Automate Blue Button Initiative All Hands Community Meeting

August 22, 2012

Meeting Etiquette

• Remember: If you are not speaking, please keep your phone on mute

• Do not put your phone on hold. If you need to take a call, hang up and dial in again when finished with your other call

o Hold = Elevator Music = frustrated speakers and participants

• This meeting is being recorded

o Another reason to keep your phone on mute when not speaking

• Use the “Chat” feature for questions, comments and items you would like the moderator or other participants to know.

o Send comments to All Panelists so they can be addressed publically in the chat, or discussed in the meeting (as appropriate). From S&I Framework to Participants:

Hi everyone: remember to keep your phone on mute

All Panelists

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Agenda

Topic Time Allotted

Welcome and Announcements 10 minutes

Call to Action 5 minutes

Project Charter Review 40 minutes

Workgroup Formation 20 minutes

Consensus Process Overview (time permitting) 10 minutes

Next Steps / Reminders 5 minutes

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Current Registrants

• Access My Records, Inc. • ADHS • Allscripts • American Academy of Family Physicians • American College of Physicians • AORN • Cerner • Data Exchange Specialist California Immunization

Registry • Department of Defense (Booz Allen Hamilton

Contractor) • Dossia • Ep-Con • eRECORDS, Inc • Florida Hospital • CakeHealth • Humetrix • Gartner • Gorge Health Connect, Inc. • Health Information Xperts • HealthURL • Healthwise and HITSC FACA • HHS • Hunter College • IMS Health • IPS Technology Services

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JOIN THE INITIATIVE: http://wiki.siframework.org/Automate+Blue+Button+Join+the+Initiative

• KirbyIMC.com • Laboratory Corporation of America • Louisiana Dept of Health and Hospitals • McKesson • Microsoft • Napersoft • Optum • OrionHealth • Sager Systems • Patient First • Patients as Partners • Regulatory Informatics • RelayHealth • Ricoh Healthcare • Sutter Medical Center of Santa Rosa • Thotwave Technologies, LLC. • Transformations at the Edge (TATE) • UnitedHealth Group • US Army • Veterans Affairs • Videntity • WellSpan Health • Wittie, Letsche & Waldo, LLP

Announcements

• The Automate Blue Button Initiative will hold weekly community meetings on Wednesdays at 3:00 pm Eastern. – To participate, please see the “Attend the Weekly Community

Meeting” section of the Automate Blue Button Wiki Page:

• http://wiki.siframework.org/Automate+Blue+Button+Initiative

Please check the meeting schedule weekly as the meeting link and call in numbers will change

Weekly Meetings

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ABBI Wiki Orientation

Weekly Meetings

Community Schedule

Contacts

Calendar

Quick Links

Call to Action

• You’re Invited! We need experts to develop standards, organizations ready to drive towards implementation, innovators to push the envelope, and patients and providers willing to provide their perspective.

• Your commitment and participation are critical to our success and the ability to provide patients and their families with electronic access to their health data when and where it is needed.

• To join the Automate Blue Button Initiative, go here: http://wiki.siframework.org/Automate+Blue+Button+Join+the+Initiativeread about the commitment process and fill out the “Join the Initiative” form at the bottom of the page.

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Project Charter Review

• This is your opportunity to provide input!

• We will discuss each section of the Project Charter in the community meeting.

• Updates will made to the wiki after the meeting. – http://wiki.siframework.org/Automate+Blue+Button+Project+Charter

• Please also review and comment on the wiki after the meeting.

Review and Comment

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• Challenge – How can we advance the implementation standards, tools,

and services associated with the Blue Button to provide consumers with automated updates to their health information in a human readable and machine readable format?

• Goals

– PUSH: Automating transmission of personal health data to a specific location, using the Blue Button

– PULL: Allowing a third party application to periodically access personal health data, using the Blue Button

Automate Blue Button Project Charter

Challenge and Goals

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Automate Blue Button Project Charter

Scope Statement

• Identify, define, and harmonize implementation standards, tools and services that facilitate the automated PUSH and automated PULL of patient information via the Blue Button

• Identify, define and harmonize content structures and specifications for the Blue Button so that information downloaded is machine readable and human readable

• Identify, define, and harmonize protocols around identification and credentialing, and protocols around access and authorization, that facilitate the automated PUSH and automated PULL of patient information via the Blue Button

