NHIN Direct Implementation Group Meeting

April 6, 2010

Agenda

» Quick Summary of Last Meeting & Reminders

» Updates Workgroups» User Story Review » Content Packaging » Security & Trust» Robust HIE Interoperability » Individual Involvement» Addressing» Abstract Model

» Calendar & Participation

» Next Steps

Reminders & Quick Summary of Last Meeting

Q&A Text Box Function

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Recap of Last Meeting

» Abstract Model Workgroup Reviewed output of the working group, set expectations that we were close to calling for consensus

» Addressing Workgroup Noted that group had level set and discussed framing for future meetings

» Other Workgroups Reviewed meeting schedule

» Other Discussion Better described purpose of Abstract Model, mappings to concrete implementations, issues related to perception of NHIN Direct vs. NHIN vs. CONNECT vs…

Timeline Review

Launch, internal kickoff, recruiting

Start external meetings

First Draft Specs

2nd Draft SpecsEarly reference implementation

Ref implementation and testing framework available

Ops/prod draft cert. and conformance testing

• Weekly teleconferences• Face to face meetings as indicated by• We Are Here

TBD7/27

6/115/6

Deliverable Review

• Recommendations on Federal role, states, etc...

• Policy recommendations for trust enablement

• Formalized models (NIEM, service orchestration)

• Core specifications and service descriptions• Conformance testing scripts and

conformance service• Reference implementation guides for edge

systems and routing systems (including sample code, testing and conformance documentation, legal and policy documentation, etc...)

• Implementation guide for CONNECT users

• Core messaging• Placements in industry journals, key social

media outlets, etc...

• Use of NHIN Direct as a model (positive or negative)

• NIEM, modeling process recommendations

Specifications & service descriptions including Policy recommendations

Process recommendations Marketing/awareness

Review of Workgroups

» User Story Review Workgroup: Provide consistent, vetted set of user stories available on the Wiki

» Content Packaging Workgroup: Define a few workable alternatives, with pros/cons, for content packaging

» Security and Trust: Provide alternatives and highlight issues relating to security and trust enablement via technology (e.g., certificates and signatures)

» Robust HIE Interoperability Workgroup: Define how to mix and match direct transactions and robust HIE/NHIN specifications and services (patient discovery and information access) capabilities at scale

» Individual Involvement Workgroup: Clarify technology issues and policy implications for individual involvement in direct transport

» Addressing Workgroup: Define an implementation neutral mechanism for addressing that enables provider/individual identification and enabling organization routing

» Abstract Model Review Workgroup: Review and finalize a formal abstract model that all workgroups can use to define common vocabulary

Updates from the User Story Workgroup

Review of First Two Meetings

» Reviewed key stories, defined story style guide, fit all Must stories to story guide, and proposed Must/Should cut points.

» Peter DeVault is the workgroup lead

» All output from group reflected in updated user stories and revised user story template

• http://nhindirect.org/User+Stories• http://nhindirect.org/space.template.User+Story

» More background in meeting notes• http://nhindirect.org/User+Story+Meeting+2010-04-01• http://nhindirect.org/User+Story+Meeting+2010-04-05

Updates from the Content Packaging Workgroup

Review of First Meeting

» Reviewed goals and objectives, discussed framing issues

» David McCallie is the workgroup lead

» Framing topics documented in notes for next meeting• http://nhindirect.org/Content+Packaging+Meeting+2010-04-07

» More background in meeting notes• http://nhindirect.org/Content+Packaging+Meeting+2010-03-31

Updates from the Security and Trust Workgroup

Review of First Meeting

» Reviewed goals and objectives, discussed framing issues• Renamed group to Security and Trust• Defined Security and Trust policy assumption that we can assume

pre-existing policy decision by data holder and transaction initiator that it is appropriate and legal to transmit data

• Will re-frame key issues for next meeting

» Jonathan Gershater is the workgroup lead

» More background in meeting notes• http://nhindirect.org/Security+and+Trust+Meeting+2010-04-01

Updates from the Robust HIE Interop Workgroup

Review of First Meeting

» Reviewed goals and objectives, discussed framing issues• Will re-frame key issues for next meeting

» No workgroup lead yet appointed

» More background in meeting notes• http://nhindirect.org/Robust+HIE+Meeting+2010-04-01

