Tools to Automate the S&I Platform

A S&I Simplification Proposal in Collaboration with NIST and AHRQ

March 29, 2013

Automating the S&I Platform 2

Growing Portfolio of Module Based Initiatives

But this has led to growing complexity and diverse designs, models and solutions

Doug Fridsma to HITPC – 3/14/133/29/2013

Automating the S&I Platform 3

S&I Core Matrix Has Captured and Standardized S&I Initiatives . . .

. . . as Shared, Reusable and Computable Components . . . Now we need a tool to use the Core Matrix

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Automating the S&I Platform 4

Components selected from S&I Initiative Use Cases

Is it… Potentially Computable for…In Common?

Re-Usable?

Computable?

Identity

Accountability

Permission, Consent

Access,Data Use

Performance/ Fulfillment

Capture, Provenance

Content:Struct/Unstruct

Coding,Classification

Completeness

Signature

Audit

Requirements Y Y Y • •Actors, Roles Y Y Y • • • • • • • •

Events, Actions Y Y Y• • • • • • • • As standards-based software services

Data Objects, Elements Y Y Y

• • • • • • • • • As standards-based data objects, messages, documents…

S&I SimplificationComponent Selection

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Automating the S&I Platform 5

Tools to Automate the S&I Platform

USHIKRegistry

RepositoryLink to NLM

NISTTest

Methods

S&ICore Matrix UCAT

IGAT

Business Requirements and

SMEs

Implementable Solutions

CEDD/FHIM/CIMI Data Models and

Mapping

Standards Developers and

Stewards

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Automating the S&I Platform 63/29/2013

R. Snelick May 8th, 2012

Automating the S&I Platform 7

NIST Role• Experience with Use Case Authoring through

SmartGrid and Model-Based standards development

• Developed automated test procedures, methods and tools for CEHRT and Mod Specs

• NIST sees the need for an implementation guide authoring tool (IGAT) which would use the UCAT for input

• UCAT is based on NIST SmartGrid platform with further specialization for the S&I Core Matrix by Art Griesser with LRI Use Case

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Automating the S&I Platform 8Test System (Allow NIST/others to build tools quickly)

Implementation Guide Authoring Tools (Create more “testable” specifications!)

Test Cases and Testing Artifacts (e.g., Test Messages)

Test Case Management Tool (Let domain experts help write the test cases!)

ImplementationGuides

(Number is increasing rapidly—no testing

tools available)

HL7 v2MU Syndromic

SurveillanceImplementation

Guide

NHINHL7 V3 Patient

Discovery Implementation

Guides

HL7 v2 MU incorporate Lab

Results & Reportable Lab

ResultsImplementation

Guides

HL7 v2MU Immunization

ReportingImplementation

Guides

IHE HL7 v2PCD

Technical Framework

IHE HL7 v2PIX/PDQTechnical

Framework

IHE HL7 v3PIX/PDQ

Technical Framework

MU - 2016 Implementation

Guides

HL7 v2 and v3 Implementation

Guides in General(HL7, CDC, PHIN,ISDS, ONC, etc.)

More coming!

How NIST Can Address the Increased Demand for Tools?

3/29/2013

R. Snelick May 8th, 2012

ImplementationGuide

Authoring &Management

Tool

The Big Picture: HL7 V2 End-to-end Testing Support

HL7 v2StandardMessageDefinition

GeneralTransactionConstraints(e.g., IG , TF,

or user input)¹

HL7 v2Standard

Value Sets

Test CaseRequirements

VocabularyLibrary(XML)

ConformanceProfile(XML)

Test CaseManagement and Authoring

Tool

MessageProfiling

Test PlanExecution

Script(XML)

Test PlanTemplate

HL7 V2Impl.Guide

Template

Test PlanEnglish

Document

Data Sheets

Impl.Guide

EnglishDocument

SpecificationValidationContext

File(XML)

¹ Support existing specifications

UseCases

VocabularyProfiling

Use CaseDevelopment

DispositionTraceability

Utilities

IG TemplateWizard

ConstraintGenerator

Test CaseDevelopment

Test ScriptGeneratorData Sheet and Juror Document

Generator

Test PlanDevelopment

DocumentGenerator

Message Maker

DataManagement

MessageGeneration

TestingInfrastructure

DocumentGenerator

Execution Engine

ValidationEngine

Test Agents

Report Generation

Communication

TestingEnvironmentsCapabilities

ArtifactRepository

TestingTools

WebApplications

TestingInfrastructureComponents

Test PlanIntegration

Validation

ResourceBundle

ManagementMessageGeneration

Engine

VocabularyLibraries

(XML)

