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Subject: RE: [ihc] Fwd: FW: Emergency data standards
Rex, Good call - I suspect the NIH (Not Invented Here) syndrome is alive and well at NIH / NHIN on this one! Although DHS are the ones working more with CDC/PHIN - and of course they have more resources. We've know for some time these folks could benefit significantly from joining OASIS - but that the roadblock to that is down on the Mall... DW "The way to be is to do" - Confucius (551-472 B.C.) > -------- Original Message -------- > Subject: Re: [ihc] Fwd: FW: Emergency data standards > From: Rex Brooks <rexb@starbourne.com> > Date: Fri, November 30, 2007 11:28 am > To: "Brett Trusko, Ph.D." <brett.trusko@oasis-open.org>, Rex Brooks > <rexb@starbourne.com> > Cc: ihc@lists.oasis-open.org, "Charlee Hess" <chess@comcare.org> > > Hi Brett, > > I would appreciate it if you and Peter think about combining the > effort to recruit participants for IHC with the need to coordinate > our efforts with the Emergency Response Community for nudging HHS to > be intelligent in taking on its responsibility for NDMS (below). > > This recruiting effort could include a for voluntary or paid employee > time to build and work in an advisory group of experts to work with > us on exploring the need for a Medical Resource Messaging > specification in the Emergency Data Exchange Language family of specs > alongside EDXL-HAVE and the more strictly emergency-related > specifications. This should be joint effort and it would be very > advantageous to involve HHS in a direct connection to HITSP and the > NDMS (below). > > I really worry about HHS because it appears that nothing is > coordinated there. ONC's NHIN seems oblivious to CDC's PHIN even > after 3 years. I'd love to hear that this is not still the case, but > perhaps a recruiting call to both, with the other copied, might be > worth considering. > > This is all a lot easier said than done. One thing that might help in > the immediate short term would be to send out the agenda for our next > meeting early next week as a reminder, with this item on it along > with Health Indicators. > > cheers, > Rex > > Cheers > > At 10:05 AM -0600 11/30/07, Brett Trusko, Ph.D. wrote: > >Rex, > > > >Very interesting. What do you need me to take on? > > > >Brett > > > >On Nov 29, 2007, at 6:28 AM, Rex Brooks wrote: > > > >>Hi Folks, > >> > >>Apparently this area is heating up. The recent release of EDXL-HAVE > >>for its second 60-Day Public Review plays into this area, as does > >>the very, very quiet development of the provisions of last year's > >>S. 3678 for Pandemic and All-Hazards Preparedness Act, which moved > >>responsibility for the National Disaster Medical System (NDMS) from > >>the Department of Homeland Security (DHS) to the HHS. > >> > >>I would like to suggest that we discuss this in the OASIS > >>International Health Continuum Technical Committee and possibly > >>contact COMCARE about participating in this effort. As informal > >>liaison to the OASIS Emergency Management TC, I could share > >>responsiblity for keeping abreast of this with another IHC-TC > >>member. Unfortunately, my existing commitments prevent me trom > >>shouldering the entire effort. > >> > >>However, we should discuss this further since our work does include > >>the Emergency Response (ER) even if it is not our main focus. > >> > >>Cheers, > >>Rex > >> > >>>Subject: FW: Emergency data standards > >>>Date: Wed, 28 Nov 2007 15:43:42 -0500 > >>>Thread-Topic: Emergency data standards > >>>Thread-Index: AcgwUQsmeHP5zEDbTt+SYfCxdcCWTQAAB1knAACzsyAAAuOSIABn6elA > >>> > >>>From: "Charlee Hess" <<mailto:chess@comcare.org>chess@comcare.org> > >>>To: <<mailto:rexb@starbourne.com>rexb@starbourne.com> > >>>X-SpamScore: 0 > >>>X-Rcpt-To: <<mailto:rexb@starbourne.com>rexb@starbourne.com> > >>>X-DPOP: Version number supressed > >>> > >>>David and Elysa asked me to forward the e-mail below to you. > >>> > >>> > >>> > >>>Thanks, > >>> > >>>Charlee > >>> > >>> > >>> > >>>From: David Aylward > >>>Sent: Monday, November 26, 2007 2:31 PM > >>>To: 'N Clay Mann'; 'Bob Cobb' > >>>Cc: '<mailto:dleonar@lumc.edu>dleonar@lumc.edu'; 'Seb Haileleul'; > >>>'Parker, David D (IHS/HQE)'; 'Laurie Flaherty'; 'Earl Hardy'; > >>>Judith Woodhall; Amy DuBrueler; 'Michael L. Glickman'; > >>>'<mailto:SHufnagel@Tiag.net>SHufnagel@Tiag.net'; 