Governance Body Meeting Thursday, March 9th, 2017 12:00 PM 1:30 - - PowerPoint PPT Presentation

Governance Body Meeting

Thursday, March 9th, 2017 12:00 PM – 1:30 PM EDT

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 opinions 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.

Governance Principles

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Agenda

Time Agenda Item

12:00 PM Call to Order & Roll-call – John Lumpkin & Charlie Ishikawa 12:03 PM Agenda Review and Approval – John Lumpkin, Chairman 12:05 PM Digital Bridge Initiative Progress (10 min) 1. Project timeline – Jim Jellison 2. Communications – Jessica Cook 12:15 PM Digital Bridge eCR Implementation Plan (20 – 30 min) 1. Presentation of the eCR implementation site cohort – Jim Jellison 2. Discussion and approval – John Lumpkin 12:45 PM Objectives or success criteria for eCR implementation (15 – 20 min) 1. Presentation – Jim Jellison 2. Discussion – John Lumpkin 3. Next Steps 1:15 PM Governance Body Organizational Plan for Phase 3 (10 - 15min) 1. Organizational plan for Phase 3 Governance work – Charlie Ishikawa 2. Discussion and Decisions – John Lumpkin Remaining Announcements – Charlie Ishikawa 1:30 PM Adjournment – John Lumpkin

Purpose

1. Describe project phase 3 progress 2. Discuss and approve the plan for phased eCR implementation 3. Discuss and approve an initial plan for

• rganizing governance work during phase 3

4. Discuss objectives or success criteria for eCR implementation

Materials and Preparation

• Governance Body Decision Making

Procedure

• For discussion and approval:

 Draft: eCR site implementation plan  Proposed organization for Digital Bridge governance work during Project Phase 3

• For discussion:

 Draft objectives and success criteria for eCR implementation

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Digital Bridge Initiative Progress

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Communications Update

• eCR webinar on March 24, 1:30-3:00 p.m. EST
• Communicating to a broad public health audience about Digital Bridge and eCR
• Health Datapalooza Panel Presentation, April 28, Washington D.C.
• “Seeing Health from the Outside In: Multi-Sector Data Sharing” (10:30 a.m. EST)
• Updated fact sheet and talking points in BaseCamp. Updated presentation slides

coming soon.

• Contact Jessica Cook (jcook@phii.org) if you have specific needs for an event or

meeting.

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Draft : eCR Implementation Plan and Approach

Jim Jellison and Benson Chang

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Session Objectives

• 1. Describe work to date in planning and preparing for implementation
• 2. Summarize initial findings of site readiness for implementation
• 3. Propose phased implementation approach
• 4. Discuss findings and proposal
• 5. Receive Governance Body approval on draft implementation plan

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Initial Preparation and Logistics for Sites

PMO Integration Lead: Rob Brown (Deloitte) 1. Site Readiness Calls

• Conducted initial calls with sites to introduce Digital Bridge / PMO and provide sites an
• pportunity to ask any questions
• Sites calls completed a developed questionnaire about site readiness in preparation for site

implementation

2. Basecamp

• Maintain Basecamp for the use of standard activities with sites (agenda, meeting minutes,

document collaboration and storage, etc.)

3. SharePoint

• Track and document progress of implementation sites
• Store de-identified test data

4. Additional Preparation in the Coming Weeks

• Site Kickoff Calls, Onboarding Guide, and APHL & CSTE Coordination Calls

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Initial Site Coordination Calls

Public Health Agency Health Care Provider EHR Vendor California UC Davis Epic Houston Houston Methodist Epic Kansas Lawrence Memorial Hospital Cerner Massachusetts Partners HealthCare Epic Michigan McLaren Health Center NetSmart (HIE-MiHIN) New York City Institute of Family Health Epic Utah Intermountain Healthcare Cerner

The PMO held initial coordination calls 3/2 – 3/6 with each of the sites:

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Agenda: Initial Site Implementation Calls

The PMO had 30 minute calls with each site to review the following:

1. Reviewing an abbreviated site readiness form from APHL/CSTE with each site 2. Reviewing new “phased” approach being proposed to the Digital Bridge Governance Body on March 9 3. Outlining the basic timeline for implementation being tentatively April – September 2017) and asking if there were any schedule blockers during that timeframe for each site 4. Providing preliminary information on the Technical Implementation Workgroup plans for coordinating implementation activities as well as operational collaboration tools (i.e. Basecamp for document repository/meeting collaboration, SharePoint for de-identified test data repository) 5. Answering any questions the sites may have

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Findings: Initial Site Implementation Calls Findings

• 1. The PMO gathered the following overall findings from calls:

A. Vendor support for payload of eICR (either 1.0 or 1.1) during the proposed Digital Bridge implementation timeframe (April – September 2017) varies

• Michigan has plans to implement eICR fully during the Digital Bridge implementation
• Other sites plan to use another CDA document (i.e. Transitions of Care) in place of an eICR

until eICR support is fully built into their products

B. Limited commitment to to implement optional Reportability Response requirements

• Michigan plans to implement the requirements
• Houston has interest but working through vendor support

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Findings (cont’d): Initial Site Implementation Calls

• 2. Several sites asked for clarification of plans from test to production case report

exchange

• 3. Several sites asked for more specific legal and policy guidance on data sharing

agreements

• 4. One site (New York City) asked about the possibility of testing reportable

conditions beyond the 5 specific for the Digital Bridge test implementations

• 5. Several sites have calendar and operational considerations they would like

taken into account in phasing assignments:

A. Kansas and Utah suggested they be assigned to the same phase due to sharing a vendor (Cerner) and collaborating on many other surveillance projects B. Kansas requested they finish their implementation by July 1 C. Massachusetts requested they be scheduled for July-August due to other system go-lives earlier in the summer

