Governance Body Meeting Thursday, August 3, 2017 12:00 – 1:30 PM EDT This meeting will be recorded for note taking purposes only FOR DISCUSSION USE ONLY – August 3, 2017
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 – August 3, 2017
Meeting Agenda Time Agenda Item Purpose 12:00 PM Call to Order – John Lumpkin 1. Describe and discuss progress and issues in implementing eCR from technical and legal 12:03 PM Agenda Review and Approval – John Lumpkin perspectives 12:05 PM eCR Implementation (55 min) 2. Discuss and approve a Digital Bridge Roadmap; 1. Progress| Wave 1 implementations - R.Brown and B.Chang 3. Request comments on a draft Digital Bridge 2. Discussion| Issue: Variations on DB-eCR Approach – J.Jellison responsibilities scope document 3. Presentation| Legal and Regulatory – J.Jellison 4. Describe recent and upcoming communications activities 12:15 PM Digital Bridge Strategy (20 min) Material 1. Action | Roadmap for the Digital Bridge – A.Cheeks-Lomax 1. Governance body decision-making procedure 2. Presentation | Draft: Digital Bridge Responsibility Scope – A.Cheeks-Lomax 2. Summary report on Phase 3 Digital Bridge workgroup progress and participation 1:20 PM Updates and Announcements (10 min) 3. For discussion: 1. Update | Communications – J.Cook 1. Issue Brief: Variations on DB-eCR Approach 2. Review decision and major actions – C.Ishikawa 2. Draft Digital Bridge Responsibilities 4. For approval: 1:30 PM Adjournment – John Lumpkin 1. Digital Bridge Roadmap FOR DISCUSSION USE ONLY – August 3, 2017
Digital Bridge eCR Implementation 1. Progress |Wave 1 implementations - Rob Brown and Benson Chang 2. Discussion | Issue: Variations on DB-eCR Approach – Jim Jellison 3. Presentation| Legal and Regulatory - Jim Jellison FOR DISCUSSION USE ONLY – August 3, 2017
Digital Bridge eCR Implementation 1. Progress |Wave 1 implementations - Rob Brown and Benson Chang 2. Discussion | Issue: Variations on DB-eCR Approach 3. Presentation| Legal and Regulatory - Jim Jellison FOR DISCUSSION USE ONLY – August 3, 2017
Session Objectives: Wave 1 Implementations 1. Overview • eCR Implementation Taskforce • Implementation Sites 2. Progress • Accomplishments and Activities • Issues and Risks 3. Implementation Timeline Revisions
eCR Implementation Taskforce Taskforce Charge Update Oversight and coordination of technical implementation of the Digital Bridge electronic case reporting (eCR) approach during project phase • Test scenarios have increased in scope 3. and complexity to complete more Deliverables thorough testing 1. Digital Bridge eCR Implementation Plan • The implementation plan is being refined 2. eCR onboarding document for public health agencies 3. eCR onboarding document for health care providers to reflect the added complexities and 4. eCR Implementation/Configuration Guide for EHR vendors dependences 5. Implementation site communication plan 6. Updated Digital Bridge Technical Architecture Diagram (as • Current Wave 1 implementation date is required) uncertain 7. Test Management Plan 8. Updated Digital Bridge requirements (as required) 9. Implementation Architecture Diagram 10. Facilitate Reportability Response feedback from the taskforce
eCR Site Participation Public Health Agency Health Care Provider EHR Vendor Wave 1: April – September 2017 Kansas Lawrence Memorial Hospital Cerner Michigan Local Public Health Clinics NetSmart Utah Intermountain Healthcare Cerner Wave 2: September – 2017/2018 (Tentative) California UC Davis Epic Houston Houston Methodist Epic Massachusetts Partners HealthCare Epic New York Institute of Family Health Epic
