May 13, 2005 “Out-of-Cycle” MeetingMinutes
08:30 AM – 13:00 PM EST
National Association of Children’s Hospitals and Related Institutions (NACHRI)
401 Wythe Street
Conference Room 1
Alexandria, VA 22314
Meeting Participants:
David Classen; Andy Spooner; Cheri Throop (Co-Chairs)
Noorullah Akhtar; Nancy Anthracite; Hema Bisarya; Lorna Dyke; Phillip Gioia (phone); Gregg Lund; Michael Miller; Rick Moore; Jason Napora; Anna Orlova (phone); Ken Pool; Mitra Rocca; Joseph Schneider; Aileen Sedman; Henry Shapiro; Lisa Simpson (phone);Sam Walters; Carl Weigle; Feliciano Yu
Meeting Objectives:
Set priorities for next projects
Draft charters
Identify project champions
Establish project timelines.
The meeting was called to order at 08:30 AM Eastern Time.
Agenda Item #1: National Updates
David led the group through a national update on ONCHIT, CCHIT, and other activities of interest related to data standards. Joe, a member of one of the CCHIT workgroups (see section 5 of meeting handout materials), explained this group’s timelines (September 2005) and urgency for our SIG to interface with this work. Based on discussion, the following motion was seconded and approved by those present.
ACTION ITEM:
1)Map PDSSIG pediatric requirements for EHR to CCHIT requirements
2)Identify gaps based on this mapping process and incorporate into strategic plan for years 2006-2008.
David also shared that efforts are underway to certify IT products post implementation. Funded by AHRQ, Leapfrog Group, and Robert Wood Foundation, a flight simulator to evaluate the CPOE post implementation is under development.
Agenda Item #2: Update on current grant-funded initiatives
Hank updated the SIG on his developmental screening project to engineer a roadmap of clinical behavioral issues to guide appropriate data requirements.
Lisa shared initial progress as the National Child Health Data Standards Workgroup, a two-year funded project, has been launched. Using our SIG’s prioritization results from January 2004, this group is working to identify clinical specific data standards (e.g. asthma). Technical panels are being formed and based on a comprehensive survey process; papers will be written for publication with a target completion date of October 2005. Lisa asked that the survey results and content information about the technical panels be shared with SIG membership. Lisa plans to hand off their workgroup’s deliverables to our SIG. Another one-day meeting for this workgroup is planned in conjunction with the NICHQ Annual meeting in March 2006.
Andy reiterated that AAP has taken the position that informatics will be integrated into each of their guidelines as a new strategic imperative.
Aileen suggested we consider developing a template tool for subspecialties to use in identifying critical pediatric requirements for the EHR following the same process steps our SIG used. There was a motion and approval of this recommendation.
ACTION ITEM:
3)Create a toolbox including templates for pediatric and other specialties to identify pediatric requirements for the EHR.
Agenda Item #3: EHR-S Project and Beyond
Andy shared the PowerPoint presentation he presented to EHR-TC in January. He also shared the outcome of the April 20th conference call including official delivery of the pediatric functional requirements to both the EHR-TC and Patient Care TC. There has been no feedback from either group post Netherlands meeting at this time.
As requested by both the EHR and Patient Care TCs, our SIG will provide whatever expertise and assistance needed as the refinement process proceeds ahead of the official 2006 HL7 balloting process.
Next steps beyond the pediatric functional requirements were discussed including storyboards, use case scenarios, and how to make the document more user-friendly for vendors, others. Based on the examples included in the current EHR pediatric requirements document, a project is proposed to develop storyboards and send these as scenarios to CCHIT as reference documents.
ACTION ITEM:
4) Develop storyboards (use case) based on examples included in current HER pediatric requirements for submission to CCHIT.
Joe and Andy updated the SIG on TEPR/AAP TLC harmonization efforts. The SIG recommended that mapping be performed using our pediatric EHR requirements.
ACTION ITEM:
5) Harmonize Pediatric EHR requirements and TEPR/AAP TLC.