'Roger Hixson'; > >>>'<mailto:bthornburg@nena.org>bthornburg@nena.org'; > >>>'<mailto:rjones@nena.org>rjones@nena.org'; 'Patrick Halley'; > >>>'<mailto:jeff.sexton@state.tn.us>jeff.sexton@state.tn.us'; 'Robert > >>>Bass'; Eileen Groell; > >>>'<mailto:jpotter@valleyhealthlink.com>jpotter@valleyhealthlink.com'; > >>>'<mailto:richard.taylor@ncmail.net>richard.taylor@ncmail.net'; > >>>'<mailto:mcginnis@nasemsd.org>mcginnis@nasemsd.org'; 'Timothy > >>>Grapes'; '<mailto:ltincher@evotecinc.com>ltincher@evotecinc.com'; > >>>'<mailto:dennis.gusty@dhs.gov>dennis.gusty@dhs.gov'; 'David > >>>Lamensdorf'; 'Donald Ponikkvar'; 'Paul Mangione'; > >>>'<mailto:Drew.Dawson@dot.gov>Drew.Dawson@dot.gov'; 'Tracy Ryan'; > >>>'Elysa Jones'; > >>>'<mailto:Letartefamily@comcast.net>Letartefamily@comcast.net'; > >>>Lauren Barna; Charlee Hess; 'Collins, David' > >>>Subject: Emergency data standards > >>> > >>>Dear Friends: > >>> > >>> > >>> > >>>I am writing informally on behalf of COMCARE, the HIMSS/COMCARE > >>>Emergency Responder Task Force, and the Health Information > >>>Technology Standards Panel (HITSP) Working Group on the Emergency > >>>Responder Electronic Health Record (ER-EHR). As you may know, > >>>this is a major effort funded by HHS to be able to develop and > >>>exchange electronic health records. For more information, > >>>please see > >>> > >>><http://www.ansi.org/standards_activities/standards_boards_panels/hisb/hitsp.aspx?menuid=3>http://www.ansi.org/standards_activities/standards_boards_panels/hisb/hitsp.aspx?menuid=3 > >>> > >>> > >>> > >>>Last year this was expanded to include an emergency use case and > >>>an associated working group was set > >>>up, <https://mail.natstrat.com/exchweb/bin/redir.asp?URL=http://www.hhs.gov/healthit/erehr.html>http://www.hhs.gov/healthit/erehr.html > >>> > >>> > >>> > >>>COMCARE has become an increasingly active member of this group. > >>>We have been very pleased at the ER-EHR Working Group's > >>>willingness to reach out beyond the traditional hospital and > >>>hospital technology-based communities, and to include the fine > >>>work coming out of the practitioner/DHS/OASIS emergency standards > >>>development process. We are working through with them the details > >>>of implementing the vision of informed emergency medical response > >>>that most of us have been working on for years, but now within the > >>>HITSP context. This coming together of different "movements" is > >>>very exciting. At the recent HITSP face to face meeting in > >>>Chicago we had an excellent session of the ER-EHR Working Group. > >>>This included a special session with a number of experts from the > >>>emergency medical world, led by Clay Mann for NEMSIS and > >>>neurosurgeon Peter Letarte for COMCARE. Clay is now participating > >>>in the Group on a regular basis. > >>> > >>> > >>> > >>>During this session, we identified three key, major standards > >>>gaps/problems that our EMS and 9-1-1 organizational members are > >>>well situated (in some cases with others) to solve. Each is > >>>critical to interoperability among the private sector and various > >>>professions during emergency medical response. > >>> > >>> > >>> > >>>The purpose of this email is to ask you to participate in two or > >>>three conference calls to scope these issues. The draft HITSP > >>>ER-EHR Interoperability Specification (IS) calls for this activity. > >>> > >>> > >>> > >>>In summary, the three suggested projects are: > >>> > >>> > >>> > >>>1. The need to have a consistent definition of incident types > >>>(This goes well beyond just EMS and 9-1-1 as well as beyond HITSP > >>>and ER-EHR.) > >>> > >>>2. Determine the best way to link data produced by various > >>>agencies. This is so the data entries about the incident and > >>>patients during a response by the different agencies and > >>>organizations can be tied together. One suggestion is the use of > >>>unique identifiers for both incidents and patients/victims. > >>> > >>>3. Inconsistent terminology describing all things about > >>>patients/victims, from their identity to their care. > >>> > >>> > >>> > >>>1 and 2. The ER-EHR Interoperability Specification supports use > >>>of the OASIS EDXL Distribution Element to route various kinds of > >>>emergency data. The DE routes messages based on incident type, > >>>among other factors. The DE calls for