Fwd: Is HPD ready for final text status??

[Lynn Felhofer]

---------- Forwarded message ----------
From: Eric Heflin <ehe...@healthewayinc.org>
Date: Thu, Apr 30, 2015 at 11:20 AM
Subject: Is HPD ready for final text status??
 

Hi,

 

We are making a preliminary decision in the IHE ITI meetings today if the IHE HPD profile is ready for promotion from Trial Implementation, to Final Text status.  Are there issues that you feel should prevent HPD from moving to final text?  Did the IHE Connectathon result in any problems that need to be addressed before HPD moves to final text?  Please forward this email on to others that I missed.

 

A few other criteria we take into account when evaluating HPD’s readiness to move to Final Text status, are uses in production or pilots and implementations available for purchase.  So if you have any data points you can publically share in regards to these issues please let us know.

 

Also please be aware that two CPs are outstanding for HPD: 766 (to clarify the semantics of R) ftp://ftp.ihe.net/IT_Infrastructure/TF_Maintenance-2015/CPs/1_Assigned/CP-ITI-766-00.doc and 683 (clarify top level organizations) ftp://ftp.ihe.net/IT_Infrastructure/TF_Maintenance-2015/CPs/1_Assigned/CP-ITI-683-01.doc .

 

One issue I’m aware of is that the diagrams have several differences between the optionality and cardinality definitions than the text.

 

Kind regards,

Eric

 

Eric Heflin, Chief Technology Officer/Chief Information Officer (CTO/CIO)

Healtheway, Inc.

1600 Tysons Blvd., 8^th Floor

McLean, VA 22102 USA

O: 703.506.7664   

F:  703.506.7664

C:  512.897.0748

www.healthewayinc.org

 

Email Confidentiality Statement

This e-mail and any attachments transmitted with it are proprietary and confidential and legally protected from disclosure. If you are not the intended recipient, or agent of the intended recipient, you are hereby notified that any reading, use, disclosure, copying, distribution, or the taking of any action in reliance on the contents of this message or its attachments is strictly prohibited.  If you received this message in error, please notify the sender immediately and delete or destroy all copies of the message and any attachments thereto.

 

[Timothy Tyndall]

Eric,

 

We have begunto implement the HPD standard for the California State Provider Directory.  We are just leaving testing and preparing to put the Directory into production first week of May.  We are also beginning testing for multi-state Federation.

 

We are connecting multiple HIE’s that are using a variety of different operating systems and have not encountered any major problems. 

 

It will be good to follow the process this year as we see the standard working.

 

Timothy

 

 

Timothy Tyndall

Director

RAIN Live Oak HIE and Telemedicine Network

1562 Cougar Ridge Road

Buellton, CA. 93427

Phone: 805-708-0127

Email: tim...@rain.org

Web: http://www.liveoaktech.net

Direct Secure Email: timothy...@direct.liveoaktech.net

[Eric Heflin]

On addition, they also stated that, in essence that there are some issues remaining that are USA specific, but these should not prevent HPD from moving forward.  I realized this was relevant, so I'm including it below.

"You and I have already exchanged email on implementation guidance for HPD. I don’t consider this a reason not to proceed, but I look forward to participating in that effort."

On Thu, Apr 30, 2015 at 12:16 PM, Eric Heflin <eric....@thsa.org> wrote:

One data point, lightly edited.

 

From: Robert Cothren [mailto:robert....@ca-hie.org]
Sent: Thursday, April 30, 2015 11:52 AM
To: Eric Heflin
Cc: Timothy Tyndall; Ayami Tyndall
Subject: RE: Is HPD ready for final text status??

 

You may make public that CAHIE plans to go to production deployment of our statewide orchestration service using HPD 1.5 in May. This is not a product for purchase, but a service that is part of the statewide HIE coordination, and was demonstrated at HIMSS15. The statewide service is a dataless HPD orchestrator that takes queries as a Provider Information Directory and dispatches queries to local directories as a Provider Information Consumer, and then consolidates their responses. It is based on RAIN’s implementation and supports the federation option. In Figure 28.3.2.3-1, what we are launching represents Provider Information Directory A (acting as an aggregator), connected to several organizations that implement Provider Information Directories 1, 2, 3, etc., some supporting the federation option and some not.

