PCAST Workgroup Meeting Slides 01-27-11

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    HIT Policy CommitteeHIT Policy Committee

    PCAST Report WorkgroupPCAST Report WorkgroupFriday, January 27, 2011

    2:00pm ET

    Paul Egerman, Chair

    William Stead, Vice Chair

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    CalltoOrderCalltoOrder

    1. Call to Order/Roll Call

    Judy Sparrow, Office of the National Coordinator for Health Information

    Technology

    2. Overview of the Agenda

    Paul Egerman, Chair

    Bill Stead, Vice Chair

    3. Discussion: RFC on PCAST

    Jodi Daniel & Doug Fridsma, ONC

    4. Use Case Examples & Comparison

    Paul Egerman & Bill Stead

    5. Public Comment

    6. Adjourn

    Agenda

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    Workgroup Members

    Members:

    Dixie Baker SAIC

    Hunt Blair Vermont HIE

    Tim Elwell Misys Open Source

    Carl A. Gunter University of Illinois

    John Halamka Beth Israel Deaconess Medical Center, HMS

    Leslie Harris Center for Democracy & Technology

    Stan Huff Intermountain

    Robert Kahn [invited]

    Gary Marchionini University of North Carolina

    Stephen Ondra Office of Science & Technology Policy

    Jonathan Perlin Hospital Corporation of America

    Richard Platt Harvard Medical School

    WesRishel Gartner

    Marc Rothstein

    Steve Stack American Medical Association

    Eileen Twiggs Planned Parenthood

    Chair: Paul Egerman, Chair

    Co-Chair: William Stead, Vice Chair, Vanderbilt University

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    Workgroup Charge

    The PCAST Report Workgroup is charged to :

    Assist ONC synthesize and analyze the public comments and

    input to the PCAST report;

    Discuss the implications of the report and its specific

    recommendations to ONC on current ONC strategies;

    Assess the feasibility and impact of the PCAST report on ONC

    programs;

    Elaborate on how these recommendations could be integrated

    into the ONC strategic framework.

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    Meeting Dates

    January 7, 4:30 to 5:30 pm/ET

    Jan 14, 2 to 4 pm/ET

    Jan 27, 11 to 2 pm/ET

    Feb 10, 12 to 2 pm/ET

    Feb 15 16 17, one of these dates (or perhaps 1.5

    days) for an in-person meeting in Washington -TBD

    Mar 3, 1 to 4 pm/ET

    Mar 17, 10 to 1 pm/ET

    Meeting Dates

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    Use Case to Illustrate Stage 1 MU Patient Summary

    Use Case #1:

    Patient presents to the emergency department

    complaining of severe chest pains that were suffered

    while patient was working on a home improvementproject. In this use case, using Stage 1 of MU, the ED

    clinician retrieves a CCD patient summary, which

    contains important information that is needed to treat

    the patient. An active medications list is necessary,

    along with a problem list. Indeed, the sample datashows an existing cardiac problem that could be

    relevant.

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    Sample Patient Summary - Text Form

    Problems

    1. AV Nodal Reentry

    Tachycardia (Active)

    2. Glaucoma (Active)

    3. Vegan (Active)

    4. Lyme Disease

    (Resolved)

    5. Corneal Abrasion

    (Resolved)

    Medications

    1. Centrum Silver 1

    PO qd

    2. Vitamin D3 1600

    units PO qDay

    3. Xalatan 1 drop

    each eye qhs

    Vital Signs

    BP: 115/70

    Pulse: 50

    Respiratory Rate: 14

    Height: 73 inches

    Weight: 170 pounds

    Body MassIndex: 22.4

    Immunizations

    Hepatitis A vaccine:

    #1 Sep 03, 2004

    Hepatitis A vaccine:

    #2 Mar 01, 2005

    Tetanus vaccine:

    Jun 20, 2008

    Pneumovax:

    Sep 03, 2009

    Influenza:

    Oct 19, 2010

    Allergies

    1. Penicillin (Rash)

    Labs

    Cholesterol: 135

    Triglyceride: 59

    HDL: 40

    Procedures

    1. RFID Chip Implant

    in right triceps

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    Patient Summary in XML

    Continuity of Care Document

    5739 Hazel Street

    Williamsport

    PA

    17701

    USA

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    Use Case to Compare Stage 1 of MU with PCAST

    Report

    Use Case #2:

    Patient presents to the ED after suffering a minor laceration that

    occurred during a home improvement project in a bathroom.

    Only simple first aid is needed. Because of the circumstances of

    the injury, the ED nurse would like to check the status of the

    patient's tetanus immunization.

    MU Stage 1 Transaction: Entire patient summary document is

    requested. As the sample data set shows, the patient summary

    would contain the immunization status, but it would also contain

    other information that is not needed.

    PCAST Approach: The nurse could request the Tetanus

    immunization status only.

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    CCD Summary of Patients Immunization Record (code)

    Hepatitis A vaccine #1

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    CCD Summary of Patients Immunization Record

    (HTML)

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    Illustration of Metadata Tagging - PCAST Approach

    XML based Structure

    Encrypted Immunization Data

    For Example:

    Privacy : Yes

    Yes;

    Dr. JamesResearch ,

    Attributes : Patient Identification , Date = June 20, 2008, Vocabulary identification

    (e.g. SnomedCT 96412003),

    Site Provenance : Manufacturer of immunization and batch number

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    Use Case from PCAST Report

    Use Case #3:

    When Patient changes provider, new physician wishesto examine multiple Mammograms that were taken at

    multiple sites over a long period of time.

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    Use Case #3 from PCAST Report (cont.)

    Structure is still

    >

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    Definition of Metadata

    Metadata: Data about data

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