the use of a common > >>>"managed" list of incident types - but such a list doesn't exist. > >>>Several years ago, we put a draft together from the lists of each > >>>profession when the detailed specification for the DE was put > >>>together and submitted to OASIS, but nothing has been done with > >>>that since. So, as remarkable as it sounds, there is no agreed > >>>upon nomenclature for incident types across professions. > >>> > >>> > >>> > >>>In addition, we cannot tie messages and data about an incident or > >>>patient/victim together (e.g. 9-1-1 to EMS to hospital) unless the > >>>various organizations that contribute information or care agree on > >>>a method for doing so. Today, each agency (system) assigns its > >>>own identifier. As the IS suggests, probably the best solution is > >>>that the number assigned by the first agency to encounter the > >>>incident or patient/victim should be followed by each succeeding > >>>organization as soon as they become aware of it. There is a lot > >>>of devil in that sentence! > >>> > >>> > >>> > >>>These first two issues are closely tied to work we have done with > >>>you and others on the EDXL messaging standards. Proper resolution > >>>will clearly need parties outside the emergency medical community, > >>>but we need to solve this problem to share information about > >>>patients. This is a good time and reason to get going on two key > >>>interoperability problems. > >>> > >>> > >>> > >>>3. Regarding patient terminology, the issue is a variant of the > >>>one that caused NENA and COMCARE a couple of months ago to request > >>>a coordinated review led by DHS (which they do not now have the > >>>resources to do). It appears that there are four primary overall > >>>collections of possible taxonomies for patient/victim care > >>>purposes: > >>> > >>> > >>> > >>> a. 9-1-1 (i.e. any NENA standards for data) > >>> > >>> b. EMS (clearly NEMSIS) > >>> > >>> c. Hospitals (DEEDS, HL7 and perhaps SNOMED) > >>> > >>> d. Global Justice Data Dictionary has significant entries on > >>>indentification, although not on treatment. > >>> > >>> > >>> > >>>Clay Manning agreed to work with the hospital folks to see how > >>>NEMSIS and DEEDS can be harmonized. We have put him in touch with > >>>our colleague Dr. Kevin Coonan who has been working on updating > >>>DEEDS. The purpose of this email is to extend the same question > >>>in other directions: other pre-hospital emergency professions. > >>> > >>> > >>> > >>>We would like to ask NENA and the NEMSIS experts to participate in > >>>a conference call in the near future to scope how we could get > >>>agreement between 9-1-1 and EMS on taxonomy, and to see if others > >>>(e.g. Global Justice Data Dictionary) need to be involved. I am > >>>acutely aware that I made a similar invitation a couple of years > >>>ago on behalf of the Department of Homeland Security, and included > >>>with it the offer of $50,000 to fund NENA, NAEMSO and others' > >>>participation in an effort to develop "common terms" between all > >>>emergency professions. When the standards program was moved to > >>>another part of the department, the new management reneged. Ok, > >>>ok. I am still sorry! > >>> > >>> > >>> > >>>So no, I am not offering to pay your expenses of participating. > >>>:-) Let's just have a first call to scope the problem and see > >>>where we go from there. > >>> > >>> > >>> > >>>It would be great if Bob Cobb for NENA, Clay Mann for EMS and Tim > >>>Grapes from the DHS EDXL project could figure out who will > >>>participate from their ends for this preliminary discussion of > >>>each of the three issue sets, and then give Eileen Groell > >>>(<mailto:egroell@comcare.org>egroell@comcare.org) 3 times in > >>>December when those folks could be on the phone for an hour. We > >>>will then let all of you know and hopefully most can join in. > >>> > >>> > >>> > >>>Thanks! > >>> > >>> > >>> > >>> > >>> > >>>David Aylward > >>> > >>> > >>> > >>> > >>> > >>> > >>> > >>> > >>> > >> > >> > >>-- > >>Rex Brooks > >>President, CEO > >>Starbourne Communications Design > >>GeoAddress: 1361-A Addison > >>Berkeley, CA 94702 > >>Tel: 510-898-0670 > > > -- > Rex Brooks > President, CEO > Starbourne Communications Design > GeoAddress: 1361-A Addison > Berkeley, CA 94702 > Tel: 510-898-0670
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