Aileen identified the continued gap between what is coded through the hospital HIM department process versus what is transmitted via tapes, etc. to vendors. Vendors are not required to accept all codes linked to each patient’s hospital encounter due to individual state and other requirements; thus coding information transmitted is often incomplete. This may have a significant impact, particularly related to E coding nomenclature used to identify adverse events. Aileen and Lorna have agreed to champion developing an advocacy statement for possible submission to CMS, AHIMA, others to address thisdisparate practice.
ACTION ITEM:
6) Develop a statement regarding standardized transmission of all ICD-9 codes linked to patient encounters.
Agenda Item #4: Public Health SIG
Ken Pool and Anna Orlova provided an update on their SIG’s activities and possible interface with the PDSSIG, in particular birth registries and the EHR. Discussion ensued related to PHRs. Cross-mapping capabilities of clinical data with public health data for children at 2 days of life forward (e.g. newborn screening; hearing screening; immunizations) was identified as a critical component. Anna will send a copy of the Public Health EHR requirements (white paper) for dissemination to PDSSIG members.
Ken recommends our SIG devote time at the September WGM to public health. Ken will be the key contact and assist in arranging time and key linkages.
ACTION ITEM:
7)Public Health SIG representatives to meet with PDSSIG during September 2005 meeting.
Agenda Item #5: CDA clinical specifications
Andy walked the SIG through the HL7-approved Children’s Preventive Health Services (CPHS) Attachment document provided by Penny Sanchez. The work to develop this product was launched well before our PDSSIG was formed. Questions regarding how to link our SIG with pediatric efforts like this surfaced including how those working on CDAs such as this one seek input from clinical specialties including clinician approval processes.
Everyone agreed further education on the CDA process outlined in this document is a critical next step. Penny Sanchez has already agreed to present to the PDSSIG during the September WGM. Andy stressed the importance of responding to the CPHS when balloted by HL7. Joe described the CCR as the generic tool where there are gaps in the current HL7 approved documents. CDA is the structure.
NCQA is using CDA modeling for their current measure requirements. SIG members are encouraged to keep apprised of these activities.
Agenda Item #5: Marketing
General consensus was reached that our SIG needs to publish what we have learned from our first product deliverable. Vendors need to be informed that this product is immediately available for their use. Although organizations represented within our SIG may understand this, the message may not be getting to the vendors who are not participating.
This will be added as an agenda item for the September WGM.
HOMEWORK ASSIGNMENTS:
Project: Map Pediatric EHR Requirements to CCHIT Requirements
Target Completion Date: September 2005
Project Champions: Andy Spooner/Joe Schneider
Participants:
Aileen Sedman
David Classen
Nancy Anthracite
First Project Deliverable:
Complete Project Charter (July)
Project: Create a toolbox including templates for pediatric and other specialties to identify pediatric requirements for the EHR
Target Completion Date: TBD
Project Champions: Michael Miller; Aileen Sedman
Participants:
Noorullah Akhtar
Feliciano Yu
Sam Walters
Mitra Rocca
First Product Deliverable:
Complete Project Charter (July)
Project: Create storyboards (use case) from the existing examples of the EHR pediatric requirements for submission to CCHIT.
Target Completion Date: TBD
Project Champion: Feliciano Yu
Participants:
Terese Finitzo
Anna Orlova
Noorullah Akhtar
First Product Deliverable:
Complete Project Charter (July)
Project: Harmonize Pediatric EHR requirements and TEPR/AAP TLC
Target Completion Date: TBD
Project Champions: Andy Spooner; Joe Schneider
Participants:
First Product Deliverable:
Complete Project Charter (July)
NEXT WGM MEETING:
September 11 — 17, 2005
19th Plenary and Working Group Meeting
Location:Town and Country Resort
San Diego, CA
Early Bird Registration and Hotel Cutoff: August 11, 2005
Pediatric Data Standards Special Interest Group Tracking Log:
ITEM: / ResponsibleParty: / Date
Initiated / Date
Closed / Additional Comments:
Finalize education day / Cheri Throop / November 14, 2003 /
CLOSED
2/15/04 / April 13, 2004 in San AntonioRecruitment / All SIG members / November 14, 2003 / ONGOING / Formal letter to FDA (David/Andy)
-See 1/19/04 minutes for specialty members still needed.
