[PPT] - Governance Body Meeting Thursday, January 12, 2017 12:00 PM 1:00 PowerPoint Presentation

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Governance Body Meeting

Thursday, January 12, 2017 12:00 PM – 1:00 PM EDT Audio: 1-866-516-9291

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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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

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Agenda

Time Agenda Item

12:00 PM Call to Order – John Lumpkin, Chair & Trish Miller 12:03 PM Agenda Review and Approval – John Lumpkin, Chairman 12:20 PM Proposed Charter Amendment – Procedure for retaining full representation in governance 1. Presentation of procedural amendment – Charlie Ishikawa 2. Discussion and approval – John Lumpkin 12:30 PM Advancing bidirectional eCR data flow by Digital Bridge in 2017 (15 - 20 min) 1. Importance of eCR report backs from public health – Scott Becker, APHL 2. Issue in approved ACK requirement and proposed solution – James Doyle, EPIC 3. Discussion and decision – John Lumpkin 12:50 PM In-person meeting agenda preview and preparations (10 min) 1. Presentation of agenda and preparation work – Charlie Ishikawa 2. Discussion – John Lumpkin Remaining Next Steps – Charlie Ishikawa 1:00 PM Adjournment – John Lumpkin

Purpose 1. Describe progress on Digital Bridge phase 2; 2. Describe progress and upcoming workgroup milestones 3. Review and approve a proposed procedure for maintaining a full Governance Body 4. Discuss the need to advance bidirectional eCR data flow by Digital Bridge in 2017;; and 5. Set expectations for the in-person meeting on January 18 – 19, 2017. Materials and Preparation

Governance Body Decision Making Procedure
For discussion:
Digital Bridge Letter to Dr. Lumpkin from APHL,

ASTHO, CSTE and NACCHO

Issue brief: Technical requirements for an eCR

acknowledgement message (ACK)

For approval:
Proposed Charter amendment – Retaining full

representation in Governance Body (pending)

For information:
Governance Body In-Person Meeting – Final

meeting agenda (pending)

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Phase 2 Project Status

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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eCR Project Timeline

2016 Q3 2016 Q4 2017 Q1 2017 Q2 2017 Q3 2017 Q4 2018 and beyond

Governance Coordinate Workgroups (WGs) and Engage Stakeholders Requirements WG Technical Arch WG Provide Technical Guidance and Monitor eCR Implementations eCR Implementations

Ongoing Curation of Functional Requirements Evolve, Extend Information Exchange Capabilities Ongoing Submission

f ECRs

Legal and Regulatory WG

Articulate Business Case for eCR

Sustainability WG Articulate Business Case for eCR

Charter Communications Plan Identify New Use Cases Refine Charter Develop Project Plan Functional Requirements Refined Technical Arch Diagram Document Lessons Learned Site Application/Criteria Defined Preliminary Sustainability Plan Measure Success Sustainability Plan Model BAAs, DUAs Recommendations Sites Selected Declare MU eCR Readiness Onboard eCRs MU eCR Deadline

REV 12/7/16

Bus. Process Matrix Task Flow Diagram & Requirements Statements

Narrative Description & Trigger Sequence Diagram Assessment of eCR Implementation

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Communications Update

HIMSS17 Session: “Enhancing Information Exchange through a Digital Bridge”

Tues, Feb. 21, 2:30-3:30

Other conference abstracts submitted and new press (detail in upcoming email

update)

Site applications due this Friday
High interest and intent from potential sites to apply by this Friday, however no

applications have been received yet. Some potential sites have requested an extension.

May open a second application round, with the application deadline in mid-February.

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Digital Bridge Workgroup Updates

Technical Architecture | Legal & Regulatory | Sustainability

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Technical Architecture Workgroup

Workgroup Charge

The Technical Architecture Workgroup is charged with defining technical requirements for electronic case reporting (eCR). Deliverables Products that describe…. 1. Technical architecture for delivering electronic case reports 2. Recommendations for how to implement the technical architecture at each implementation site 3. Assumptions for any technical requirements, including the use of any specific technical standards, specific tools/shared services and their availability for use in implementation sites.

Update

Activity Dates Additional Requirements Reconciliation 12/5 – 1/11 eICR Required Data Elements Discussion 12/19 – 1/4 Submit Reconciled Functional Requirements for Governance Approval 1/18

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Legal and Regulatory Workgroup

Workgroup Charge

Advise a legal SME as he authors a formative assessment of the legal and regulatory issues governing eCR implementation nationwide, and model agreements for Digital Bridge Phase 3 eCR implementation work. Deliverables By January 31, 2017, recommend to Digital Bridge Governance…

A formative assessment of eCR technique authored by the Legal SME
A summative assessment of eCR implementation plans in up to 5

public health jurisdictions (i.e., state or local government) including 1) identification of jurisdiction-specific legal and regulatory issues including liability risks for public health case report senders and receivers and 2) recommendations for liability risk mitigation.

Draft business associate agreements, data trading partner

agreements, or memoranda of understanding that can be used as models by those seeking to implement eCR technique.

