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Agenda

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Welcome, Goals

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Public Health Reporting Architecture

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Use Cases/Bundles and MELD System

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HDEA Initiation (Hospital UC)

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HDEA Workflow Progression

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DEX Bundle Reception/Processing

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EDAV

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Next Steps

Welcome, Goals (5 minutes, Prachi)

Public MedMorph Health Reporting Care Surveys Solution Architecture (5 minutes, Prachi)

Use Cases/Bundles and MELD System (5 minutes, Mike)

Hospital use case patient: Brigg Dishman

Individual resource files for Brigg Dishman for loading into MELD/elsewhere

Brigg Dishman bundle produced/sent during Mini-Connectathon

Ambulatory use case patient: Fleming Strathman

Individual resource files for Fleming Strathman for loading into MELD/elsewhere

Fleming Strathman bundle produced/sent during Mini-Connectathon

HDEA Processing (15 minutes, Dragon)

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(Hospital UC first, Ambulatory UC second - time permitting)

Provisioning Workflow

HDEA Initiation

HDEA Workflow Progression (Notification, Report Creation, Report Submission)

HDEA-Generated Bundle Review

DEX Bundle Reception/Processing (MS Team, 10 minutes)

 Bundle Automated Bundle Validation

Bundle Upload to EDAV

Lessons Learned (10 minutes)

List…

Next Steps (10 minutes)

Sprint Schedule

Weekly Tech Team Meetings

Testing

Additional bundles (add more patients, more invalid bundle testing to cover known/expected issues)

Other EHR systems (Cerner, Epic, others)

Explore/address issues uncovered by pilot project

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Topics for this week

  • Update on 9/29 end-to-end bundle testing

    • HCS 9/29 Bundle Testing Project Plan

    • IG with dual profile (US Core and base FHIR profiles accepted)

      • Dragon is testing with MELD

      • Looking at issues with generated bundles

    • Extension/reference handling in bundles

      • Status: Dragon is making code changes to filter these out (on hold pending review of bundles generated using MELD)

    • Data entry into MELD

      • CHI will provide a patient data in a clean format for data entry purposes

  • Friday issues from 9/26 call:

    • Use MELD with an external HDEA (CHI/Drajer/NewWave)

      • Done

    • Get clean patient data into FHIR resources (CHI → NewWave)

      • JSON can be loaded quickly

      • Share spreadsheet with clean data when available

      • Can FHIR shorthand be used to facilitate transfer from CSV?

    • Send IG link to DEX team before EOD 9/26 (Dragon)

  • Schedule ongoing technical meetings

    • Weekly

    • Thursday afternoons?

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C34 recap

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Fed Retrospective of Connectathon 34 / Guidance for Future Connectathons

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DEX/HCS/RESP-NET testing going forward

  • Integrate HDEA updates made during C34 (done)

  • Fed suggestions

    • Code base move to CDC?

    • Aim for integration of changes / successful testing by 9/29?

      • 2 meetings/week

        • One track: code base (validation sync) (next meeting Thursday 4pm)

        • One track: data (entry into MELD {Cerner/Epic unlikely} ) (timing tbd)

    • Run against MELD, Epic, Cerner

    • Dev team review discrepancies (Prachi to send spreadsheet)

  • Continue with testing of HCS bundles

  • PlanDefinition issues discovered

    • Prachi slides

  • Work with HCS team when bundles are loaded into analytics platform

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Bundles for C34 (and forward)

  • Continue working on clinically valid bundles (Core1, Core2, Core3)

  • Ask Cerner/Steve Hill to enter data as new, separate patients

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DEX updates

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RNOF updates

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NCHS Partition

Testing notes:

Multiple bundles (3) are being sent due to retries

Smoking status data is invalid - update

References can cause an infinite loop

FHIR data from real-world systems have profile and extension issues (previously documented)

Provide patient data as individual resources for loading into MELD/elsewhere (see Dishman/Strathman resources above), resources as returned from MELD/elsewhere to HDEA, bundles as sent to DEX (see Dishman/Strathman bundles above)

Discussion (All, 10 minutes)

Next Steps (All, 10 minutes)

Bundle Export to Analytics Platform

Export from Analytics Platform for QA

Data Validation & Bundle Analysis (e-Health Signs)

HCS Sprint Schedule (Coordination between DEX, Carradora, HCS)

Weekly Tech Team Meetings

Attendees: DEX, Drajer, Carradora, MS, NewWave, DHCS, Cindy Bush (Optional)

Timing - determine in email (Mike to send)

Testing for Upcoming Sprint Cycles (All)

1 Rerun HDEA on Cerner, Epic sandboxes (using existing data)

2 Rerun HDEA on Cerner, Epic using clinically valid data

3 Add additional bundles (add more patients, more invalid bundle testing to cover known/expected issues) (Synthea or other tools?)

4 Review of data content against reporting requirements

5 Explore/address issues uncovered by pilot project

6 Engage with EHR vendors re sandbox updates, etc.

Supporting Infrastructure for Sprint Cycles