eCR Implementation Taskforce Activities Initial AIMS Connectivity (hello world message) • Utah - Completed • Kansas - Completed PHINMS polling test • Michigan - Reviewing legal agreements for VPN connectivity • Houston - Working with the jurisdiction and Houston Methodist on direct transport Validator • NIST Validator has been customized/configured for eICR • Additional performance testing is underway for inline and online validator • Online Validator is publicly accessible for testing: https://validator.sandbox.aimsplatform.com/hitspValidation2/ • Validator presentation will be delivered during the next Digital Bridge monthly all-site meeting • Allscripts has started to test with the Online Validator RR Constructor • Initial work on building RR has started
eCR Implementation Taskforce Activities (cont.) RCKMS Integration • Continuous Integration/Deployment completed and in testing • Configuration has been completed. Testing with RCKMS team started on July 5, 2017 • RCKMS Performance Testing on AIMS ongoing • Session #1 was completed on June 22, 2017 • Session #2 was completed on July 13, 2017 • Session #3 is underway this week. Focused on throttling and burn-in • Release and deployment planning with APHL ongoing Trigger Code Analysis • Conducting an analysis of what codes (lab and/or clinical codes) are currently used for the five reportable conditions to identify whether the RCTC align with codes seen by PH and used by EHRs/HC • RCTC will be updated based on analysis results • Zika reporting logic updated to meet jurisdictional needs
eCR Implementation – Risks & Issues # Issue Impact Mitigation 1 Cerner implementation for eICR 1.1 support is delayed due Medium Cerner is pursuing engagement of Cerner/Intermountain resources for to competing priorities. development while at the same time pursuing development leveraging Intermountain Research Informatics department. 2 An increase in the complexity and thoroughness of the test Medium Test scenarios have been sent to Lantana. scenarios will cause a delay in the creation of the test eICR. # Risk Impact Mitigation 1 Epic implementation for eICR 1.1 support (minus travel Medium Current Wave 2 timeline being pushed out allows enough time for Epic to roll out history) is delayed. support for eICR 1.1 (minus travel history). 2 Third party security assessment will not occur before initial Medium On eCR roadmap for March 2018 implementations are in production. 3 Legal agreements & Data use agreements beyond initial High The legal workgroup has identified a law firm to begin the planning and creation of implementation (risk for both Implementation and the legal and data use agreements. sustainability workgroups).
DRAFT Revised Implementation Timeline – Wave 1 March April May June July August September October November 15 30 15 30 15 30 15 30 15 30 15 30 15 30 15 30 15 30 Planning Planning Site Selection RCKMS & AIMS Development & Test Development RCKMS Criteria Testing (Internal, Jurisdictional Criteria) and Testing Finalize Test Scenarios Finalize Test Data Performance Testing (Iterative) Integration Testing (AIMS & RCKMS Together) Functional Testing (AIMS & RCKMS Separate) Engagement Engagement With Implementation Sites With Implementation End-to-End Testing RCKMS Training Complete Sites Complete AIMS Transport Onboarding In Progress Legal Agreements Not started Post Production Establish Post Production Technical Support Help
Digital Bridge – Wave 1 Timeline Dependencies Testing (RCKMS, AIMS) Test Scenarios – In Process • Test Data – Not Started • Testing (end-to-end with sites) AIMS Onboarding – Not Started • AIMS Onboarding (including RCTC configuration) Trigger Code Analysis – In Process • Cerner development and schedule – Not Started • Production Cutover Legal Agreements – Not Started •
Digital Bridge eCR Implementation 1. Progress |Wave 1 implementations - Rob Brown and Benson Chang 2. Discussion | Issue: Variations on DB-eCR Approach – Jim Jellison 3. Presentation| Legal and Regulatory - Jim Jellison FOR DISCUSSION USE ONLY – August 3, 2017
Background 1. One DB implementation site has 2 implementation projects 2. Some partners have concerns with one of the implementations 1. Timeliness 2. Completeness 3. Scalability FOR DISCUSSION USE ONLY – August 3, 2017
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