Digital Bridge Governance Principles Transparency: Stakeholders will have Utility: The governance body will prioritize • • visibility into the governance body’s work use of existing information technology and opportunities to provide input. standards and infrastructure as it pursues shared and realistic goals that benefit all Respect for Process: Governance body • parties. members will adhere to an agreed upon decision-making process. Members will Representativeness: Governance body • observe delineated and agreed upon roles members will represent their broader field and responsibilities. and be responsive to the goals of the Digital Bridge partnership. Outreach: The governance body can solicit • opinions and presentations from Trust: Governance body members will • stakeholders to inform its decision-making. honor commitments made to the Digital Bridge effort. FOR DISCUSSION USE ONLY – November 2 nd , 2017
Digital Bridge Strategic Roadmap Milestones & Critical Activities PHASE III (2017) PHASE IV (2018-2019) PHASE V (2020-2021) PHASE VI (2022-2023) Jun Aug Nov Jan Aug Apr Dec Jan Nov Dec Jan Jan High Use case 2 Wave 1 – Wave 2 – Test launched Wave 1 – Test Production Operating implementation implementation model Wave 1 legal complete complete Wave 2 legal implemented agreements signed Use case 3 agreements signed launched Governance Wave 2 - Implement long by-laws Production term technical drafted architecture eCR legal agreement Operating model Governance templates developed self- sustaining Develop and Recommend Body changes Reportability recommend long long-term implemented Response (RR) funding modal term technical Published By-laws approved Develop long architecture by Governance term legal Digital Bridge Body strategy Implement Funding Model communications new funding 100% in effect plan-V2 Template for model Infrastructure for Legal agreement Complexity eCR legal new use cases Use case templates developed agreements criteria agreed for new use cases Digital Bridge upon recruitment strategies & Begin Technical marketing Evaluate Architecture funding model Stand up Evaluation technical Legal agreement Legend Concept of operations templates developed for Operations workgroup Operations Establish Digital developed subsequent use cases Bridge success Funding Establish stories communications Technical Infrastructure Governance body advisory group 7 sites up approves long term Legal and running Governance technical architecture Users & Use Cases body approves Marketing Reporting on use case 3 Governance Communications materials for five conditions ody approves funders use case 2 Critical Path Low Identify Other Milestones Operating model funders approved by governance body *** General Notes: (1) Complexity is used as a rough proxy for the needed resources and effort to complete a milestone, (2) Overall timeline and milestones are subject to change depending on project dependencies. FOR DISCUSSION USE ONLY – November 2 nd , 2017
Thank you for your feedback Opportunities to address requested November topics will be provided during today’s meeting where indicated below: 1. “Update on status of initial implementation sites.” 2. “Legal and project plans for both wave 1 and 2.” 3. “Implementations and 2018 plan.” 4. “How do we get to where we are building trust and solving problems?” 5. “How much can we realistically take on given we have not yet seen more than a few eCR sites, none operational at this time. Are we moving too fast?” 6. “The next use case.”
