S&I Public Health Tiger Team (PHTT) Meeting Notes
Date: 8/12/14
Time: 2:00 – 3:00 EDT
Attendees: Sharon Tiplady, Dan Chaput, Mark Sum, Charlie Shisikawa, John Roberts, Rita Altamore, Sam
Ramosevac, Lea Trujillo, Jim Jellison, Michael McPherson, Kristina Cordes, Kari Guida, Marcus Rennick,
Dina Dickerson, Sarah Mange, Rita Torkzadeh, Sanjeev Tandon, Karen Monsen, Jeff Benning (LIC), Shreya
Soni, Kristina Cordes, Marques Merriweather, Heather Patrick, Hetty Khan, Hwagan Chang, John
Abellera, John Ritter, Gonza Namulanda, Tammara Jean Paul, Bryant Karras, Catherine Staes, Cathy
Welsh, Stephen Soroka, Genny Luensman, Peter Goldschmidt, Nedra Garrett, Melvin Crum, MariBeth
Gagnon, Shu McGarvey, John Donnelly (sp?)
Total Participants - 51
PLANNED AGENDA
 Admin Update
o Brief overview and update of iniatives
 Review potential audiences
o Conferences (started last week)
o Teleconference, webinars and educational series
 PHTT Deliverables (including brief look at our charter)
o Shall we further define deliverables and dates?
o Perhaps some high-level quarterly plan
 SWOT analysis of PHTT (including a brief look at our charter)
 Presentation follow-up/status
ADMIN UPDATES
 Looking for participants for IHE connectathon in January 2015
 Tipsheet that came out, any questions let us know
 DAF
o Our interest is primarily in the multiple data source accessed by a distributed query
(formerly query health)
o Decision was unanimous by community to move forward with:
 Pursue FHIR for simple DAF data element queries using existing DSTU and create
profile and IG as needed.
 Monitor CQL and how it evolved as a query syntax for complex queries instead
of developing a parallel query syntax
 CQF
o See slides for update
 Continuing to pursue partnerships with Million Hearts
 Watching EHDI pilot project
PLACES TO PRESENT – WEBINARS/TELECONFERENCES/CONFERENCES
 Charlie: HIMMS – EHRA (HER Vendor association group)
 John Roberts: HL7 – PHER
 Locals NALBHO – National Association of Local Boards of Health http://www.nalboh.org

SDC capture initiative looking to get participants in IHE connectathon this January. Registration
is August through October, will send out PDF of information.
 John Ritter – category of healthcare executives/administrators. They might want to send
somebody to list in on this
o Best to represent?
o Hospital association
o Someone associated with the finances to assess the impact on finances and funding
 John Ritter – anyone who builds/utilizes/manages/governs/legislates HIEs they need to know
what the public health window can/should be.
 Via chat from Rita Torkzadeh to Host (privately): IHE Quality Research and Public Health (QRPH)
Domain
 Via chat from Charlie Ishikawa to All Participants: AHIMA
 Bryant – dissemination opportunity working with PHII and the work their doing to educate the
fellows and i-TIPP and other informatics trainees around the country
o Group of professionals that know how to educate informatics
o Don’t have a conference but have regularly scheduled webinars with targeted audience,
keep them in the loop so they can keep others in the loop
o Public health university professors, they don’t really have a society
 A lot of informatics faculty are members of other organizations such as AMIA.
 Bryant - CMS conference in DC, Bryant attending a regional conference at the end of this month
and will be discussing some of these topics.
o Who from CMS? Medicaid directors?
 Each state tends to send 3 representatives, HIT coordinator, the incentive
program manager, and someone else.
o Who might we contact? Anita for DC, could she also do the regional ones?
 Dan to follow up with Anita to see what we can do in that space.
 Charlie - People who desire to donate money and run foundations/donors/benefactors, they
need to know what the latest and greatest interests are.
 John Roberts – CDC operates a CDC public health informatics fellowship program (both in house
and deployed out to the states)
o PHII is the educational arm of the fellows program
 John Ritter – the organizations that hope to certify systems or prove their validity. Certifying
organizations that grant certification. Authorized Trust in Bodies? CCHIT and its cousins
o John Donnelly – valid path, it’s usually associated with some type of program, such as
the MU program, testing and certification bodies would certainly have to know about
the requirements for public health.
