Governance Body Meeting Thursday, January 10, 2019 12:00 P.M.– 1:00 P.M. ET This meeting will be recorded for note-taking purposes only FOR DISCUSSION USE ONLY – January 10 th , 2019
UPDATE PENDING FOR DISCUSSION USE ONLY – January 10 th , 2019
Meeting Agenda Time Agenda Item Purpose: 12:00 PM Call to order – John Lumpkin The purpose of this meeting is to work toward a common vision for exchanging actionable information between health care and public health. 12:03 PM Agenda review and approval – John Lumpkin 12:05 PM Consent agenda – John Lumpkin Consent Agenda Workgroup updates • 12:10 PM Risk log Risk Log eCR Implementation progress – Laura Conn • Implementation progress update • 12:30 PM Action – John Lumpkin For Action Legal Workgroup Charge – Walter Suarez • Charge: Legal Workgroup • For Discussion 12:35 PM Discussions – Bob Harmon and Michael Iademarco Preliminary eCR recommendations • eCR Transition Preliminary Recommendations • • In-person meeting agenda and expectations 12:50 PM In-person meeting expectations and preparation – Charlie Ishikawa 12:57 PM Announcements – Jelisa Lowe and Charlie Ishikawa 1:00 PM Adjournment – John Lumpkin FOR DISCUSSION USE ONLY – January 10 th , 2019
Consent Agenda | January 2019 John Lumpkin (Chair) FOR DISCUSSION USE ONLY – January 10 th , 2019
Governance Meeting Consent Agenda Protocol January 2019 Consent Agenda Items 1. Pre-meeting: 1. Workgroup updates: a. Chair places items that are believed to be a. eCR Implementation Workgroup non-controversial or routine b. Evaluation Committee b. Items should be received with sufficient • CSTE Presentation Abstract review time c. Pilot Participation Workgroup 2. Start of meeting: d. Transition Workgroup 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 FOR DISCUSSION USE ONLY – January 10 th , 2019
Risk Log: eCR Implementation Progress Laura Conn and Kirsten Hagemann (eCR Implementation Taskforce Co-Chairs), Rob Brown (Digital Bridge PMO) FOR DISCUSSION USE ONLY – January 10 th , 2019
eCR Implementation Update Laura Conn & Kirsten Hagemann (eCR Implementation Taskforce Co-Chairs), Rob Brown (Digital Bridge PMO)
Update: eCR Implementation Workgroup • The Utah site went live on December 20, 2018 • The Houston site went live on November 14, 2018 Initial connectivity issues preventing the RR from getting • • Reportability Responses were returned to Houston to Intermountain have been resolved Methodist for all eICRs Intermountain had a lapse in sending case reports • • Challenges uncovered in testing with Houston between 12/26/2018 – 1/4/2019 • Epic product does not trigger from diagnosis fields, Challenges uncovered in testing with Utah • diagnosis trigger codes are being triggered out of problem Generation of new test patients was more time and • list resource intensive than originally anticipated • Used production environment for testing Timing of how eICRs are generated within the EHR to • • Lab tests were not coded as LOINC at HM– APHL TA minimize duplicate eICRs is being revisited provided support for mapping local codes to LOINC codes Intermountain test environments and interfaces have • been up and down preventing from testing and creation of some test patients Implementation WG: Kirsten Hagemann has returned as co-chair • The Technical Specifications is going through a revision • Site engagement and preparation for implementation continues • Most active sites include California and New York • FOR DISCUSSION USE ONLY – January 10 th , 2019
DRAFT Digital Bridge eCR Implementation Timeline Estimate- 2019 Jan 2019 Feb 2019 Mar 2019 Apr 2019 May 2019 June 2019 July 2019 Aug 2019 Sept 2019 Oct 2019 Nov 2019 Dec 2019 Michigan Site Michigan Site Production Connectivity/Onboarding/Testing California Site California Site Connectivity/Onboarding/Testing Production Kansas Site Kansas Site Potential Interested Implementation Sites: Connectivity/Onboarding/Testing Production Allscripts • Delaware • • Health & Hospitals New York City Site New York City Site • Illinois Connectivity/Onboarding/Testing Production • Iowa • Kentucky Anticipate discussion of • Maryland New York State Site New York State Site how eCR onboarding will • MDLand Connectivity/Onboarding/Testing Production • Minnesota be opened up as part of North Carolina • North Dakota eCR transition • Ohio • • Pennsylvania • South Dakota • Tennessee Note: Massachusetts site currently searching for provider to participate • Wisconsin Houston in production – 11/14/18 Utah in production 12/20/18 Today FOR DISCUSSION USE ONLY – January 10 th , 2019
