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From S&I Framework to
Participants:
Hi everyone: remember to keep your
phone on mute 
S&I Framework
Prescription Drug Monitoring Program Initiative
PDMP-to-EHR Data Format Standard
Driving To Consensus –
Assessment of Four Candidate Data
Formats
First Topic - Review
• Reach consensus on data format standard for
exchanging patient information between
PDMP and provider EHR systems
• 11 February:
– Consensus on Data Elements to support the Use
Case
– Consensus on the four candidate data format
standards
– Initiated discussion of attributes to be used for
assessment
Page 3
Data Format Standard – Community Discussion
• Google Groups Discussions:
– Continued discussion of assessment attributes
• Ten attributes proposed, grouped by qualitative level of
importance to the Use Case
• Three rankings suggested for each
• For Today (25 February):
– Brief overview of the assessment process
– Share assessment of the four standards
– Develop consensus recommendation for the data
format standard
Page 4
PDMP Data Format Evaluation
• The Use Case
–
–
–
–
–
A provider logs into an EHR system for a patient encounter
Patient presents with pain treatable with a controlled substance
EHR automatically queries the PDMP using patient identification
PDMP presents Provider with existing patient prescription information
Provider can make informed decisions about treatment options
• Overview of the strategy for evaluating the proposed
standards
– List the standards under consideration
– Establish the criteria for the evaluation, and the appropriate weighting
for the Use Case
• Assess each standard and make a recommendation
5
Standards for Consideration
Based on PDMP S&I Framework Community WebEx meetings
and discussions managed over Google Groups threads, the
following standards have been identified by the community for
evaluation:
• ASAP Web Service
• NCPDP Script (Medication History Request and Response
messages)
• PMIX PDMP Schemas (based on NIEM)
• Consolidated CDA
6
Attributes for Standard Assessment
Attribute
Relative Scale
Weighted
Value
Availability of an XML format
Very important
3
Ease of adoption and integration by EHRs/HIEs–
includes technical complexity
Speed of adoption into the EHR/HIE Ecosystem– how
widely used is it, plus others
Wide use of the XML version of the format
Very important
3
Very important
3
Important
2
Suitability for the PDMP-to-EHR Patient Encounter
Use Case– coverage of necessary data elements
Important
2
Separation of transport and content
Important
2
Ease of adoption and integration by PDMPs
Less important
1
Speed of adoption into the PDMP Ecosystem
Less important
1
Available at no cost
Less important
1
Accredited standards body
Less important
1
7
Assessment Raw Score
• Each of the attributes proposed as an assessment criterion
can be found in shortened version in the left column labels in
the following table.
• Each standard was applied a raw score according to the
following:
Raw Score Description
Raw Score
Standard meets
3
Standard partially meets
2
Standard does not meet
1
8
Assessment Table
Criterion
XML Spec
EHR Ease
EHR Speed
XML Use
Suitability
Separation
PDMP Ease
PDMP Speed
Cost
Accredited
TOTALS
Weight
3
3
3
2
2
2
1
1
1
1
ASAP
NCPDP
PMIX/NIEM
CCDA
Raw
Score
Score x
Weight
Raw
Score
Score x
Weight
Raw
Score
Score x
Weight
Raw
Score
Score x
Weight
3
1
1
1
3
1
1
2
1
1
9
3
3
2
6
2
1
2
1
1
3
3
3
2
2
3
2
2
1
3
9
9
9
4
4
6
2
2
1
3
3
1
1
1
3
3
2
1
3
1
9
3
3
2
6
6
2
1
3
1
3
3
2
2
2
3
1
1
2
3
9
9
6
4
4
6
1
1
2
3
30
49
36
45
9
Consensus on Data Standard
• NCPDP and CCDA rank highest, with NDPDP
edging out CCDA
• Do we have consensus around NCPDP as the
data standard that best addresses our Use
Case?
10
PDMP S&I at HIMSS
PDMP: Technical Framework for Interoperability
WHEN:
Wednesday, March 6th
TIME:
11:00 AM – 12:00 PM CT
LOCATION:
HIMSS13 Conference, New Orleans, LA
MITRE Government VIP Room #213
MITRE will convene representatives from the S&I Initiative, the EHR
vendor community, and other interested parties to explore the
recommendations from the Standards & Interoperability Framework
Initiative. There will be a demonstration featuring an open source
reference implementation for integrating PDMPs with electronic health
record systems. The goal of this forum is to allow participants to
connect and summarize the outcomes of the effort to enable
interoperability between HIE/EHR and PDMP vendors.
11
Also at HIMSS…
PDMP: An Introduction to Using Health IT to Combat Prescription Drug Abuse
WHEN:
TIME:
LOCATION:
Monday, March 4th
2:00 – 3:00 PM CT
HIMSS13 Conference, New Orleans, LA
MITRE Government VIP Room #213
This session will share an overview of the effort to enhance access to prescription drug monitoring
programs (PDMP). The goal is to educate, raise awareness and build connections between key
stakeholders who have not been involved in the project work to date. Sharing information to date will
provide stakeholders with the initial framework to pursue PDMP initiatives.
PDMP: Pilot Impact, In Their Own Words
WHEN:
TIME:
LOCATION:
Tuesday, March 5th
4:00 – 5:00 PM CT
HIMSS13 Conference, New Orleans, LA
MITRE Government VIP Room #213
The PDMP project is conducting multiple pilots to rapidly test the feasibility of using health IT to
enhance PDMP access and affect clinical decision making. This session will present a deeper dive into
the design and outcomes of four FY13 pilots showcasing the workflow, ease of use, and added technical
value of presenting PDMP data in EHR and pharmacy systems. The goal of this session is to have
multiple pilot participants share specific information about their pilot designs and outcomes.
12
Backup
13
Jan 28 Meeting: Scoping – the Use Case
• The primary use case
centers on getting initial
PDMP information to EHRs
Not all data elements can be
regarded the same
• Some elements may not
be recorded in the PDMP
(variations across states,
for example)
• Some elements may be
more important for this
use case than others
14
PDMP S&I Community Focus/Scope
Needs for standards (data format and content; transport and security protocols)
NCPDP Script
NCPDP
Telecom
EHR System
EHR System
EHR System
Data Out
ASAP
PDMP
Portal
Pharmacy
Provider
Provider
Provider
Switches
NIEM-PMP
Pharmacy
Benefits Mgmt
PMPi /
RxCheck
NIEM-PMP
PDMP
Other State PDMPs
Page 15
WG Recommended Set of Data – the “Complete” List
■ The Work Groups defined a standard set of data that should be
available to support clinical decision making
Patient
Prescriber
Dispenser
Prescription
First name
Last name
Street address
City
State
ZIP code
Date of birth
Identification (ID) qualifier
and/or patient identifier
(situational)
Gender code (situational)
Species code (situational)
Phone number (situational)
First name
Last name
Street address
City
State
ZIP code
Phone number (situational)
Drug Enforcement Agency
(DEA) number (situational)
Pharmacy or dispensing
prescriber name
Street address
City
State
ZIP code
Phone number (situational)
DEA number (situational)
National Council for
Prescription Drug Programs
(NCPDP)/National
Association of Boards of
Pharmacy (NABP) Provider ID
(situational)
National Provider Identifier
(NPI) (situational)
Name of drug
Strength
Form
Quantity dispensed
Days’ supply dispensed
Date prescription filled
Date written
Refills authorized
Refill number
Refill status to indicate a full
or partial refill
Prescription number
Full list recommendation: section 2.2.1.1 page 16-17
Page
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