 NIST
 Bryant - Association for Health Statistics??
o NCBHS?
o NAPHRegistries Bryant – similar in emergency preparedness realm – look up proper
name.
o NEMSIS – emergency management other is
o NAPSIS – National Association for Public Health Statistics and Information Systems
 NACCR – National Association for Cancer Registries
 Bryant - Prescription drug monitoring?
o NCPDP
Will clean that list up a bit and come around to it next time
TIMELINE AND DELIVERABLES
Looking at things by quarters, we’re in the middle of 3rd quarter for 2014.
Chunk out work by quarter to get some deliverables in mind and clear objectives to be driving towards.
Look at charter and deliverables. Charter might not be spot on and might need some adjusting











July – September (3rd Quarter)
Participation in S&I Initiatives - ongoing
Artifacts and activities – a little unclear but that’s ok
Public Health-related use cases for S&I Initiatives – there might be a gap there in the world of
data provenance. Will talk about that before the end of today’s meeting.
o Are public health use cases represented right now within our 3 major areas of focus?
 Jim Jellison – DAF and CQF don’t have as much well thought-out material on
those 2 as we do SDC.
Public Health-related use cases that span multiple S&I initiatives
S&I Initiatives dependencies
Key public health focused leads for each S&I initiative including policy, practice, and technical
level leads as needed – have we done that well, might be a little short in that deliverable/might
want to be better organized?
o Don’t want everyone to be on every call, but not sure we’re as optimized as we could
be, not sure we’re covering all the places we need to cover
 Jim Jellison – agree
 Make for a deliverable for this quarter, propose that we document leads for
each imitative (we started it at some point in time but need to nail it down)
 We try to attend as many meetings as possible but some meetings are very low
down in the weeds
o Clarify DAF and CQF use cases (deliverable)
 Catherine Staes – was co-author was co-author or use case and has been
defined and can be shared. Public Health pilot projects being done?
 Jim’s comment was that compared to other use cases we speak more
about SDC, but the DAF and CQF use case that addresses public health is
not as at the top of our mind as the other are.
 Catherine – if people wanted the 101 on what CQF is about, and there is
a public health use case related to Chlamydia screening. RCKMS project
(not a formal CQF project) there will be mapping things along that same
line. If the need is to understand what the overall use case is Catherine
is happy to present.
 Will be in touch with Catherine, maybe next time we can dive into that
use case in particular
o Clarify Data Provenance use cases (deliverable)
o Add deliverable for presentation materials
Revisions to standards that incorporate emerging technologies (e.g. FHIR as the standards
become developed and available)
PHTT standards, guidance, approaches, and recommendations for promotion – deliverable for
this quarter: determine a format for this so we can start thinking now about what our end
project is going to be
Documented processes for ensuring public health objectives are communicated to S&I leads and
PHTT standards document are maintained
October – December timeframe (4th Quarter)
o
Marcus pointed out while working on presentation materials – question of
implementing. How do you actually implement one of these frameworks.
 Presentations on implementation model
 If we’re not clear on this, people imagine it being very easy and solving every
problem that they have.
o Deliver our message to a larger audience
o Final reports and recommendations on the outcome of at least one pilot for each
initiative with a public health-related use case – pilot recommendations (begin)
o Jim Jellison – not sure how coupled we want to get with IHE Connectathon – put as
deliverable for September
 Work with connectathon contacts
 Prepare for showcase in April
John Donnelly – technical project manager for the IHE connectathon. Registration is in September, if
parties are interested in supporting the profiles from vendor side would have to express their interest in
September. For the showcase later, in April, promotion of public health use cases in all flavors we would
be interested in having a robust topics.
We can distribute this list of deliverables to be reviewed by members and incorporate any additional
suggestions.
Success Criteria from charter
 Could we do a better job in identifying resources for S&I Pilots? Are we missing opportunities.
 Engage stakeholders – don’t know that we have done this, should this be a success criteria?
