S&I Simplification Use Case Authoring Tool (UCAT) Introduction

1. S&I SimplificationUse Case Authoring Tool (UCAT)Introduction In collaboration with NIST and AHRQ 25 March 2013

2. S&I SimplificationCross Initiative Effort to… • Compile and Distill Components from All S&I Initiatives • For easy reference, organization, comparison • 13 Use Cases with 33 Multi-Step Scenarios • Initiatives: TOC, LCC, LRI, LOI, PD, esMD, QH, DS4P, PHRI, HeD • Convey Uniform and Integrated Patterns of: • Patient Flow– with Patient as Actor • Provider (Work/Process) Flow– with Provider as Actor • Information Flow– including System as an Actor • Show: • Event Steps with Actions taken – by Actors in Roles – to support individual health and provide healthcare • Health record entries resulting from Actions taken • Show Commonalties, Patterns of Repetition/Re-Use • Both Current and Potential S&I Simplification/UCAT Intro

3. S&I SimplificationComponent Selection S&I Simplification/UCAT Intro

4. S&I Simplification/UCAT Intro

5. S&I SimplificationCore Matrix (LINK to Core Matrix Spreadsheet v2.4) • Status – of S&I Initiative Analysis • Key – Contents of All Tabs • Assertions – Basis for Initial Requirements • *Common Requirements • *Common Actors • *Scenarios, Events – w/Action examples • *Common Actions • *Common Data Objects * Re-usable Components S&I Simplification/UCAT Intro

6. S&I Simplification/UCAT Intro

7. S&I SimplificationProgression (LINK to Progression Spreadsheet) • To Date • S&I Simplification + AHRQ • Core Matrix + USHIK Registry • Future • S&I Use Case Requirements Phase with Use Case Authoring Tool (UCAT) • S&I Use Case Harmonization Phase with NIST Tools • Standards Selection • Implementation Guide (Tools) • Testing (Tools) S&I Simplification/UCAT Intro

8. S&I SimplificationIngredients – UCAT Prototype S&I Simplification/UCAT Intro

9. S&I SimplificationUse Case Hierarchy S&I Simplification/UCAT Intro

10. 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 and Refinements • Ability to track status of information • Component Lifecycle Management • Agreement to Productize UCAT Next Steps • Add remaining 14 S&I Use Cases • One-time manual entry • Resolving differences from template • Refine existing master template • USHIK integration • CEDD integration • Evaluate handoff to downstream tools • Implementation Guide, Testing… S&I Simplification/UCAT Intro

11. S&I SimplificationBenefits • Capture Once, Re-Use Many Times • Component + Standard + Imp Guide + Testing • Each Re-Use Instance: x 2 Savings • Facilitates Cross Agency • Facilitates S&I Cross Initiative • Unlocks Value of S&I (maximizing re-use, return) • Experience Shows: • AHIC/HITSP: 5 Years, 17 Use Cases (3+/yr) • S&I: 2 Years, 13 Use Cases (6+/yr) • Now w/UCAT: ? S&I Simplification/UCAT Intro

12. Tools to Automate the S&I Platform A Proposal March 29, 2013 DRAFT

13. Growing Portfolio of Module Based Initiatives But this has led to growing complexity and diverse designs, models and solutions DRAFT Doug Fridsma to HITPC – 3/14/13

14. 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 DRAFT

15. Tools to Automate the S&I Platform • S&I • Core Matrix • UCAT • IGAT Business Requirements and SMEs • USHIK • Registry • Repository • Link to NLM • NIST • Test Methods Standards Developers and Stewards CEDD/FHIM/CIMI Data Models and Mapping Implementable Solutions DRAFT

16. Why UCAT First? • Foundational to all downstream automation and tools • Highest leverage is at the beginning analysis and design of an initiative • COnstructiveCOst 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 DRAFT