Scope and support for Legal and Regulatory Workgroup during project

Phase 3, and beyond

Update

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

Activity Dates

Recommendation of assessment, and presentation and discussion of summary assessment of implementation plan

12/20

Recommendation of summary assessment of implementation plan, and presentation and discussion of draft agreements

1/13

Present completed Legal and Regulatory deliverables to Governance Body for review and approval

1/18

Recommendation of agreements, and discussion of future charge for legal and regulatory eCR work

1/31

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Sustainability Workgroup

Workgroup Charge

Define a sustainability plan for eCR that articulates a business model for infrastructure support as described by the Digital Bridge Requirements and Technical Architecture Workgroups. Deliverables 1. Recommendations on site selection criteria for the eCR implementation phase of Digital Bridge and accompanying application process description 2. Preliminary sustainability plan for delivering electronic case reports using Digital Bridge technical infrastructure and shared services. 3. Assumptions and issues for any sustainability requirements, including the use of any specific technical standards, specific tools/shared services, project management and system maintenance functions and their availability for use in implementation sites, and underlying funding/business model to support any of them.

Update

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

Activity Dates Sustainability WG Meetings 12/15- 1/10 Sustainability WG In-Person Meeting 1/9 Share key components of eCR Sustainability with Governance Board 1/18

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Proposed Charter Amendment

Procedure for retaining full representation in governance

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Proposal: Charter Amendment

Issue

Absence of procedure for filling representative vacancies. Considerations 1. Principles – Process and Representativeness 2. Governance Structure – Three fields, five Organizations 3. Quality – Complete perspective and balance are key for sound decisions on Digital Bridge

Proposal

Add a Charter procedure to clarify responsibilities and

expectations. Procedure has two parts:

1. Filling an Organization’s vacancy

a. Process: Organization notifies PMO of vacancy and replacement b. Time: Due within 2-weeks of a vacancy c. Decider: Organization

2. Filling a Governance Body Organization vacancy.

a. Process: PMO and Governance Body develop list of candidate organizations b. Time: Complete within 3-weeks of vacancy c. Decider options:

a. Governance Body b. Governance Body Chairperson c. Project Office

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Advancing bidirectional eCR data flow by Digital Bridge in 2017

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Advancing bidirectional eCR data flow by Digital Bridge

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Issue

Electronic Case Reporting (see Process Notes spreadsheet for process narrative and related details; refined per Tech Arch Workgroup 12/12/2016) Electronic Case Reporting (see Process Notes spreadsheet for process narrative and related details; refined per Tech Arch Workgroup 12/12/2016)

Health Care Provider Health Care Provider Public Health Agency Public Health Agency Decision Support Intermediary Decision Support Intermediary

1. Begin Patient

Visit

5. Match?
2. Review,

Deliver and Document Patient Care Yes No End

4. Compare to

Public Health Trigger Codes Iterative process - Real-time or timed? Iterative process - Real-time or timed?

3. Provider

Initiated eICR

6. Build eICR
7. Send eICR to

Decision Support Intermediary

8. Document

Activity Related to eICR

24. Provide

supplemental Information (if requested)

25. Create

Supplemental Information Report

26. Send

Supplemental Information Report

II. Load Trigger

Codes (asynchronous) Start

16. Build

Supplemental Information Request Yes

13. Report to

Public Health? Yes No

12. Determine Public

Heath Reportability Input Reporting Criteria (specificity)

9. Receive Electronic

Case Report

14. Determine Public

Health Routing (for eICR)

19. Send eICR

No

15. Need

Supplemental Information?

18. Send

Reportability Response

20. Disposition eICR
III. Load

Reporting Criteria (asynchronous)

17. Build

Reportability Response

27. Determine Public

Health Routing For Supplemental Info

I. Manage

Public Health Reporting Criteria Input trigger criteria (sensitivity) See Requirements for details on Reportability Response

21. Receive eICR
VI. Manage

Case Information

28. Receive

Supplemental Information

V. Public

Health Electronic Lab Reporting (ELR) ELRs

23. Receive

Reportability Response

IV. Load

Routing Criteria (asynchronous) Input Routing Criteria

22. Need

Supplemental Information? No End Yes

10. Valid Message/

Document? No Yes

11. Build, Send Error

Message

A A

Future state – Subject to change Future state – Subject to change Future state – Subject to change Future state – Subject to change Future state – Subject to change Future state – Subject to change Future state – Subject to change Future state – Subject to change

Disagreement on nature of acknowledgement (ACK) from Public Health Decision Support Intermediary (DSI) to the Healthcare Provider’s HER (Step 18)

Considerations

1. TAW deemed Reportablity Response (RR) required, but that is in conflict with 11/10 Governance Body decision 2. eCR ”Acknowledgement” has 3 parts:

A - eICR received or not;
B - eICR formed or malformed;
C - Reportability Response