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Automate Blue Button Project Charter

Value / Vision Statement

Consumers want more access to and portability from their health care information. They want to be able to: • Better understand their health and make more informed

decisions • Help to make sure that they and all of their care team

members are on the same page • Improve the accuracy and completeness of the information • Plug it into apps and tools that promise to make

information truly available when and where it’s neededc

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Automate Blue Button Project Charter

Success Metrics

For dataholders: • Number of existing BB dataholders that implement Auto Blue

Button • Number of new dataholders that take the pledge and implement

Auto Blue Button

For patients: • Number of patients that access their data using Blue Button • Number of patients that use new features of Blue Button (both

push and pull)

For third-parties: • Number of application developers parsing Blue Button data • Number of patients using applications that are powered by Blue

Button

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Automate Blue Button Project Charter

Target Milestones & Timelines

Driving Milestones

• Pilot Push implementation by November 22, 2012

• Pilot Pull implementation by March 3, 2013

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Automate Blue Button Project Charter

Expected Deliverables

• Workgroup Charters

• Use Case(s) and Functional Requirements

• Standards for Blue Button

• Implementation Guidance for Blue Button

• Tool development to support Blue Button

• Pilots and results

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Automate Blue Button Project Charter

Relevant Standards & Stakeholders

• DIRECT: A set of transport standards, services, and use cases that any data holder or receiver can implement, to package and send/receive electronic health information in a private and secure fashion.

• ToC Content Recommendations: Recommendations on document structures to fulfill Meaningful Use Stage 2 Transitions of Care requirements (consolidated CDA). (http://wiki.siframework.org/ToC+Document+Recommendations)

• OAuth & OpenID: Community-developed, industry-standardized protocols for authentication and authorization. (Note: The FHA is currently developing a RESTful approach to information exchange that leverages OAuth and OpenID.)

• LRI Content Recommendations: Recommendations on document structures for Lab Interfaces to electronic health records

• RHEx: Working on security standards (OpenID and OAuth) and content standards (working now) for applying a RESTful design approach to exchanging health information.

• OSEHRA is an open, collaborative community of users, developers, and companies engaged in advancing electronic health record software and health information technology

• Markle Foundation's recommendations for Blue Button (including privacy and security specifications)

• Work to create and encourage adoption of a new CCD to Blue Button “Transform tool” (to support OPM request)

• Work underway to specify use cases for using EHRs and DIRECT to transmit updated summaries of care to a patient as they become available.

Push

Project

Pull

Project

Content

Sub-Group

Proposed Workgroups

Automating transmission of personal health data to a specific location • Discovery: review existing standards and formulate project charter and scope

• Work on use cases

• Define deliverables and timeline

• Scope input needed on content and privacy and security

Allowing a third party application to periodically access my personal health data • Discovery: review existing standards and formulate project charter and scope

• Work on use cases

• Define deliverables and timeline

• Scope input needed on content and privacy and security

A Blue Button file must be machine-readable and human-readable • Review existing efforts and standards to leverage

• Develop plan to support PUSH and PULL projects

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Workgroup 1: Push

Automating transmission of personal health data to a specific location

By patient request, a provider can specify in an EHR that a patient be sent an updated copy of his/her personal health information as it becomes available

A patient can specify in a dataholder’s system to be sent an updated copy of his/her personal health information as it becomes available.

PUSH

EXAMPLE USE CASES

REQUIREMENTS & ASSUMPTIONS

IN SCOPE (TO BE CONSIDERED)

OUT OF SCOPE (NOT TO BE CONSIDERED)

• Patient/Provider is already authenticated in dataholder’s system.

• Transport must be secure • Data sent must be both

human-readable and machine-readable

• Transport standards, services, and specifications

• Content standards: whether or not to include in implementation guide(s)

• Implementation guide(s) to support use case(s), building off existing standards

• Policy concerns and constraints. This initiative will define the mechanism, – how and where they apply it will be up to state and local laws

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Workgroup 2: Pull

Allowing a third party application to periodically access my personal health data

PULL

EXAMPLE USE CASE

A patient can direct a third party application to periodically have access to his/her personal health information via the internet. The dataholder will ensure this data is made available and follow certain privacy and security standards.