Governance Body Meeting Thursday, November 2, 2017 12:00 – 1:30 PM ET This meeting will be recorded for note taking purposes only FOR DISCUSSION USE ONLY – November 2 nd , 2017
FOR DISCUSSION USE ONLY – November 2 nd , 2017
Meeting Agenda Purpose: Time Agenda Item The purpose of this meeting is to work toward a 12:00 PM Call to Order – John Lumpkin common vision for exchanging actionable information between public health and health care. 12:03 PM Agenda Review and Approval – John Lumpkin Objectives: By the end of this meeting, the governance body will 12:10 PM eCR Implementation Progress have • Laura Conn, Kirsten Hagemann, Rob Brown 1. Identified and discussed the status and future plans for the initial eCR implementation sites, 12:45 PM Scalability Issue Brief 2. Discussed strategic questions and concerns over Jim Jellison • making final decisions related to an operating model and future use case, and 1:05 PM Strategy Workgroup Update 3. Provided comments and suggestions to improve the Mary Ann Cooney and Richard Paskach • accuracy and completeness of a draft scalability Alana Cheeks-Lomax • issue brief Materials: 1:25 PM Digital Bridge Communications – Jessica Cook 1. PMO Work Plan: eCR Scalability Assessment 1:28 PM Review decisions and major actions – Charlie Ishikawa 2. Scalability Issue Brief – Version 1 1:30 PM Adjournment – John Lumpkin 3. eCR Implementation activity status report 4. Meeting slides FOR DISCUSSION USE ONLY – November 2 nd , 2017
eCR Implementation Laura Conn and Kirsten Hagemann (Taskforce Co-Chairs), Rob Brown FOR DISCUSSION USE ONLY – November 2 nd , 2017
Updated Implementation Timeline (DRAFT) Mar 2017 – Sept 2017 Oct 2017 Nov 2017 Dec 2017 Jan 2018 Feb 2018 Mar 2018 Apr 2018 Planning Site Selection RCKMS & AIMS - Development & Test Test Package (Scenarios, Narratives, and Test Data) Performance Testing (Iterative) Integration Testing (AIMS & RCKMS Together) RR Constructor Development RR Standard Publication Engagement With Implementation Sites RCKMS Training Complete DB Site DB e #1 #1 DB Site DB e #1 #1 Site #1 Si AIMS & RCKMS End-to-End Testing Production Onboarding (eICR & RR) Legal Agreements DB DB Site e #n #n (TBD) D) Onboarding & End-to-End Testing FOR DISCUSSION USE ONLY – November 2 nd , 2017 Complete In Progress Not Started
eCR Implementation Risks and Issues # Issue Impact Mitigation PMO presented the Cerner and Intermountain implementation brief vetted by Cerner implementation for eICR 1.1 support is delayed the eCR implementation taskforce to the governance body at the October 1 Medium due to competing priorities meeting. Cerner and Intermountain have also identified a resource and should have the solution production ready by end of 2017. Continuing to monitor the status of the test package with CDC and CSTE to be An increase in the complexity and thoroughness of the completed end of November. CDC and CSTE walked through a test scenario, test 2 test scenarios will cause a delay in the creation of the test High narrative and test eICR for the implementation sites at the monthly all site eICRs meeting. # Risk Impact Mitigation Third party security assessment will not occur before 1 Medium On eCR roadmap for 2018/2019. initial implementations are in production Legal agreements and data use agreements beyond initial The legal and regulatory workgroup is working on creating legal and data use 2 implementation (risk for both implementation and High agreements for the initial implementations, and an eCR scalability assessment strategy workgroups) will occur for future implementations. HL7 RR ballot reconciliation process is complete. RR discussions scheduled with Reportability response (RR) standard changing between 3 Medium sites to address surfacing questions. RR publication expected by December balloting and November publication 2017. CSTE (RCKMS team) has mitigated their contract gap in the short term and is Technical partners CSTE and APHL may have funding and 4 High actively looking into longer term solutions. APHL has expressed concerns about sustainability shortfalls for FY18 limited resources and funding for eCR. FOR DISCUSSION USE ONLY – November 2 nd , 2017
Site Status in Preparation for Onboarding and Testing Provider/HIE & PH Vendor/HIE Provider Public Health Implementation Sites Connectivity Additional Notes Activities Activities Activities with AIMS Cerner and Intermountain development work for Utah can be leveraged for Kansas. For public health (PH), the activity remaining is the ability to Kansas receive a reportability response (RR). Successful AIMS connectivity test with PH. Discussions with provider connectivity beginning. For PH, the activities remaining are the ability to receive eICR 1.1 and Michigan N/A ability to receive RR. Initial connectivity testing underway between AIMS and MiHIN. Cerner and Intermountain (IMH) obtained resource to get them production ready by end of 2017. PH is ready; their activities are Utah complete. Successful AIMS connectivity test with PH. IMH connectivity being established. Epic’s software updates are released. Working through provider California concerns. PH is making progress. Epic’s software updates are released. Provider and PH are making Houston progress. AIMS is working with provider and PH on direct transport. Epic’s software updates are released. Provider and PH are making Massachusetts progress. For PH, the activities remaining are test and production environment setup and the ability to receive RR. Epic’s software updates are released. Working through provider New York concerns. PH is making progress. FOR DISCUSSION USE ONLY – November 2 nd , 2017 Not Started – 0% In Progress – 50% Complete – 100%
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