NATIONWIDE HEALTH INFORMATION NETWORK GOVERNANCE Doug Fridsma Director, Office of Interoperability and Standards

NATIONWIDE HEALTH INFORMATION NETWORK GOVERNANCEDoug FridsmaDirector, Office of Interoperability and Standards

S&I Framework coordination

Tools and Services(Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository, Testing Scripts, etc)

(Stanley)


(Stanley)

Use Case Developmentand Functional Requirements(Accenture)


Standards Development

(TBD)


(TBD)

Certificationand Testing

(Stanley/Deloitte)


(Stanley/Deloitte)

Harmonization ofCore Concepts

(Deloitte)


(Deloitte)

Implementation Specifications

(Deloitte)


(Deloitte)

Pilot Demonstration Projects

(Lockheed Martin)


(Lockheed Martin)

Reference Implementation

(Lockheed Martin)


(Lockheed Martin)

Subject matter experts, priorities setting

Stds, operational and technical coordination

Versioning, code and dev. coordination

Certification criteria, testing

NHIN Exchange, other pilot projects



(Stanley)


(Stanley)




(TBD)


(TBD)


(Stanley/Deloitte)


(Stanley/Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)

Subject matter experts, priorities setting

Use Case Development and Coordination

» Organizing Principles• Bottom-up, driven by use cases and need (think NHIN Direct)• “use case steward”• Focused on stakeholders• Inclusive of all stakeholders

» Stakeholders• Federal advisory committees (HITPC, HITSC)• Meaningful use requirements• VLER pilots• Federal partners• Patients, privacy, security experts

Prioritization and Backlog Lists

04/21/23



(Stanley)


(Stanley)




(TBD)


(TBD)


(Stanley/Deloitte)


(Stanley/Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)

Stds, operational and technical coordination

Prioritization and Backlog Lists

04/21/23

Strategic Priorities Strategic Priorities

Operational Priorities

Operational Priorities

“Day to Day” Priorities within each functional

team

“Day to Day” Priorities within each functional

team

S& I Overview of Roles and Controls

04/21/23

Core artifacts are versioned and controlled

Core artifacts are versioned and controlled

Artifacts are “packaged”

and released

Artifacts are “packaged”

and released

Each artifacts has a

responsible role

Each artifacts has a

responsible role

Artifacts and releases have prioritization and approval

points, or “controls”

Artifacts and releases have prioritization and approval

points, or “controls”



(Stanley)


(Stanley)




(TBD)


(TBD)


(Stanley/Deloitte)


(Stanley/Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)

Versioning, code and dev. coordination

Versioning and Development Coordination

» Principles• Leverage knowledge of open-source communities• Support rapid, iterative and open development• Coordination with both the use-case teams and the certification and

testing teams» Highly operational coordination, using software development tools



(Stanley)


(Stanley)




(TBD)


(TBD)


(Stanley/Deloitte)


(Stanley/Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)

Certification criteria, testing



(Stanley)


(Stanley)




(TBD)


(TBD)


(Stanley/Deloitte)


(Stanley/Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)

NHIN Exchange, other pilot projects

Nationwide Health Information Network

» Onboarding requires

• Conformance testing against standards specifications– Product level conformance for CONNECT (like EHR certification)– Addition conformance testing against specific standards used in the

Nationwide Health Information Network (constrained C32, etc)– Certification of “HISPs” may provide coordination mechanism

• Interoperability testing – “Scripts” about how exchange occurs (send, acknowledge, response)– More challenging that conformance testing, but automatic testing can

help

• Agreement to operate in a particular way – DURSA defines some of the behaviors expected (ie, breach

notification, etc)– Uses contracting mechanism for enforcement



(Stanley)


(Stanley)




(TBD)


(TBD)


(Stanley/Deloitte)


(Stanley/Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Deloitte)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)


(Lockheed Martin)

The goal of the S&I Framework

15

Low HighLo

wH

igh

FocusedCollaboration

A Thousand Flowers Bloom

Commandand Control

Participation

Classic

Trade-Off

Focus

» Consensus Driven Process» Open Collaboration» Established core guiding

principles» Driven by business needs and

elaborated use cases» Real world pilot implementation » Establish coordination

mechanisms across the entire spectrum of the S&I Framework

Final Thoughts

» Coordination is not one-size-fits all

» Different parts of the S&I framework require different coordination mechanisms

• Not all aspects of the S&I framework require formal governance established through rule-making. Need to maintain flexibility for those things that require rapid response to changing needs.– Strategic priorities– Certification to standards and implementation specification– Operational coordination for harmonization, code and

versioning control– Approval of implementation specifications for specific purposes

Documents

NATIONWIDE HEALTH INFORMATION NETWORK GOVERNANCE Doug Fridsma Director, Office of Interoperability and Standards