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Proposed Phasing: eCR Implementation Sites

• Phase 1 (tentatively April - May 2017)
• Michigan, California
• Phase 2 (tentatively June – July 2017)
• Kansas, Utah
• Phase 3 (tentatively August – September 2017)
• Houston, Massachusetts, New York City

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Rationale for Proposed Phasing of eCR Implementation Sites

• Phase 1
• Michigan is currently prepared and willing to implement all requirements for the Digital

Bridge, including eICR and Reportability Response

• California is the site least familiar with Digital Bridge and can help test the completeness and

accuracy of the implementation plan

• Phase 2
• Considers Kansas and Utah requests that they be phased together and Kansas request to be

done by July 2017

• Synergies from sites having common vendor (Cerner)
• Phase 3
• Considers Massachusetts request to be phased in July/August 2017
• Synergies from sites having common vendor (Epic)

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Proposed Implementation Timeline | Initial Draft

Activity

Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan

Identify data sharing and business associate agreements Setup AIMS & RCKMS Infrastructure at individual sites Test planning activities Create test data evaluation plan Configure site specific technical/ staging environments Testing phase Evaluation Defect tracking and resolution Production data cutover

Activities for All Sites Activities for Phase 1 Sites Activities for Phase 2 Sites Activities for Phase 3 Sites

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Discussion: Objectives for eCR implementation

Jim Jellison

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Objectives for eCR Implementation

At least one site will demonstrate eCR capacity during implementations

1. EHR implements all codes in Reportable Condition Trigger Codes (RCTC) 2. EHR has capability to update triggers 3. EHR can generate an eICR (1.1) for all conditions, based on all types of triggers 4. EHR is able to send eICR to APHL Informatics Messaging Services (AIMS) Platform 5. AIMS is able to invoke CSTE’s Reportable Conditions Knowledge Management System (RCKMS) 6. RCKMS is able to evaluate eICR 1.1 and provide determination of reportability 7. AIMS is able to route Reportability Response (RR) to HC partner 8. AIMS is able to route eICR 1.1 and RR to appropriate PH jurisdiction(s) 9. PHA consumes eICR report and stores report information into surveillance system

• 10. EHR is able to move forward with the initial implementation in place to a production

implementation

• 11. PH jurisdiction is able to move forward with the initial implementation in place to a

production implementation

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Governance Body Organizational Plan for Phase 3

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Purpose of Governance Organizational Plan

The purpose of the organizational plan for Digital Bridge governance from March 2017 – January 2018 is to… 1. Ensure stakeholder agreement and buy-in on issues consequential to all stakeholders 2. Maximize efficiency in Governance Body decision making 3. Maximize opportunities for broad participation in Digital Bridge by stakeholder communities 4. Assure expert technical input on issues

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Phase 3 Digital Bridge Governance Scope and Work

There are four sets of activities/issues to be governed during project phase 3 (see diagram). These issues are: 1. Improving governance processes; 2. Implementing the Digital Bridge eCR model 3. Characterizing the feasibility of alternative eCR technical and/or legal approaches 4. Envisioning and planning for the future of the Digital Bridge initiative. The job of phase 3 governance is to:

• A. Provide assurance that these questions are

answered; and

• B. Consent to the ultimate answer of each

question.

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Proposed delegation of issues to workgroups

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Proposed Workgroup: Implementation Task Force

Purpose Oversee eCR implementation, support coordination, and advise Governance Body in determining whether reportable conditions business requirements were met by implementation sites. Advisory Issue 2a. What reportable conditions surveillance business and technical requirements were met?

• Processes, technologies

Active Period March 2017 – January 2018 Membership Implementation sites, designees from Governance Body organizations Max size: 20 – 30 people Staff PMO/Deloitte

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Proposed Workgroup: Evaluation Committee

Purpose Advise evaluation work and evaluation findings Advisory Issue 2b. What was the satisfaction with the Digital Bridge eCR approach?

• difference in expected and actual outcomes; improvements
• 2c. What resources are needed to make the Digital Bridge eCR approach

possible nationwide?

• costs: direct, indirect, and in-kind

Active Period May 2017 – January 2018 Membership Designees from Governance Body organizations Max size: 15 – 25 people Staff PMO and evaluation team

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Proposed Workgroup: Techno-Legal Tiger Team

Purpose Identify and define alternative technical and legal approaches to eCR, and advise legal SME/team in work Advisory Issue 3a. What alternative technical and/or legal arrangements would make eCR more feasible?

• 3b. Which alternative approaches should be pursued?

Active Period May 2017 – January 2018 Membership Designated experts in technical and/or legal matters Max size: 8 – 12 people Staff PMO and Legal Team

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Proposed Workgroup: Strategy Working Group

Purpose Identify and define strategic goals and objectives, and devise and recommend strategies Advisory Issue 4a. What will be the future of Digital Bridge? – use cases, commitments, vision and mission

• 4b. How will the Digital Bridge be organized?
• business services, governance, program, and finance

Active Period April 2017 – January 2018 Membership Governance Body representatives Max size: 4 – 8 people Staff PMO/Deloitte

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Next Steps

Phase 3 Governance Organization

• 1. Today
• A. Receive Governance Body

comments and change requests

• B. Receive Governance Body

approval

• 2. Upcoming weeks
• A. Identify workgroup leadership and

members

• B. Develop workgroup charges (i.e.,

deliverables and timeline)

• C. Submit to Governance Body for

approval (before or during April meeting)

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Announcements

DBGB Meetings

• Future meeting dates and times TBD @ 1/month