 All lines are muted during presentation.  Lines are un-muted during Q&A ◦ If not asking question, please mute your line  *6 to mute your phone  *7 to un-mute  Questions can also be submitted via the Chat Box.

 Scott Gordon, PhD Director, eHealth, ASTHO  Barbara Massoudi, MPH, PhD CDC BioSense 2.0 Redesign Team  Kieran Dunne, MS CDC BioSense 2.0 Redesign Team  Mike Alletto, MS CDC BioSense 2.0 Redesign Team

Jurisdiction Public-Access Hospital

Shared Spaces BioSense 2.0 Environment Jurisdiction Public-Access Hospital

BioSense In Collaboration with

Agilexwww.agilex.com BioSense 2.0 NwHIN CONNECT Kieran Dunne Agilex Technologies

Agilexwww.agilex.com What is CONNECT CONNECT is an open source software solution that supports health information exchange – both locally and at the national level. CONNECT uses Nationwide Health Information Network standards and governance to make sure that health information exchanges are compatible with other exchanges being set up throughout the country

Agilexwww.agilex.com Why CONNECT? Set up a health information exchange within an organization Tie a health information exchange into a regional network of health information exchanges using Nationwide Health Information Network standards

Agilexwww.agilex.com How to participate Install NwHIN CONNECT at local site Exchange self-signed certificates with BioSense 2.0 Gateway Configure Gateway to communicate to BioSense 2.0 Gateway Send HL7 data via Administrative Distribution Transaction

Agilexwww.agilex.com BioSense 2.0 NwHIN Direct Receiver

Agilexwww.agilex.com What is Direct? The Direct Project specifies a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet

Agilexwww.agilex.com Why is there a need for Direct? Communication of health information among providers and patients still mainly relies on mail or fax Slow, inconvenient, expensive Health information and history is lost or hard to find in paper charts Current forms of electronic communication may not be secure Encryption features of off-the-shelf clients not often used in healthcare communications today Physicians need to transport and share clinical content electronically in order to satisfy Stage 1 Meaningful Use requirements. Need to meet physicians where they are now Direct will be one of the communication methods in the Nationwide Health Information Network Sources:

Agilexwww.agilex.com BioSense 2.0 Direct Architecture Sender HISP Security and Trust Agent Apache James Configuration Services BioSense HISP Security and Trust Agent Apache James Configuration Services SQUIRRELMAILCLIENTSQUIRRELMAILCLIENT SQUIRRELMAILCLIENTSQUIRRELMAILCLIENT SMTP port 25 IMAP 110

Agilexwww.agilex.com How to participate Install NwHIN Direct at local site Create Direct address at local site Generate and Exchange certificates Send HL7 data to as an

Agilexwww.agilex.com CONNECT vs. Direct CONNECT Targeted towards Enterprise level usage Includes auditing and policy engine Complicated install Direct Targeted towards smaller usage level Small hospital, larger practice Less infrastructure Easier to install

Agilexwww.agilex.com More Information Direct Project CONNECT Onboarding documents Coming soon to

Agilexwww.agilex.com Questions?

Mike Alletto 17 May 2012

Data Providers PHIN-MS NwHIN-Connect and Direct SFTP Mirth-to-Mirth VPN AWS Cloud BioSense 2 System hosted in the Amazon Cloud

* BioSense 2.0 was accredited and approved to operate on 14 Nov 11 (approved at FISMA-MODERATE) * The system went into live operations on 15 Nov 11 * The BioSense 2.0 application / environment received an Authorization to Operate (ATO) from CDC. It has been through the CDC’s Certification & Accreditation process, which meets Federal Information Security Management Act (FISMA) requirements. * CDC incorporates the use of National Institute of Standards and Technology (NIST) Special Publications (computer security guidance) in its Certification and Accreditation (C&A) processes. Some of the guidance specifically incorporated can be found in: * NIST SP : Guide for Developing Security Plans for Federal Information Systems * NIST SP : Guide for Applying the Risk Management Framework to Federal Information Systems: A Security Life Cycle Approach * NIST SP : Recommended Security Controls for Federal Information Systems and Organizations Note: The FISMA requirements and NIST guidance are publicly available. The NIST guidance is collected in the Computer Security Resource Center of the National Institute of Standards and Technology (NIST) site:

27 Secure Data Store Secure State and Local data storage Shared data access for approved partners Approved data for open access to public Local Access Shared Access Public Access Data Source Local Providers Regional or National Providers Public Health Community Environment User Interface Services Sample Jurisdictions Others State or Local User Authorized Collaborator General Public CDC User Database Service Collaboration Devices Transport Services Business Services RODS ESSENCE Data Transform and QA Others Data Access Services Raw Data

* * QUESTIONS