2/27/04: Efforts to enroll international pediatrician participant underway
3/31: Andy/Cheri develop draft brochure (COMPLETED)
5/3: Recruitment continues; need for international representation.
Request Liora Alshuler to attend May 3, 2004 meeting / Cheri Throop / January 19, 2004 / CLOSED
5/3/04 / 2/27: Liora has agreed to present
4/20/04: Follow up with Liora
Request Clem McDonald to attend May 3, 2004 meeting / Paul Biondich / January 19, 2004 / CLOSED
5/3/04 / 4/20/04: Communication to Paul regarding Clem’s availability.
4/25/04: Paul contacted Stan Huff who will be presenting at our meeting.
Request Clinical Decision Support SIG presentation at May 3, 2004 meeting / Cheri Throop / December 22, 2003 / CLOSED
4/21/04 / 2/27: Request made and DCS S:IG representative plans to attend
4/21: Matt Sailor to present
Growth Chart Project Update / Aileen Sedman / January 19, 2004 / OPEN / 2/27: See minutes
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Prenatal to Perinatal Care Project / Andy Spooner / January 19, 2004 / OPEN / 2/27: See minutes
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Developmental Care Project / Paul Biondich / January 19, 2004 / OPEN / 4/13: Update provided for education day
5/3: Update provided for WGM
5/3/04: integrate in to PIR-EHR
WIC documentation form project / Cheri Throop
Ellen Schwalenstocker / January 19, 2004 / OPEN / 2/27: See minutes
3/31: Hema Bisarya will assist with this project.
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Pediatric Electronic Health Record Project / Feliciano Yu / February 27, 2004 / CLOSED
4/20/05 / 3/31: David Milov will assist wit this project.
4/13: Update provided for education day
4/13: Noorullah Akhtar will assist with this project
5/3: Update at WGM
5/3/04: integrate in to PIR-HER
7/6/04: Accountability for specific sections assigned
Asthma Core Measures / Cheri Throop
Ellen Schwalenstocker / January 19, 2004 / CLOSED
Measures in JCAHO pilot (Spring 2005) / 2/27: see minutes
3/31: Hema Bisarya will assist with this project.
4/13: Update at education day
5/3: Update at WGM
5/3/04: integrate in to PIR-EHR
Strawman proxy ballot process / Andy Spooner
David Classen / January 19, 2004 / CLOSED 5/3/04 / 2/27: See minutes
3/31: Draft document will be sent to SIG members prior to May meeting
4/26: PDSSIG Decision Making document to SIG members for approval
5/3: Agenda item for WGM
IOM Electronic Health Record framework –distribution to SIG members / David Classen / January 19, 2004 / CLOSED2/9/04 / 2/9/04: Distributed
Invite Helga Ripen to PDSSIG conference call / Cheri Throop / May 3, 2004 / OPEN / 5/3/04: member of NHII group
Form PDSSIG Vocabularies subgroup (Paul Biondich; Clem McDonald; Stan Huff) / Andy Spooner / May 3, 2004 / OPEN / 5/3/04: See minutes
Recruit and recommend pediatric representation on SNOMED CT working group (Kent Spackman)
- Funding for representative
June 1, 2004 / CLOSED6/1/04
OPEN / 5/3/04: See minutes
6/1/04: See minutes. Paul Biondich is willing to serve in this role.
6/1/04: SIG Co-chairs to work on this issue.
Conference call with Kent Spackman (SNOMED CT)
Discussion with Ed Hammond: Coordination efforts – our SIG and SNOMED CT
Funding inquiries: NLM and AAP / Andy Spooner/David Classen
David Classen
Andy Spooner / June 1, 2004 / CLOSED7/20/04
CLOSED
6/29/04
OPEN / Pediatric Representation
David had conversation with Ed Hammond on June 29 2004. He advised that we proceed with conference call as planned.
