2008-10-28

Meeting Information

Attending:  Toby Vandemark, Chair; Tim Alexander, James Crisp, Susan Cummings, James Fiore, Ben Greenberg, Monica Hanks, Tito Harris, Tarang Shah, Carl Singer, Valerie Smothers, Leah Wang. 

Agenda Items

1. Review minutes of last call

There were no comments and the minutes were approved.

2. Review updated specification (and schema)

Toby asked the group if they had reviewed the specification and schema and had comments. Valerie reviewed that the point of care learning data types and elements were incorporated into the schema and specification. In addition, the data type for the relevant element in point of care learning data was changed to the XML schema language Boolean data type to simplify the schema. Carl asked what the group should do if they had questions. Valerie asked that any questions be directed to the listserv. Carl asked if there was an example of point care learning data XML in the specification. Valerie commented that beneath the point of care learning data element description there was an example.

3. Implementers update

Toby asked those implementing to provide an update on their implementation efforts. Leah summarized the status of the Medscape pilot with the American Osteopathic Association. They use the professional profile for identity resolution to match records with the AOA. They still need to work on the logistics and workflow for sending activity report data to AOA. They have completed a proof of concept using automatically generated XML and manual submission. The AOA does identity resolution nightly, so Medscape needed a process for receiving data at a later date. They are working to operationalize the workflow so that there are no manual steps. Once that is in place, they will begin a marketing campaign to announce the new function to DOs.

Carl summarized that CE city has not done work on this yet. It is slated for future release of one of their products. He will check on the date for which it is slated before the next call.

James Fiore asked Leah how many surgery customers use their product. They would like that information once the spec is implemented. Leah offered to look into that. Once the pilot is complete, Medscape would be anxious to provide services to all physicians. They just need partners interested in receiving the data. James offered to continuing to discuss this with Leah off-line. The American board of surgery collect CME data for recertification. Currently they collect paper certificates. If they could get electronic data from the first party verified source, that would be much easier. This would simplify the application and approval process. Many other boards would be interested. He added that another possibility would be for CE providers to see data to the ABMS, which could then serve as a central repository for specialty certification boards.

James Crisp described current implementation of Genova technologies. They have completed design and data mapping as well as selection of XML technologies. They are about to begin coding in November. Valerie asked Susan to describe how they are using the standard. Susan replied that they are using the standard for communicating point of care learning data and conference completion data. They are hoping to send the data to the Iowa board and University of Iowa in December.

Valerie asked Leah if there were any problems with the manual submission. Leah replied that they had no problem so far using the web form. Tim added that they are using dummy data so far, and it would be great to try the specification using real test data. Then added that Medscape was glad to have completed the proof concept successfully. Their data conforms to the schema properly. They have unit tested both sending and receiving, but they still need a full integration test.

Carl added that CE city already has an interface with AOA that they need to switch to the new schema format. Valerie asked if they were doing any work related to point of care learning. Carl replied that he was not sure but that he would talk to others.

Ben asked if there was any threshold for sending data. Carl explained they currently do it in real time. AOA queues it up for processing overnight. They communicate confirmation of processing to CECity. Leah commented that she hadn't realized that response processing would be delayed.

James crisp asked if batch processing was used, how many records would be sent at once. Carl replied that XML was not a good format for large volumes of data. There may be issues of parsing and processing. There are techniques to handle processing of large XML documents in a more efficient manner.

Tim asked if it was more efficient to send fewer large documents were smaller ones. Carl replied that from their perspective, smaller was better. They send it activity report for every activity. This is more scalable than batch processing. Valerie added that batch processing can be more difficult with regard to error reporting as well.

James Fiore described that they would want to receive a batch for each person who agrees to send the data. When the individual authorizes data to be sent, data would be sent in a batch to the American Board of Surgery. They currently have a similar process with the American College of Surgeons. When a surgeon applies for certification, they must agree to transmit the operative log from the American College of Surgeons. A link takes them to the appropriate ACS website, where the physician can authorize the transmission. Then the data is sent.

Leah commented that they also have an opt in process, but that they will send data to AOA each time I D.O. completes an activity. Carl added that it might be interesting to document that use cases one time batch data transmission. Valerie emphasized that the business case should drive the technology adoption. If data collection is necessary only at one point in time, but batch processing approach may be desirable. If data needs to be collected on a continuous basis, the continuous approach to data collection may be preferable.

4. Submission to Standards Committee

Toby asked Valerie to speak about submission to the standards committee. Valerie related that the point of care learning working group had met in the morning and to that there was not sufficient implementation for them to recommend sending the specification to the standards committee. From her perspective, it might be best to wait until Medscape moves from dummy data to testing with real data. James Fiore agreed that we should not send the specification to the standards committee until it has been tested with more than dummy data. Carl agreed it would be good to make sure that it's working properly.

Toby suggested postponing the next call to allow implementers more time to implement and provide feedback regarding the specification. She suggested moving the date to December. Valerie agreed to work with Toby to find an appropriate date.

5. Open discussion

Decisions

The group will await further testing before sending the specification to the Standards Committee for review.

Action Items