How should we work with that? Is our charter wrong? Or is there something we should be
doing that we are not doing?
o Jim Jellison – now that I look at this again, many of those items seem vague. Maybe it’s
too ambitious, if we could get a public health use case tested for SDC, CQF, and DAF
either through connectathon showcase venue or some other way. If we were to do
that, we will have done all the other success criteria and it’s more tangible.
o John Ritter – I disagree a bit. If we have a successful test at IHE’s connectathon will we
have also engaged the university professors, the benefactors and donors, healthcare
analysts, people who make laws that govern the HIEs? The list that we created 15
minutes ago lists the stakeholders, so our deliverable needs to list all those stakeholders
and how we touch to each one of them.
o John Donnelley – excellent point, to your initial question in terms of the connectathon
and showcase is certainly a subset of those stakeholders. Don’t think it will reach all of
them, but need to think of the venues that do reach those individuals. Professionals that
are interested in the population health space as well as immediate care delivery,
audience that might drive the uptake and interest.
 Making a deliverable to flesh out how to reach our individual stakeholders
 If we do that in this quarter it should give us deliverables/tasks for the next
quarter.
One more deliverable – Refine Charter
 We pushed through charter so we wouldn’t get stuck
 Comment that charter was vague, we decided to leave it vague so we had agility in what we
wanted to do. Might be worth revisiting the charter
SWOT ANALYSIS
Strength - is obvious
 there’s a great need of the work we’re doing
 We have a well engaged team
Opportunities
 Are they well stated in the charter? Or is that a weakness?
 Others?
Weakness
 Even though we have a lot of great people, we are a community-led effort: resources are tight
Threats
 Of people and time
 Are there other weaknesses/threats either for the project (PHTT) or the program (what we’re
trying to push out into the real world).
o Threat with competing priorities to the project (PHTT), program – are there challenges
in the real world? Are we missing legal complexities we should be addressing in the
project?
o John Donnelly – I think there are. Legal is one aspect, there are certainly operational
policy issues that will play in to implementations. Earlier talking about implementation
pilots, these will get fleshed out. Bigger question, general weaknesses in the program or
obstacles: for me in the middle of deployment it’s about transition. A lot of use cases
are not new use cases, new ways to deal with electronic data, better tools, different
ways. First challenge is what is the transition from the current program (each state
might be different of how they’re meeting the national objectives). Transition planning
should be part of the guidance, not just the end result of how we’re using the tools but
how to get there.
o Dan – dovetails with Marcus’ point we’re missing the implementation model but also
the change-transition model. Other processes might need to change or systems might
need to change, throwing it under opportunity for now to capture.
o Under Threat: Added legal, operational, policy, privacy and security (might not be a real
threat but might be a topic as we present, will need to have materials ready to show
how privacy and security are overlayed on top of these systems)
o Jim Jellison – weakness or threat? This community is comfortable enough with
informatics to think about the 3 initiatives concurrently, but as this becomes
communication exercise to folks who aren’t informaticians, don’t know that we’re going
to be able to communicate DAF, CQF, SDC in a short period of time. Communications
might need prioritization.
 Can talk about that when we meet next to talk about it at a high enough level,
politely disagree
o This serves as risk management
o How would failure be identified?
 Manifest that there are so many meetings and just goes on forever that are
boring and just dies out.
 Failure to communicate it
 Pilots themselves are unsuccessful
 Carrying a bad idea too far forward, don’t have the resources to live with bad
idea or good ideas that could never be implemented
 Would capture those as threats




Add a failure to identify a public health need
Potential failure would have this whole topic to stay in the IT realm too long.
The sooner we can get it to be part of the business solution set and not an IT
initiative is a way out of becoming a failure.
Is there a great need? Do we need to state it?
Dan’s other threats
Data Provenance (of interest for 2 reasons)
 Frameworks for analyzing the data that make up data provenance
o Data provenance is the source of the data
o Big Data, could we predefine methodologies for looking at data provenance to score
pieces of data based on the metadata data provenance will define
 Looking at large data sets, particularly data in an HIE or data coming from DAF, looking at how
we support tools for analyzing the data set.
o Public health statistical people like to have very clean data sets, as we move into a world
of big data, will the public health profession be happy to work with dirtier data sets?
o Can discuss further
The group working on the presentation will be reconvening sometime in the near future.