PDSSIG “one-pager” as communication tool / Andy Spooner/David Classen/ Cheri Throop / July 6, 2004 / CLOSED7/20/04 / (Due July 21 for upcoming AAP and NHII meeting)
Conference call with Dr. Dale Nordenberg / Andy Spooner/David Classen/Cheri Throop/ Carl Weigle / August 3, 2004 / CLOSED 9/1/04 / Conference call convened; Follow up communication regarding PDSSIG
Obtain copy of EHR-S excel tool from Patient Care TC / Cheri Throop / September 29, 2004 / CLOSED10/4/04 / Requested post HL7 meeting; received October 4, 2004
Obtain copy of storyboard examples from Patient Care TC / Cheri Throop / September 29, 2004 / CLOSED10/4/2004 / Provided by Dan Russler to our SIG
SIG Members sign up to monitor SIG/TC listserv / PDSSIG / September 29, 2004 / OPEN / EHR TC – Andy Spooner
Public Health – Therese Finitzo
Data Modeling – Sam Walters
Patient Safety – Cheri Throop/ Aileen Sedman
Community Health - ?
Patient Care – Noorullah Akhtar
SNOMED Group: formal request to form pediatric group / Paul Biondich/Andy Spooner/David Classen / October 25, 2004 / OPEN / Waiting for formal communication to co-chairs from SNOMED
Discussion on publicizing and recruitment needs
David to communicate with Ed Hammond
Recommendations to EHR-TC / Cheri Throop / November 22, 2004 / CLOSED11/24/2004 / E-mail of DC recommendations for EHR-TC consideration.
Recommendations to EHR-TC / Cheri Throop / December 20, 2004 / CLOSED12/23/04 / E-mail of Supportive Care recommendation to EHR-TC for their consideration.
Develop more formal business/communication plan for PDSSIG / Cheri Throop
David Classen
Andy Spooner / January 24, 2005 / OPEN / For recruitment needs as communication vehicle
Formal Letter to EHR-TC with global recommendations / Cheri Throop
David Classen
Andy Spooner / January 24, 2005 / OPEN / Post EHR-TC joint meeting on 1/26/05.
Formally submit to EHR-TC during April conference call
Publish our project / Co-leaders and entire PDSSIG / January 24, 2005 / OPEN / Recommendation of EHR-TC during joint meeting on 1/26/05
Map PDSSIG pediatric requirements for EHR to CCHIT requirements / Andy Spooner
Joe Schneider / May 13, 2005 / OPEN / 5/13/05: project team proposed; champions identified; charter under development
Create toolbox including templates for pediatric and other specialties to identify pediatric requirements for EHR / Michael Miller
Aileen Sedman / May 13, 2005 / OPEN / 5/13/05: project team proposed; champions identified; charter under development
Create storyboards (use case) from the existing examples of the EHR pediatric requirements for submission to CCHIT / Feliciano Yu / May 13, 2005 / OPEN / 5/13/05: project team proposed; champions identified; charter under development
Harmonize pediatric EHR requirements and TEPR/AAP TLC / Andy Spooner
Joe Schneider / May 13, 2005 / OPEN / 5/13/05: project team proposed; champions identified; charter under development
Develop statement regarding standardized transmission of all ICD-9 codes linked to patient encounters / Aileen Sedman
Lorna Dyk / May 13, 2005 / OPEN
Parking Lot Issues: / Date Identified / Date Resolved:
Aileen asked how we prevent redundant work across HL7 groups as well as across national entities / January 19, 2004 / September 29, 2004 (see meeting minutes)
Aileen asked for further guidance on what format our SIG projects need to be for delivery to other HL7 groups. / February 27, 2004 / September 29, 2004
(see meeting minutes)
Aileen asked how HL7 work is kept up to date. / May 3, 2004 / September 29, 2004
(see meeting minutes)
PDSSIG Logo model under review by HL7 for their approval / May 18, 2004 /
July 6, 2004
How do we handle external vocabularies?(Hank Shapiro) / October 25, 2004How do we deal with existing guidelines in developing a standardized approach?(Hank Shapiro) / October 25, 2004
Issues of functionality of decision support as it relates to vocabulary, context, and measures (Hank Shapiro) / October 25, 2004
PDSSIG MEMBERSHIP LIST:
David Classen, M.D., M.S.SIG Co-Chair
Associate Professor, University of Utah
VP, First Consulting Group
561 E. Northmont Way
Salt Lake CityUT84103
(888) 546-8746
(801) 596-3443 (fax)
Andy Spooner, M.D., FAAPSIG Co-Chair
Director of Medical Informatics
LeBonheur Children's MedicalCenter
50 North Dunlap Street
MemphisTN38103-2800
(901) 572-3292
(901) 572-5198 (fax)
Cheri Throop, R.N., MHSA, RHIT, CPHQSIG Co-Chair
Chief Quality Advisor
Child Health Corporation of America
6803 West 64th Street, Suite 208
ShawneeMission, KS66202
(913) 262-1436
(913) 262-1575 (fax)
Noorullah Akhtar, M.D.
