State CDA Pilot Projects
description
Transcript of State CDA Pilot Projects
Delaware’s Journey
STATE CDA PILOT PROJECTS
1. Two Projects Not One2. What is CDA3. Template Development4. Execution5. Conclusion
STATE CDA PILOT PROJECTS
• Template Development Project• Execute Data Exchange Project
TWO PROJECTS NOT ONE
• Project Teams Make-Up– Project Executive Team– State Pilot Team• State Personnel• Vendors
– Template Team• Modelers
TWO PROJECTS NOT ONE
• Delaware was unique– There were participants on both Template
Development and the State Pilot teams– Other participating jurisdictions only had
representation on the state pilot team• As a dual participant there were approximately
12 additional hours of conference calls added to our calendars each month
TWO PROJECTS NOT ONE
• CDA(Clinical Document Architecture) by definition isWHAT IS CDA?
an XML-based markup standard intended to specify the encoding, structure and semantics of clinical documents for exchange. (fancy webpage)
Author
Raw CDA XML
Author Rendered CDA
• Reportable Conditions – Determine reportable conditions – Who are they reportable to?• Reportable to the State Health Offices• Reportable to the CDC• Reportable to both• Do you share this data with other states?
TEMPLATE DEVELOPMENT
– Similarities• Naming conventions• Formats• Medication
recommendations• Treatment
recommendations• Demographics
Gather reportable condition forms from multiple sourcesLA-County, New York City, Massachusetts ,Michigan
TEMPLATE DEVELOPMENT
– Differences• Naming conventions• Formats• Medication
recommendations• Treatment
recommendations• Demographics
• Implementation guidelines– If published guidelines exists then you can
follow the guidelines– If there are no published guidelines then you
have to look at developing vocabulary and submitting to PHIN VADS(PHIN Vocabulary Access & Distribution System)
TEMPLATE DEVELOPMENT
• What is MDHT– MDHT is a JAVA based application, built on the
open source application Eclipse maintained by The Eclipse Foundation
• Who do you need?– CDA Expert• Templates / Constraints• Background
– Understand both business and technical sides of project – Does not need to be technical but it helps
• There is technical language that may get mixed in
LEARNING MODEL DRIVEN HEALTH TOOL(MDHT)
Place Holder for MDHT screenshot
MDHT Screen Shot
MDHT was the most time consuming part of the project
– Learn a new tool– Technical issues• Network issues• Firewalls• Permission issues
– Time constraints– Competing priorities
LEARNING MODEL DRIVEN HEALTH TOOL(MDHT)
• Learning a new tool– Different than other development tools– Even with a technical background the
learning curve proved difficult at times because there were a lot of manual steps that could have been automated.
LEARNING MODEL DRIVEN HEALTH TOOL(MDHT)
• Weekly conference calls• Conference calls 2x a week• Extra Conference calls a week when
needed
Modeling DONE
NEAR THE END OF MODELING
• State Pilot Project Team– Business Analysts • EMR, DERSS (NEDDS based system), and DPHL(Lab)
– Vendors• Core Solutions, Labware, Orion Systems
EXECUTE THE MODEL
• Delaware’s initial CDA execution planEXECUTE THE MODEL
EMR/EHR
EMR DERSSDHIN
Lab Instruments
Lab RequestCD
A La
b Re
sult
Set
CDA Lab Result Set
Lab Request
Rhapsody
LIMS Lab Result
Lab
Requ
est
• Delaware’s actual CDA execution planEXECUTE THE MODEL
EMR/EHR
DERSS
DHINCDA Result Set
Rhapsody
CDA Result Set
• Why change the execution plan?
– Time• Vendor Business Model was not flexible enough to
dynamically deliver resources in 30 days or less• LIMS vendor could not perform the work needed in
the required time frame
EXECUTE THE MODEL
• Resource intensive project– States participating at all levels will need
additional resources– Template development is time consuming
and public private partnership is worth considering
– Forces you to think about your entire data sharing model
– Opens up new opportunities for collaboration– Allows you to better plan your funding for
data integration
CONCLUSION
Pilot Participants– Marcy Parykaza, Delaware– Jean Collison, Delaware– Patricia Burke, Delaware– Barry Borden, Delaware– Andrew Rentschler, Delaware– Kendall Patterson, Delaware– Core Solutions(EMR Vendor)
Template Team– Anna Orlova, PHDSC– Maiko Minami, PHDSC– Alla Fridman, PHDSC– Lisa Nelson, PHDSC– Sarah Quaynor, PHDSC– Kendall Patterson, Delaware– Sondra Renly, IBM Research– Lori Reed-Fourquet, eHealthSign– Nikolay Lipskiy, CDC
PARTICIPANTS