3. Standards for B and C are immature 4. TAW reached partial solution: Add “Initial Implementation Requirement”

Required – required for all

Implementations

Optional – not required, however

implementation is encouraged

Deferred – not required and not to be

implemented, but added to future requirements

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Solution Options

A. Technical Acknowledgment Required, Application Level Acknowledgments Optional

i. eICR received/not received is Required for Digital Bridge Initial Implementations ii. eICR data formed/malformed is Optional for Digital Bridge Initial Implementations iii. Reportability Response is Optional iv. Technical feasibility and standards will be tested in implementation, and experience used in SDO work

B. All Acknowledgements (1-3) required

i. eICR received/not is Required for Digital Bridge Initial Implementations ii. eICR data formed/malformed is Required for Digital Bridge Initial Implementations iii. Reportability Response is Required iv. Technical feasibility and standards will be tested in implementation, and experience used in SDO work

Electronic Case Reporting (see Process Notes spreadsheet for process narrative and related details; refined per Tech Arch Workgroup 12/12/2016) Electronic Case Reporting (see Process Notes spreadsheet for process narrative and related details; refined per Tech Arch Workgroup 12/12/2016)

Health Care Provider Health Care Provider Public Health Agency Public Health Agency Decision Support Intermediary Decision Support Intermediary

1. Begin Patient

Visit

5. Match?
2. Review,

Deliver and Document Patient Care Yes No End

4. Compare to

Public Health Trigger Codes Iterative process - Real-time or timed? Iterative process - Real-time or timed?

3. Provider

Initiated eICR

6. Build eICR
7. Send eICR to

Decision Support Intermediary

8. Document

Activity Related to eICR

24. Provide

supplemental Information (if requested)

25. Create

Supplemental Information Report

26. Send

Supplemental Information Report

II. Load Trigger

Codes (asynchronous) Start

16. Build

Supplemental Information Request Yes

13. Report to

Public Health? Yes No

12. Determine Public

Heath Reportability Input Reporting Criteria (specificity)

9. Receive Electronic

Case Report

14. Determine Public

Health Routing (for eICR)

19. Send eICR

No

15. Need

Supplemental Information?

18. Send

Reportability Response

20. Disposition eICR
III. Load

Reporting Criteria (asynchronous)

17. Build

Reportability Response

27. Determine Public

Health Routing For Supplemental Info

I. Manage

Public Health Reporting Criteria Input trigger criteria (sensitivity) See Requirements for details on Reportability Response

21. Receive eICR
VI. Manage

Case Information

28. Receive

Supplemental Information

V. Public

Health Electronic Lab Reporting (ELR) ELRs

23. Receive

Reportability Response

IV. Load

Routing Criteria (asynchronous) Input Routing Criteria

22. Need

Supplemental Information? No End Yes

10. Valid Message/

Document? No Yes

11. Build, Send Error

Message

A A

Future state – Subject to change Future state – Subject to change Future state – Subject to change Future state – Subject to change Future state – Subject to change Future state – Subject to change Future state – Subject to change Future state – Subject to change

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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In-person Meeting Agenda

Preview and preparation

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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FOR MEETING DISCUSSION USE ONLY – 1/12/2017

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Digital Bridge Governance Body Meeting

January 18 – 19, 2017 Task Force for Global Health, Decatur, GA

Part 1

Reconnect Reflect

Part 2

Decide eCR.. Technical Architecture Legal and Regulatory Implementation

Part 3

Envision Sustainability

eCR
Digital Bridge

The next “use case”

Purpose The purpose of this meeting is to complete and approve products for Digital Bridge eCR implementation, and strengthen the Digital Bridge partnership by framing sustainability issues and plans, and prioritize bi-directional use cases for Digital Bridge work. Objectives By the end of the meeting, the Digital Bridge Governance Body will have…. 1. Concluded work on eCR Digital Bridge phase 2 objectives with approval on all products critical to eCR implementation (project Phase 3), specifically:

A. eCR Technical Architecture and Requirements
B. Legal and Regulatory Guidance
C. Implementation site schema, and evaluation plans

2. Identified, documented and discussed critical sustainability issues for eCR infrastructure, and Digital Bridge Governance 3. Described and validated a path to determining the future Digital Bridge focus for bi-directional health or public health data exchange 4. Documented and affirmed next steps and Governance Body commitments to advancing the Digital Bridge initiate

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

Interactive Board Meeting Workshop Wednesday Thursday

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Digital Bridge Governance Body Meeting

January 18 – 19, 2017 Task Force for Global Health, Decatur, GA

Prepare by …

1. Ensure access to BaseCamp (materials will be posted

there)

2. Review materials provided by COB Friday, January 13
3. Seek input from membership and/or colleagues:

v “What should we consider in selecting the next use case for Digital Bridge?”

4. RSVP for Wednesday night dinner reception (7 PM)

FOR MEETING DISCUSSION USE ONLY – 1/12/2017

Part 1

Reconnect Reflect

Part 2

Decide eCR.. Technical Architecture Legal and Regulatory Implementation

Part 3

Envision Sustainability

eCR
Digital Bridge

The next “use case”

Interactive Board Meeting Workshop Wednesday Thursday

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Next Steps

DBGB Meetings

January 18th – 19th – In-person Meeting
Future meeting dates and times TBD

FOR MEETING DISCUSSION USE ONLY – 1/12/2017