 

<snip>

 

From: Eric Heflin [mailto:ehe...@healthewayinc.org]
Sent: Thursday, April 30, 2015 9:20 AM
To: Willis, Sarah; Roth, Celina; bi...@careevolution.com; scott...@surescripts.com; gr...@careevolution.com; benjam...@nextgate.com; deb....@surescripts.com; djorg...@inpriva.com; siva.ka...@verizon.com; shai....@verizon.com; david....@nextgate.com; dave....@surescripts.com; mic...@mhnusbaum.com; curtis....@surescripts.com; marc.s...@nextgate.com; ganesh.su...@surescripts.com; jeff....@surescripts.com; umb...@careevolution.com; witt...@gmail.com; jbl...@medallies.com; lc...@medallies.com; robert....@ca-hie.org; John.d...@siemens.com; jfi...@medallies.com; jason.r...@dhsoha.state.or.us; ppa...@medallies.com; miranda...@hdsdata.com; 'Barker, Robert'; 'christoph...@ge.com'; 'Venier, David'; 'Shalimov, Dmitry'; 'Rodrigues, Deepthi S (CGI Federal)'; dav...@mirth.com; tim...@rain.org; nagesh....@drajer.com; jtdon...@intepro.biz; Lippitt Jr., Alexander; kory....@hhs.gov; matthe...@hhs.gov; 'Pupo, Erik (US - Miami)'; 'Thomas....@ssa.gov'; 'Alberto...@hhs.gov'; 'wsuj...@sujansky.com'; 'Robert Cothren'; 'Miranda Jason R'; 'acam...@precisiontech.biz'; Vance, Sandra; 'Jennifer Harvey'; 'Misbah, Jawad'; 'Annika Webb'; Kraufmann, Ben; Wissell, Laurie; Handler, Ivan; Michel MORETON (HMS); Bill Beighe - PMG; Hi...@epic.com; Meyer,Greg; David Schramm; Band, Iver; Drew Csillag; Foley, Thomas; Naresh.Su...@cgifederal.com; ihe-hpd-im...@googlegroups.com
Cc: lynn felhofer (gmail) (felhof...@gmail.com)
Subject: Is HPD ready for final text status??
Importance: High

 

Hi,

 

We are making a preliminary decision in the IHE ITI meetings today if the IHE HPD profile is ready for promotion from Trial Implementation, to Final Text status.  Are there issues that you feel should prevent HPD from moving to final text?  Did the IHE Connectathon result in any problems that need to be addressed before HPD moves to final text?  Please forward this email on to others that I missed.

 

A few other criteria we take into account when evaluating HPD’s readiness to move to Final Text status, are uses in production or pilots and implementations available for purchase.  So if you have any data points you can publically share in regards to these issues please let us know.

 

Also please be aware that two CPs are outstanding for HPD: 766 (to clarify the semantics of R) ftp://ftp.ihe.net/IT_Infrastructure/TF_Maintenance-2015/CPs/1_Assigned/CP-ITI-766-00.doc and 683 (clarify top level organizations) ftp://ftp.ihe.net/IT_Infrastructure/TF_Maintenance-2015/CPs/1_Assigned/CP-ITI-683-01.doc .

 

One issue I’m aware of is that the diagrams have several differences between the optionality and cardinality definitions than the text.

 

Kind regards,

Eric

 

Eric Heflin, Chief Technology Officer/Chief Information Officer (CTO/CIO)

Healtheway, Inc.

1600 Tysons Blvd., 8^th Floor

McLean, VA 22102 USA

O: 703.506.7664   

F:  703.506.7664

C:  512.897.0748

www.healthewayinc.org

 

Email Confidentiality Statement

This e-mail and any attachments transmitted with it are proprietary and confidential and legally protected from disclosure. If you are not the intended recipient, or agent of the intended recipient, you are hereby notified that any reading, use, disclosure, copying, distribution, or the taking of any action in reliance on the contents of this message or its attachments is strictly prohibited.  If you received this message in error, please notify the sender immediately and delete or destroy all copies of the message and any attachments thereto.

 

--
You received this message because you are subscribed to the Google Groups "IHE ITI Planning Committee" group.
To unsubscribe from this group and stop receiving emails from it, send an email to itiplan+u...@googlegroups.com.
To post to this group, send email to iti...@googlegroups.com.
Visit this group at http://groups.google.com/group/itiplan.
For more options, visit https://groups.google.com/d/optout.