REQUIREMENTS & ASSUMPTIONS

IN SCOPE (TO BE CONSIDERED)

OUT OF SCOPE (NOT TO BE CONSIDERED)

• Data must be transmitted securely

• Patient must give application consent to pull health information from data holder

• Data sent must be both human-readable and machine-readable

• Authentication, transport, and content standards.

• Leverage REHx project (Oauth and OpenID)

• Leverage ToC project • Leverage lab interface

project

• Policy concerns and constraints. This initiative will define the mechanism, – how and where they apply it will be up to state and local laws

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Sub-Group: Content

A Blue Button file must be both machine-readable and human-readable.

A patient can point a software or web application to their Blue Button file and it can parse it.

A patient can download a copy of his/her records and is able to read and print it out.

CONTENT

EXAMPLE USE CASES

REQUIREMENTS & ASSUMPTIONS

IN SCOPE (TO BE CONSIDERED)

CHALLENGES

• File must be both human-readable on multiple platforms: PC, Mac, iOS, and Android

• File must be printable • File needs to be machine

readable

• Leverage work done by HL7 and Consolidated CDA

• Leverage work done by the ToC S&I Initative

• A cross-platform file that is self contained.

• Enabling easy-parsing of the file. Should take a developer less than 3 minutes to use.

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For those of you who are committed members, we ask you to vote on the Automate Blue Button Project Charter:

• Yes

– A Yes vote does not necessarily mean that the deliverable is the ideal one from the perspective of the Initiative Member, but that it is better to move forward than to block the deliverable

• Yes with comments

– If a Consensus Process attracts significant comments (through Yes with comment votes), it is expected that the comments be addressed in a future revision of the deliverable.

• Formal Objection- with comments indicating a path to address the objection in a way that meets the known concerns of other members of the Community of Interest. "Formal Objection" vote without such comments will be considered Abstain votes.

– A Formal Objection means that the objector cannot proceed with the project unless the objections are met. It is acceptable and expected to use a Formal Objection in a first consensus round to communicate a point of view or process issue that has not been addressed in the drafting of the initial deliverable.

– Should a Consensus Process attract even one "Formal Objection" vote with comments from an Initiative Member, the deliverable must be revised to address the "Formal Objection" vote (unless an exceptional process is declared).

• Abstain (decline to vote)

Note: Each Organization, no matter the number of Committed Members only receives 1 Vote. If there are multiple committed members from your organization please verify your collective vote with them

Consensus on the Project Charter

Submitting your Vote

1. Review the Project Charter:

– http://wiki.siframework.org/Automate+Blue+Button+Project+Charter

2. Complete the Voting Form:

– NOTE: You must be a Committed Member to Vote

• Yes

• Yes with comments.

• Formal Objection

• Abstain (decline to vote)

3. Submit your Vote

4. A Message is displayed verifying your vote was recorded

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Automate Blue Button Project Charter Consensus Vote

Jane Smith

Committed Member

Viewing your vote

5. View and track your Vote. (Voting record is directly below the Voting Form.

• Note: you may need to refresh your browser to see your vote

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Note: All Consensus Votes are due Sept 17th by 8:00 pm EST

Next Steps

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• Next Steps – Comment on the Project Charter: – http://wiki.siframework.org/Automate+Blue+Button+Project+Charter

• Next Work Group Meeting

– 3:00pm - 4:30pm Eastern, Wednesday, August 29, 2012 – http://wiki.siframework.org/Automate+Blue+Button+Initiative

• All ABBI (ABBI) Announcements, Meeting Schedules, Agendas,

Minutes, Reference Materials, Use Case, Project Charter and general information will be posted on the HeD Wiki page – http://wiki.siframework.org/Automate+Blue+Button+Initiative

For questions, please contact your support leads • Initiative Coordinator: Pierce Graham-Jones (pierce.graham-jones@hhs.gov)

• Subject Matter Experts: to be announced

• Project Management: Jennifer Brush (jennifer.brush@esacinc.com)

• S&I Admin: Apurva Dharia (apurva.dharia@esacinc.com)

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Contact Information

Useful Links

• Automate Blue Button Wiki – http://wiki.siframework.org/Automate+Blue+Button+Initiative

• Join the Initiative – http://wiki.siframework.org/Automate+Blue+Button+Join+the+Initiative

• Automate Blue Button Project Charter – http://wiki.siframework.org/Automate+Blue+Button+Project+Charter

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