Use Case and Functional Requirements (UCR) Workgroup Laboratory Results Interface InitiativeFebruary 3, 2011

Office of Standards and Interoperability

Use Case and Requirements Workgroup Kick-off Agenda

» Kick-off Objectives» Workgroup Committed Members» S&I Support » Logistics» Charter/Scope of Initiative » Workgroup Objectives, Activities & Scope» How to Participate and Contribute (Wiki Navigation & Comment Process)» Next Steps

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 Workgroup Kick-off Objectives

» Introduction to your fellow committed community members and support team

» Active discussion and agreement upon the approach and scope for the Laboratory Results Interface initiative and first use case

» Understanding of key next steps and responsibilities as a participant of the Use Case and Requirements Workgroup

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Current List of Workgroup Committed Members (updates still in progress)

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Workgroup Committed Member Organization

Nikolay Lipskiy CDC-PHITPO

Nic VanDuyne NYeC

Paul Edge Microsoft

Carrie Adams NeHII

William Ormerod Siemens

Hans Buitendik Siemens

Wayne King Covisint

Lorre Pacheco Sunquest

Eric Heflin Medicity, IHE, ITI, NWHIN

Brian Ahier Oregon HIE Planning Team

Ken Willett Ignis System

Wes Kennemore Association of Public Health Laboratories (APHL)

Srinath Remala Association of Public Health Laboratories (APHL)

Seonho Kim ApeniMED (formerly known MEDNET), CHIC, NWHIN and MITA TAC

TBD Veteran’s Health Administration

Arturo Sanchez-Ruiz University of North Florida, School of Computing

Workgroup ONC/S&I Support

» Initiative Coordinator: Jitin Asnaani, ONC S&I Framework» Community Workgroup Lead: TBD» S&I Framework Support Members

 

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S&I Framework Functions Support Members

Use Case(Support Leads)

Merideth VidaEd Larsen

Harmonization Jillian Wanner, John Stinn

Implementation Specifications Jillian Wanner, John Stinn

Reference Implementation Michael Nenashev, Andriy Selivonenko, Joan DuHaimeChitra Ragu

Demonstrations and Pilots Dave Colbert, Charles Ndunda, Anjali Gupte, Chitra Ragu

Certification & Testing Chris BrancatoChad Clay

Tools Kevin Puscas

Architecture Dragon Bashyam, Marc Bernard

FHA Erik Pupo, Neal Richards

Ground Rules

» Stakeholder participation in person or by phone; not by proxy

» Engage in Workgroup meetings in a professional manner, do not interrupt other Workgroup members when they are speaking

» Encourage Participation; bring forth subject matter expertise and knowledge relevant to the Initiative

» Actively Listen

» Present a United Front by Consensus

» Issues will be resolved in a timely manner within workgroups or offline and resolution of these issues are priority within the workgroups themselves

» Workgroup Minutes will be posted to the Wiki 48 hrs after each Workgroup

Laboratory Results Interface (LRI)Initiative Charter

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Laboratory Results Interface Initiative Charter /Scope

» Challenge: There are at least two standard specifications for ambulatory laboratory reporting, neither of which are adopted universally across industry. The cost and time to initiate new electronic laboratory results interfaces hampers broad adoption of such interfaces. The field by field details of HL7 v2 implementation guides used by clinical labs and EHRs vary, creating a need for mapping or configuration per interface, and the prevalence of core subsets of LOINC codes for common tests and analytes also varies, causing downstream issues in decision support and quality reporting.

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Scope: Limited to address this challenge for the subset of lab reporting to primary care (internal medicine, family practice, pediatrics).

Optionally: Enable pilots that demonstrate electronic results delivery through the agreed-upon standard, including linkages with directories and transport .

http://jira.siframework.org/wiki/display/SIF/LRI+-+UCR+Workgroup+Charter

Use Case and Requirements WorkgroupObjectives, Activities and Scope

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 Initial Workgroup Objectives

» Engage Stakeholders as Committed Members, Invited Experts, or Interested Parties in the creation of the Use Case for the Laboratory Results Interface Initiative

» Create a finalized Use Case that demonstrates value and supports the proposed goals and success criteria for the Laboratory Results Interface Initiative

» Publish a finalized Use Case that contains necessary content, supported by artifacts, to enable Harmonization and subsequent S&I Framework efforts to occur

» Establish the Use Case and supporting artifacts in a reusable fashion to support future health information interchange Initiatives

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Operating Procedures and Conditions

» Use Case and Functional Requirements Workgroup will draft, review, and update the Use Cases

» Workgroup Meetings will occur on a weekly basis by conference call with face to face meetings to occur at the very end of the Discovery Phase

» Once realized, the final Use Case draft will be posted to the Wiki for public comment, which is another opportunity to engage additional Stakeholders

» The process for which to document comments and feedback is one that promotes transparency and collaboration; feedback and actions will be captured in a table so Stakeholders are able to trace their own comments through each action taken by the Workgroup Leads

» Public comments will be evaluated and dispositioned by the Use Case and Functional Requirements Workgroup with guidance from the Initiative Coordinator and ultimately ONC

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Use Case Outline

» Business Processes• Preface & Introduction• Overview & Scope of Use

Case • Background• Policy Issues• Regulatory Issues• Communities of Interest • Challenge Statement • Value Statement • User Story • Use Case Assumptions• Pre-Conditions• Post-Conditions • Issues & Obstacles• Data Set Considerations

» Use Case Diagrams• Actors & Roles • Use Case Diagram

» Business Scenarios• Activity Diagram• Base Flow of Scenario • Sequence Diagrams

» Functional Requirements • Information Interchange

Requirements • System Requirements

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Use Case Mapping (for Illustrative Purposes)

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Overview and Scope of Use Case» Overview

• The Laboratory Results Interface Initiative focuses on defining requirements, specifications and standards for electronic exchange of clinical laboratory test results.