[Eric Heflin]

Thanks for the response Timothy!

Would you consider HPD ready to become final text as it is currently written (meaning that it cannot be changed, at least in theory)?

--
You received this message because you are subscribed to the Google Groups "ihe-hpd-implementors" group.
To unsubscribe from this group and stop receiving emails from it, send an email to ihe-hpd-implemen...@googlegroups.com.

[Timothy Tyndall]

Eric,

 

We have tested it fairly extensively and I would say it is ready to be final text and set in place as a solid standard.  It may be valuable to prepare a working paper on the first production applications of the new standard as it unfolds this year.  That would add to the literature on it and might be of use to encourage adoption.

 

Timothy

[Kevin Paprocki]

Hi Eric,

 

We at Epic have been reviewing the latest HPD trial implementation as part of the ONC 2015 Certification Criteria. Although the current spec defines a rich set of elements, the schema for provider contact information is not robust enough to support transmitting patient health information. For example, Org Practice Address, Electronic Service URI (in the U.S. realm would be the Direct address), and Org Business Phone are all multiple-valued fields, how would we associate one line of this field to the other?

 

This is a serious concern for practical implementation of the standard. Most doctors work in multiple facilities. Those facilities have different fax machines and may even have different EHR systems that require different Direct addresses. If a directory consumer chooses the wrong fax number or Direct address, patient health information may be transmitted to the wrong place, which is considered a breach of privacy. If a user wants to send a fax or direct message, It's unreasonable to expect them to pick from a list without any context.

 

We have a number of other smaller concerns, including inconsistencies in terminology across the document. In its current state, we do not think it’s ready to be final text. When are you planning on making the final decision? We’ll need some time to compile our list of concerns.  

[Greg Carver]

Kevin, regarding your concerns about associating specific contact info for a provider with a specific practice, I believe that's largely covered by attaching such data to the optional attributes in HPDProviderMembership.  It doesn't incorporate all of the contact details you can put on individual provider, but it seems to get the obvious stuff.  I also can't recall immediately if you can attach an electronicservice to a membership, but that might be helpful.

Of course the root of this is actually the spec is written to operate in 2 modes... one with relationships directly spelling provider <-> organization relations, and another mode where they're independent (see figure 28.1.1.1-1 in the spec).  Directories and data sources aren't required to associate organization-specific contact data with the related organization, so there's no guarantee you'll find this capability used in every directory.  Indeed, maintaining this data promises to be extremely painful.

Nevermind perfectly valid directories where each organization maintains it's own unique individualprovider entry and avoids the HPDProviderMembership.  In some ways, you could argue the schema is far too robust already...

Greg

[Gary Teichrow]

Great point Greg about HPDProviderMembership and a fine and accurate characterization of the difficulties to be faced by folks brave enough to stand one of these up and curate the data within it.

In short, the HPD schema is pretty dang solid... bordering on too robust, haha. 

What I'm not in love with (anymore....) is leveraging DSML/HTTP via an LDAP centric integration profile.   The need to take what should be a simple query/response pattern and orchestrate several DSML queries to the HPD endpoint and then weave the resulting response data together for the client executing the search is 'the' flaw in the whole dang thing.  I'm fairly convinced of that now, having worked with it for a couple years in production situations.  It's been a tough flip flop for me mentally.

FWIW, I tossed a useful HPDClient out a while back in an attempt to address this complexity a bit by putting this out on GitHub.  Not very active as you can see, haha.  But it did do all the back and forth orchestration and take a more simple query/response approach for the client. 

We then placed this jar into Mirth Connect Channel and then allowed a client to do an HTTP GET with JSON hpdSearch payload to the Connect channel and receive a JSON response back.  It worked pretty nicely.

But, to me, that's how HPD should behave itself:  HTTP/JSON, with the same HPD schema we have now for the provider/org data, just expressed in JSON.

but I ramble as usual...

Gary

This message, and any documents attached hereto, may contain confidential or proprietary information intended only for the use of the addressee(s) named above or may contain information that is legally  privileged. If you are not the intended addressee, or the person responsible for delivering it to the intended addressee, you are hereby notified that reading, disseminating, distributing or copying this message is strictly prohibited. If you have received this message by mistake, please immediately notify us by replying to the message and delete the original message and any copies immediately thereafter.  Thank you for your cooperation.