17. Use Case Authoring Tool DRAFT

18. NIST Role (Kevin – maybe quotes from Frederick • Experience with Use Case Authoring through Smart Grid • Developed automated test procedures, methods and tools for CEHRT and Mod Specs • UCAT is based on NIST platform with further specialization for the S&I Core Matrix by Art Greisser DRAFT

19. Brief Overview of Process Flow DRAFT

20. UCAT Demonstration • NEED OUTLINE FROM ART • Show how to create a human readable, machine computable UC example from Core Matrix and UCAT DRAFT

21. 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 • Add remaining 14 S&I Use Cases to UCAT • One-time manual entry • Resolving differences from template • Refine Core Matrix master 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 … DRAFT

22. Simplification – Automating the S&I PlatformBenefits S&I Platform • 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+/yr) • S&I: 2 Years, 13 Use Cases/Initiatives (6+/yr) • With UCAT: ? • With IGAT, With Test Methods? Automated Tools Faster, real world adoption DRAFT

23. Appendices • Gary Dickinson Presentation - DRAFT Use Case Authoring Tool - Simplification Introduction • Art Greisser Presentation - "Use Cases" Slide Set • Frederick’s Presentation - ? • Link to USHIK S&I Pilot Site • Link UCAT Portal TBD DRAFT

24. Use Cases • Arthur Griesser, PhD • Prometheus Computing, LLC

25. What reduces development time the most? • Better tools for developers? • More training for developers? • More experience in domain? • Better understanding of requirements?

26. What reduces development time the most? • Better tools for developers? • More training for developers? • More experience in domain? • Better understanding of requirements? ✓

27. COnstructive COst MOdel Effort is Doubled if analysis is shortchanged

28. Why Is Analysis So Important? • 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

29. Police in Gumperda, Germany, arrested a 64-year-old retired do-it-yourselfer in November after he drilled through a neighbor's wall in their duplex home. The man had spent two days trapped in his own basement, where he had laid bricks and mortar for a room but apparently forgot to leave himself an exit. [BBC News, 11-25-10] Chuck Shepherd’s News of the Weird, week of Dec 12, 2010

30. 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

31. UML? • Suitable for parts of a use case: • Use case diagram • Activity diagram • Communication diagram • Usually a small fraction of a use case • UML does not define use case structure

32. Beware • Analysis Paralysis • Duplication • Conflicting Requirements • Excessive Complexity

33. The Next Level

34. What if... • We could just “run” use cases as tests? • Traceability guaranteed • Tests & use cases always in synch • Less effort, expense • Tests are as complete as use cases

35. Today

36. Better Today Executable Verify >

37. Use cases • Specify how user gets value from system • Describe interaction of user & system • Abstractly

38. Use cases Tests • Specify how user gets value from system • Describe interaction of user & system • Abstractly Ensure Verify Concretely (specific test data)

39. S&I SimplificationGeneral High Level Goals • [G1] Decrease | limit waste • Time spent working on artifacts • Unused or unreachable artifacts • [G2] Increase domain penetration • The more use cases and scenarios, the more fully the domain issues can be understood and addressed • [G3] Centralize information • Create a network of specialized information that can be shared • [G4] Increase | facilitate collaboration • Manage centralized information so it stimulates collaboration (i.e. online services) • [G5] Facilitate integration of information in process • Information generated at a point in the process should flow and be easily usable by underlying processes • [G6] Reuse of existing infrastructure Simplification/UCAT Intro

40. S&I SimplificationUse Case Authoring Tool • Facilitates use case components capture (G1-2) • Facilitates use case components reuse (G1-2) • Creates a repository of use case components (G3) • Is accessible online (G4) • Allows for developed use cases to be electronically handled by underlying processes (i.e. implementation guides) (G5) • Helps the developed use cases to stay consistent (G1-3-5) • Allows full access of the underlying data to trusted members for integration with the existing infrastructure (G6) Simplification/UCAT Intro