

FOR DISCUSSION USE ONLY – June 7th, 2018

eCR Implementation – Issues & Risks

FOR DISCUSSION USE ONLY – June 7th, 2018

# Risk Impact Mitigation 1 Third party security assessment will not occur before initial implementations are in production. Medium On eCR roadmap for 2018/2019. AIMS has real-time security monitoring and regular tests to assure this risk is mitigated. A third party security assessment will be scheduled in 2018 if funding is identified. 2 Technical partners CSTE and APHL may have funding and sustainability shortfalls for FY18. High Potential funding gap for DSI beginning July 1, 2018. Funding is uncertain for AIMS and RCKMS. Earliest potential new federal funding for RCKMS is October 1, 2018. # Issue Impact Mitigation 1 Cerner implementation for eICR 1.1 support is delayed due to competing priorities. Medium Cerner’s corporate eICR solution should be complete by August 2018. 2 Epic will only support triggering on diagnosis (SNOMED, ICD-10CM) and resulted lab test name (LOINC) for the initial implementation sites. This limits the ability for RCKMS to identify reportability of the eICRs. This issue may also be widespread and encountered by other sites as implementation progresses. Analysis is still evolving. High Epic intends to provide this as a standard functionality in the next version of Epic, but it poses an issue for the initial implementations. The group continues to conduct further analysis of the impact and potential workarounds (i.e., additional mapping). 3 Intermountain has encountered troubles pulling in some

• f the required data for the eICR.

Medium Currently, Intermountain is working to go through validation of the eICR to determine the list of data fields. Unable to pull data for ServiceDeliveryLocationRoleType, so this field was hardcoded with a generic SNOMED code.

Addressing Funding Gap Risk

Jeff Engel (CSTE) and John Lumpkin (RWJF)

FOR DISCUSSION USE ONLY – June 7th, 2018

Pilot Participation Workgroup

Jim Jellison, Adam Greene, and Chris Brancato

FOR DISCUSSION USE ONLY – June 7th, 2018

Pilot Participation Workgroup

• Purpose
• Oversight, facilitation, and support for the participants who transmit electronic initial

case reports (eICRs) as part of the Digital Bridge pilot (“Participants”)

• Draft High-level objectives
• Determine whether to admit new participants into the Digital Bridge pilot
• Suspend or terminate participants in accordance with Pilot Participation Agreement
• Manage any amendments of the Pilot Participation Agreement
• Receive participants’ information, including an executed copy of the Pilot

Participation Agreement or Joinder Agreement

• Authorize the assignment or transfer of the Pilot Participation Agreement to a third

party in accordance with Pilot Participation Agreement

FOR DISCUSSION USE ONLY – June 7th, 2018

Proposed Membership

• APHL (one member)
• Electronic health record organizations (two members)
• Public health authorities (two members)
• Participant organizations (two members)
• Discussion needed
• Workgroup leadership
• Need for changes to charge or proceed to motion for approval

FOR DISCUSSION USE ONLY – June 7th, 2018

Announcements

Charlie Ishikawa

FOR DISCUSSION USE ONLY – June 7th, 2018

CANCELLED: JULY 5th MEETING NEXT MEETING Thursday, August 2nd, 2018, 12:00 – 1:00 PM EDT Action Items …

FOR DISCUSSION USE ONLY – June 7th, 2018