Pediatric Intensive Care Physician
Driscoll Children's Hospital
3533 South Alameda Street
Corpus ChristiTX78411-1721
(361) 694-5445
(361) 694-5449 (fax)
Nancy Anthracite, M.D.
9423 Jongroner Court
Potomac MD 20854
202-273-4960 (office)
301-738-2150 (home)
Paul G. Biondich, M.D., M.S.
Assistant Professor of Pediatrics/Informatics
Children’s Health Services Research Program
RileyHospital for Children/The Regenstrief Institute
1050 Wishard Blvd, RG5
Indianapolis, IN46202
(317) 630-7785
Hema Bisarya, RD, MHSA
Project Manager
Child Health Corporation of America
5005 W. 158th Street
Overland ParkKS66224
(913) 262-1436
(913) 262-1575 (fax)
Wayne Brandes, D.O., M.P.H.
Director of Healthcare Informatics
American Institutes for Research
ProspectCenter
10720 Columbia Pike
Silver SpringMD20901
(301) 592-2108
(301) 593-9746 (fax)
Arpi Chalian, M.D., F.A.A.P.
Healthcare Executive
Cerner Corporation
2800 Rockcreek Parkway
Kansas CityMO64117-2551
(417) 786-3880
(816) 571-3357 (fax)
Constantine Constantinides, M.D.,Ph.D.
HealthCare cybernetics
41 Derigny Street
GR - ATHENS 104 34
GREECE
Tel.: +30 6945 85 76 42
Deb Coonen, R.N.
Clinical Informatics
Children’s Hospital of Wisconsin
PO Box 1997 MS 600
Milwaukee, WI53201-1997
Lorna Dyk, R.N., M.B.A
Director of Resource Management Services
The Children's Hospital
1056 East 19th Avenue
DenverCO80218
(303) 864-5834
(303) 861-6963 (fax)
Donna Lee Ettel, Ph.D.
Research Associate
University of SouthFlorida
Division of Child Health Outcomes
601 4th Street South, CRI 1008
Saint Petersburg, FL33701
(727) 553-3673
(727) 553-3666 (fax)
Kaye H. Fendt, M.S.P.H.
Research Associate Professor, Department of Pediatrics, UNC-CH
2814 Meadows Drive
Hillsborough, NC27278
(919) 966-9043
(919) 843-7351 (fax)
Terese Finitzo, Ph.D.
Vice President Performance Support Services
OZ Systems
2515 McKinney Avenue, Suite 850
DallasTX75201
(215) 631-6161
William (Bill) Fletcher
Manager, Outcomes
Children’s Hospital Central California
9300 Valley Children’s Place
Madera, CA93638-8761
(559)353-5043
(559)353-7296 (fax)
William Flood M.D.
InscriptionHouseHealthCenter
PO 7397
Shonto, Arizona 86054
928-672-3000
928-672-3005 (fax)
Gary Frank, M.D.
Nemours Foundation
4600 Touchton Road East
Building 200, Suite 500
Jacksonville, FL 32246
CDR Emory Fry, M.D.
Head, Department Application Development
Naval Medical Center, San Diego
34800 Bob Wilson Drive
San Diego, CA 92134
619-532-8998
Phillip Gioia, M.D., M.P.H.
Children's Health Specialists
37 West Garden Street, Suite 201
AuburnNY13021
(315) 253-6257
Edward M. Gotlieb, MD, FAAP, FSAM
Medical Director
The Pediatric Center
5405-D Memorial Drive
Stone Mountain, GA 30083
(404) 296-3800
Stone Mountain, GA 30083