• The scope of the Laboratory Results Reporting to Primary Care Providers (in an Ambulatory Setting) Use Case includes requirements to enable the incorporation of clinical laboratory test results into an EHR as structured data using as part of a defined laboratory transaction.   

» In Scope• Sending and Receiving primary care core clinical laboratory test results• Incorporate clinical laboratory test results into certified EHR as structured data  

» Out of Scope• Ordering laboratory tests• Querying for laboratory results• Querying for historical laboratory results• Receiving historical laboratory results • Secondary use of laboratory data• Specialty laboratory orders • Receiving specialty laboratory results• Hospital ordering and reporting of laboratory results14

Use Case and Requirements Workgroup

How to Contribute in Between Meetingsvia the Wiki

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Navigating the Wiki

This menu can be used to access the contents of the LRI UCR Workgroup, as well as information on the S&I Framework and other Initiatives

These tables will list the artifacts that are open for Comments, the artifacts up for

Consensus, and the deadlines for both.

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These as are hyperlinked to enable easy access to the content that is up for comments.

Navigating the Wiki (Continued)

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This table lists the different Workgroup Participants of the Lab Results Interface Initiative – Use Case and Requirements Workgroup

The “Related Links” section is another way to access various

material relevant to the Lab Results Interface UCR Workgroup

Gathering Comments Using the Wiki

» The Review and Comments Log within Wiki will be used to:  

• Gather feedback from Committed Members, Invited Experts and Other Interested Parties.

• Document the actions taken by the Workgroup Lead(s) and/or Initiative Coordinator in relation to the comment

• Understand how each comment adds value to the final product

• Account for each suggestion, promoting teamwork and a positive environment for those who have dedicated their time to participating in the separate Initiatives

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How to add information within the Review Log:

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1) Click “Edit” at the top right hand corner within the Review Log of interest

How to add information within the Review Log (Continued):

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2) Populate cells in Columns 1-5 (in the next available row) within Table 13) Click “Save” in the top right corner of the page:

How to Trace Actions Taken Within the Review Log:

4) Scroll down the Review Log page until you arrive at Table 2(shown above)5) Navigate to the row within Table 2 which is assigned the same number as the row in Table 1 where you left your comments.

• Example: If you left your comment in Row 1 of the first table, the actions taken on your comment will be listed in Row 1 of the table shown above. 21

Next Steps

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Next Steps » Identification of Subgroup to review Existing/Related Use Cases » Please complete prior to the next Workgroup (Thursday, 2/10 at 3pm ET – please note

the time change)• Review and Comment:

– Preface and Introduction– Overview and Scope

• In Scope• Out of Scope• Background

• Review Only:– Overview and Scope (continued)

• Policy Issues• Regulatory Issues• Communities of Interest

– Challenge Statement – Value Statement

Wiki Link:http://jira.siframework.org/wiki/display/SIF/LRI+-+Use+Case+and+Requirements+%28UCR%29+Workgroup

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Questions

» If Questions, please contact UCR Workgroup Team Leads:

• Ed Larsen; e.larsen@ix.netcom.com

• Merideth Vida; merideth.c.vida@accenture.com

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Appendix

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Workgroup Logistics » The Laboratory Interface Use Case and Functional Requirements Workgroup will meet weekly:

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Date Time (1 hr) Workgroup Session

Thursday, February 3, 2011 2pm ET. Conference Call

Thursday, February 10, 2011 3pm ET. Conference Call

Thursday, February 17, 2011 3pm ET. Conference Call

Thursday, February 24, 2011 3pm ET. Conference Call

Thursday, March 3, 2011 3pm ET. Conference Call

Thursday, March 10, 2011 3pm ET. Conference Call

Thursday, March 17, 2011 3pm ET. Conference Call

Thursday, March 24, 2011 3pm ET. Conference Call

Thursday, March 31, 2011 3pm ET. Conference Call

Thursday, April 7, 2011 3pm ET. Conference Call

Thursday, April 11 – April 14, 2011 3pm ET. Face-to-Face Meetings (TENTATIVE)

Thursday, April 21, 2011 3pm ET. Conference Call

Thursday, April 28, 2011 3pm ET. Conference Call

Related/Existing Use Cases

» AHIC • Public Health Case Reporting• Biosurveillance (Visit, Utilization, and Lab Result Data)• Electronic Health Record (Laboratory Result Reporting) • General Laboratory Orders • Order Sets

» NHIN Direct Project • A Provider EHR orders a test • Laboratory reports test results for some specific conditions to public health• Laboratory sends lab results to ordering provider • Direct Specialist sends summary care information back to referring provider• Direct Hospital sends discharge information to referring provider

» HIMSS• Biosurveillance - Monitoring and Detection• Cancer Reporting - Prostate Cancer, Chronic Lymphocytic Leukemia

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Related/Existing Use Cases (continued)

» IHE• Publishing of lab summary at discharge• Publishing of patient report into the regional patient health record• Ambulatory provider shares a laboratory report• Private and/or public laboratory publishes all its reports automatically• Health care institution produces a cumulative laboratory report of test

performed on the patient• Public health laboratory shares report in a regional repository

» Other• EHR-Laboratory Interoperability and Connectivity Specification (ELINCS)

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http://jira.siframework.org/wiki/display/SIF/LRI+-+UCR+Background+and+Reference+Materials