Action: Legal Workgroup Charge John Lumpkin (Chair) FOR DISCUSSION USE ONLY – January 10 th , 2019
ACTION: Legal Workgroup Charge Charge Advise, identify and define the best available legal frameworks to achieve national scale-up for eCR and recommending alternative technical approaches to make eCR more feasible from legal and regulatory perspectives. Where indicated by the Digital Bridge governance body, the Legal Workgroup may also advise on data exchange related to other use cases. Objectives Review and contribute to draft Digital Bridge responses, as directed by the • governance body, for public Digital Bridge Workgroup • comments and requests for information from federal agencies or offices (e.g., Office of Civil Rights’ Request for Information on Modifying HIPAA Rules to Charge Improve Coordinated Care) that may impact data exchange between the Legal Workgroup healthcare and public health sectors. FOR GOVERNANCE BODY REVIEW AND APPROVAL Tuesday, January 8, 2019 Advise on key, common elements that should be included in future agreements • to support national eCR scale-up and steady states, taking into consideration legal and policy requirements of public health agencies. • Review and advise as to how the Trusted Exchange Framework and Common Agreement (TEFCA) and other trust networks may be leveraged to support national eCR scale-up and steady states. • Advise on a long-term legal framework roadmap for Digital Bridge initiatives. Leadership: Walter Suarez, Kaiser-Permanente FOR DISCUSSION USE ONLY – January 10 th , 2019
Discussion: Preliminary eCR Transition Recommendations Bob Harmon and Michael Iademarco (Transition Workgroup Co-Chairs) FOR DISCUSSION USE ONLY – January 10 th , 2019
Discussion Points 1. Purpose of the report 2. Highlight recommendations 3. Encourage every GB member to review and comment by next Friday, 1/18
Preliminary eCR Transition Recommendations Question charged to answer Organization Name Designation Representing • “Beyond demonstrating and evaluating eCR, what will Digital Bridge do for general eCR John Lumpkin – primary RWJF Member Sponsor Hilary Heishman – alternate adoption and to assure eCR sustainability?” Michael Iademarco - Co-chair CDC Member Sponsor Bill Mac Kenzie – primary Purpose Laura Conn – alternate • Share the workgroup's initial ideas with the Bob Harmon – Co-chair Cerner/Epic Member Vendors governance body and receive feedback to James Doyle – alternate finalize recommendations for endorsement and Kaiser Walter Suarez – primary implementation. Member Healthcare delivery Permanente Richard Paskach–alternate HealthPartners Mary Ann Cooney – primary ASTHO Member Public health Governance Action Schedule Mylynn Tufte – alternate 1. Posted on 1/7 Scott Becker – primary eCR operators and APHL Member 2. Comments returned no later than 1/18 Patina Zarcone – alternate public health Kathy Tuner – primary 3. Discuss, modify and adopt by 1/23 – 1/24 (in- eCR operator and CSTE Jeff Engel – alternate Member person meeting) public health Meredith Lichtenstein – tertiary Vivian Singletary – primary PHII/Deloitte Observer PMO Andy Wiesenthal – alternate (PMO) John Stinn–alternate FOR DISCUSSION USE ONLY – January 10 th , 2019
Overarching Recommendation By October 2019, Digital Bridge should transition its eCR demonstration work to supporting efforts led by U.S. Centers for Disease Control and Prevention to scale up the eCR approach for general adoption, working with partners. For this goal, our recommendations are intended to advance two strategic objectives: (1) increase the implementation and use of eCR nationwide, and (2) set an initial technical framework for further bidirectional information exchange beyond notifiable conditions
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