PDMP & HITI Solution Planning Workgroup

SessionJune 5, 2014

Agenda

1. Solution Planning Approach

2. Current Standards Landscape Summary

3. Questions to be Answered

4. Relevant Workflows

5. Evaluation of Proposed Solutions

Solution Planning Work Group Approach

1. Overlay standards currently in general use per transaction - focus on transactions for integrated solutions

2. For each alternate workflow, propose solutions for harmonizing standards in order to pull PDMP information into EHR or Pharm. IT Systems synchronously

3. Document pros and cons for each proposed solution and prioritize in terms of technical feasibility D

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Summary of Current Standards Landscape

Key Takeaways:• EHR HIE PDMP transaction model is currently in use as a transaction model

{SCRIPT/PMIX}• EHR In-State PDMP direct model not general used

– If used, interface layer necessary to perform necessary translations to PMIX• PDMP PDMP, Hub PDMP, HIE PDMP transactions leverage PMIX-NIEM Architecture• Translation from EHR system standards (eg. HL7 messaging) to PMIX must occur prior to Hub

to PDMP transaction– Thus, translations can occur from the EHR system to the HIE, the HIE to the Hub, the EHR

system to the Hub, or the HIE to the PDMP• Pharmacy IT systems do not need to go through pharmacy intermediary

– Pharmacy IT can route through HIE, but generally do not for purposes of controlled substance data exchange

• SCRIPT used for medication history exchange, but not currently for PDMP-specific data exchange within Pharmacy IT landscape

• Network intermediaries (Emdeon, Surescripts) can provide PDMP data exchange translations and infrastructure

• NABP PMPi will be capable of translation services

Questions to be answered:

• How do we define intermediaries and their relationships to Health IT systems?o Can we collapse all types of intermediaries into one entity? (i.e. pharmacy,

switch, HIE, etc.) or do they require to be differentiatedo Pharmacies may have need for intermediaries o Future state use of intermediaries or networks to provide controlled substance

history reports

• Can Pharmacy IT systems and EHR systems be collapsed or need to be differentiated?o Differences in pharmacy and clinician workflows / data systems and

expectations in PDMP data transmitted?

• Differences in care settings - Ambulatory vs. Acute; In-hospital pharmacies vs. retail pharmacies. Are different standards needed for different EHR systems or different pharmacy settings?

• Are there certain workflows that are unfavorable?

Relevant Workflows

Current Landscape

Proposed Solution Set

EHR In-State PDMPPharmacy In-State PDMP

EHR Intermediary In-State PDMPPharmacy Intermediary In-State PDMP

EHR Hub PDMP(s)Pharmacy Hub PDMP(s)

EHR Intermediary Hub PDMP(s)Pharmacy Intermediary Hub PDMP(s)

EHR In-State PDMP Hub PDMP(s)Pharmacy In-State PDMP Hub PDMP(s)

EHR In-State PDMPPharmacy In-State PDMP

EHR Intermediary*Pharmacy Intermediary

EHR Hub Pharmacy Hub

1. Aligns to in-scope Use Case scenarios

2. Approach may require translation mapping between ASAP, NCPDP SCRIPT Medication History, and H L7 V2 Messaging to PMIX Architecture

3. Implementation Guide will have to include data element modifications/additions to fully support PDMP & HITI Use Case requirements

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*Intermediary - An entity (service, or set of services) that routes the transaction to a receiving entity. May perform value added services such as translating data from one format to another

LegendProposed

Potential

Remove

Evaluate Proposed Solutions

Solution Plan: Solution Plan

Next Steps

• Review: Transaction and solution evaluations

• Next All Hands meeting is Tuesday, 6/10 from 12:00 pm to 1:00 pm ETo Data Elements Analysis

• Next Solution Plan Workgroup Session is Thursday, 6/12 from 12:00 pm to 1:00 pm ETo Continue Workflow – Standards Evaluationso Evaluate prioritization of proposed solutionso Goal: Finalization of solution set

• Reminder: All PDMP & HIT Integration Announcements, Meeting Schedules, Agendas, Minutes, Reference Materials, Harmonization materials, Use Case, Project Charter and general information will be posted on the PDMP Wiki page– http://wiki.siframework.org/PDMP+%26+Health+IT+Integ

ration+Homepage