ConformanceProfiles(XML)

Test CaseSpecificContext

Files(XML)

Domain Specific

Tools

JurorDocuments

Utilities

Documentation

Communication

ResourceBundle

Test PlanExecution

Script(XML)

R. Snelick May 8th, 2012

DomainExperts

Domain Experts and Test Case Developers

User Input Tool Generated

Software Engineers

Tool Developers

ImportValue Sets

DITA XML

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Automating the S&I Platform 10

Why UCAT First?• Foundational to all downstream automation and tools

• Highest leverage is at the beginning analysis and design of an initiative• COnstructive COst Model – Overall effort is doubled if analysis is

shortchanged• Correct is hard... but easier than later fix • Ounce of prevention • Measure twice, cut once • “By failing to prepare, you are preparing to fail” Ben Franklin

• Use Cases• Study how users get value from system• Define how users interact with system • Help subsequent efforts deliver value • Are contracts between users & developers

• Refer to Art Griesser Presentation in Appendix

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Automating the S&I Platform 11

Use Case Authoring Tool

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Executable

Verify ▶

Automating the S&I Platform 12

Use Case Authoring Tool

• Specify how user gets value from system

• Describe interaction of user & system

• Abstractly

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Tests

Ensure

Verify

Concretely (specific test data)

Use cases

Automating the S&I Platform 13

UCAT Demonstration• Reusable “atomic” Lego blocks• Navigating through Lego assemblies• Creating a new use case from existing blocks• Reconstructing a use case document• Seeing differences between use cases• Browsing change history• Multi-vocabulary support• Access your data your way

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Automating the S&I Platform 14

S&I Simplification – Demonstration of ConceptUse Case Tool Status

Current Capabilities• Imported Core Matrix

• Captured use case template structure• Populated completely for LRI

• Can construct new use cases from reusable components

• Can create human readable use cases (in UC template)

• Can curate underlying UC information

• Can use underlying info programmatically• SQL query

• Import: CSV• UCAT Native• Simplification Core Matrix• ISO/HL7 10781/16527 EHR/PHR System

Functional Models

• Export: JSON, CSV

• Ability to clone

Additional Capabilities• Ability to track status of information

• Component Lifecycle Management

Next Steps• Approve automated tools and Core Matrix approach

for S&I and embed in process

• Complete UCAT as end user product• Resolve licensing

• Add remaining 14 S&I Use Cases to UCAT• One-time manual entry

• Refine Core Matrix master template• Resolve differences from template

• USHIK Integration

• S&I Data Integration • CEDD, FHIM, or CIMI . . .

• Evaluate and design handoff to downstream tools• Implementation Guide Authoring• Testing Tools, MDHT, V2 …

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Automating the S&I Platform 15

• Capture Once, Re-Use Many Times• Each Re-Use Instance = x 1 Savings• Facilitate Cross S&I Initiative Coordination• Facilitate Cross Agency/Domain

Coordination• Unlocking Value of S&I (maximizes re-use,

return)• Experience Shows:

• AHIC/HITSP: 4 Years, 17 Use Cases/Initiatives (4+/year)

• S&I: 2 Years, 13 Use Cases/Initiatives (6+/year)

• With UCAT: target 1 or 2 per week depending on similarity to previous use cases

• With IGAT, With Test Methods?

Simplification – Automating the S&I PlatformBenefits

UC Requirements

Implementation Guides

Test Methods

Faster, real world adoption

S&I Platform

Automated Tools

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Links• Gary Dickinson Presentation - Use

Case Authoring Tool - Simplification Introduction• Art Griesser Presentation - "Use Cases" Slide Set• Frederic de Vaulx Presentation• Rob Snelick IGAT – HL7 V2 Presentation• S&I Core Matrix• Progression Spreadsheet• USHIK S&I Pilot Site• UCAT Portal TBD

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Automating the S&I Platform 17

Acknowledgements

Gary Dickinson CentriHealth / S&I Simplification WG Chair

Michael Fitzmaurice / Robin Barnes AHRQ / USHIK

Kevin Brady / Frederic deVaulx / Rob Snelick NIST

Art Griesser Prometheus / NIST Contractor

Steven Hufnagel Military Health Services Contractor

Caryn Just / Ed Larsen S&I Support Staff

3/29/2013