Updates from the Individual Involvement Workgroup

Review of First Meeting

» Reviewed goals and objectives, discussed framing issues• Framing issues for next meeting noted at

http://nhindirect.org/Individual+Involvement+Meeting+2010-04-08

» Richard Elmore is workgroup lead

» More background in meeting notes• http://nhindirect.org/Robust+HIE+Meeting+2010-04-01

Updates from the Addressing Workgroup

Review of Second Meeting

» Discussed a concrete proposal for an addressing specification• Formalized at http://nhindirect.org/Addressing+Specification• Expectation of ability to move to call for consensus at next meeting

» Wes Rishel is workgroup lead

» More background in meeting note• http://nhindirect.org/Addressing+Meeting+2010-03-31

Updates from the Abstract Model Review Workgroup

Agenda

» Action Items

» Next Steps and Backlog

Action Items – First an Overview

» Abstract Model’s goal is to provide an implementation-agnostic expression of the transactions between actors implied by user stories

» In other words, a common frame of reference and terminology on which concrete implementation ideas may be mapped

• Makes no implication about one versus many mappings» Currently modeled as three “legs”

• Source to HSP• HSP to HSP• HSP to Destination

» Does not make any assumptions about how the responsibilities are deployed (i.e., an HSP is not, by definition, a separate org from a Source, but it could be)

» See http://nhindirect.org/NHIN+Direct+Abstract+Model

Action Items

Message Status Support Owner Status/Due Date

Add Transaction 1.3 to fully support the concept of message status

Arien Completed 3/31

Language Cleanup Owner Status/Due Date

Clarify language for consistency and accuracy

Arien et al Completed 4/5

Next Steps

Finalize Abstract Model Language & Get

Workgroup ConsensusOwner Status/Due Date

Review any final concerns from the Workgroup on 4/7/2010 call and obtain final consensus.

Arien/Brett 4/7/2010

Bring to Implementation Group for Consensus

Owner Status/Due Date

Present to Implementation Group on 4/13/2010. Implementation Group members: Please take the time to read the abstract model before 4/13/2010.

Brett/Arien 4/13/2010

Comment and Contact Information

» If further refinements to the Abstract Model are necessary based on input from other workgroups, such refinements will be discussed and brought to the Implementation Group.

» To comment further on this topic please visit http://nhindirect.org/Abstract+Model+Workgroup

Calendar & Participation

Workgroup Schedule

» Workgroups adhere to the below schedule, meeting via teleconference on a weekly basis

Workgroup Meeting Time

User Story Review Workgroup Mondays 11am-12pm EST

Content Packaging Workgroup Wednesdays 1pm-2pm EST

PKI/Certificates Workgroup Thursdays 2pm-3pm EST

Robust HIE Interoperability Workgroup Tuesdays 2pm-3pm EST

Individual Involvement Workgroup Thursdays 1pm-2pm EST

Addressing Workgroup Wednesdays 3:30pm-4:30pm EST

Abstract Model Review Workgroup Wednesdays 11am-12pm EST

Over 130 Implementation Group Participants

» PHR• Google • Microsoft (HV/Amalga)

» EHR• Allscripts• Cerner• eClinicalWorks• Epic• GE • NextGen • McKesson (through RelayHealth)• Oracle Health Sciences

» HIE Technology• RelayHealth (also PHR)• Axolotl• Mirth• VisionShare• GE • MedAllies• CSC• Medicity• Kryptiq• MobileMD• IBM/Open Health Tools

» HIT Association• Clinical Groupware Collaborative» Medical Associations• American Academy of Family Physicians

» State/Regional HIO• CA (Jonah and David Lansky)• CA (Redwood MedNet)• TN (CareSpark)• MA (NEHEN-CSC) • MAeHC• NY (HIXNY) • NY (Hudson Valley) (through MedAllies)• HITOC (Oregon Health Information

Technology Oversight Council)• RIQI (Rhode Island Quality Institute)• Carespark

» IDN• Kaiser• BIDMC/CareGroup

» Consulting• Manatt• Gartner• CGI Federal

» National Network• SureScripts• Medplus/Quest

» Federal• VA• SSA

• NIH NCI• CMS• NIST

Next Steps