Electronic Submission of Medical Documentation (esMD) Author of Record Workgroup Wednesday June 13,

Meeting Etiquette Please announce your name each time prior to making comments or suggestions during the call Remember: If you are not speaking keep your phone on mute Do not put your phone on hold – if you need to take a call, hang up and dial in again when finished with your other call –Hold = Elevator Music = very frustrated speakers and participants This meeting, like all of our meetings, is being recorded –Another reason to keep your phone on mute when not speaking! Feel free to use the “Chat” or “Q&A” feature for questions or comments NOTE: This meeting is being recorded and will be posted on the esMD Wiki page after the meeting From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute 2

Agenda 3 TopicPresenterTimeframe Administrative ItemsSweta1:30-1:35 pm Author of Record OverviewBob / Dan1:35-1:40 pm NSTIC PresentationDebbie Bucci1:40-2:05 pm DIRECT PresentationJohn Hall2:05-2:30 pm Charter ReviewAll2:30-3:00 pm

Announcements Schedule of esMD Meetings moving forward: The AoR Charter is posted to the wiki and is available for comment ( +Author+of+Record+Workgroup+Charter) +Author+of+Record+Workgroup+Charter – Please provide comments by Friday, June 22 nd, Day/TimeMeeting Wednesdays at 10 AM ETHarmonization of UC 1 & 2 Wednesdays at 1:30 PM ETAuthor of Record Fridays at 2 PM ETHarmonization of UC 1 & 2

esMD Initiative Timeline 5 Author of Record WG Use Case and Requirements L1 Pilots (TBD) SDS Structured Content WG (Use Case 2) Use Case #2: Sending eMDR Outline Use Cases & Stories Harmonization/ Standards Analysis of Registration Harmonization/ Standards Analysis of eMDR Use Case #1: Registration Combined Registration/ eMDR Pilots (TBD) 11/30-12/7 Charter Consensus Pre-Discovery Initiative Charter/Scope Today (6/13/12) Oct ‘11 Kick-Off/ F2F Oct ‘12 Jan ‘12April ‘12 July ‘12 PPA Workgroup (Use Case 1) Target Initiative Completion: Oct ‘12 Pre-Discovery Harmonization L1 AoR Workgroup Through April 2014

AoR Proposed Timeline 6 Author of Record Level 1 Use Case and Requirements L1 Harmonization L1 SDS Today (6/13/2012) June ‘12Oct ‘12July ‘12August ‘12Sept ‘12 Target Initiative Completion: Oct ‘12 Pre- Discovery Nov ‘12Dec ‘12Jan ‘13Feb ‘13Mar ‘13 Pilots L1 Author of Record Level 2 Use Case and Requirements L2 Harmonization L2 Implementation Guide L2 Implementation Guide L1 Author of Record Level 3 Use Case and Requirements L3 AoR Kickoff (6/13/2012)

Initiative Requirement Summary InitiativeIdentify Proofing Digital Identity Management Signing (Exchange Artifact) Encryption Delegation of Rights Author of Record DS4POrg/IndividualYes Direct ProjectAddress/ServerYes esMDOrg/IndividualYes Healthcare Directories Org/IndividualYes Audit? LCCOrg/IndividualYes Query HealthOrg/IndividualYes Transitions of Care Org/IndividualYes 7 Mandatory Optional with consequences Optional Future Uses

Author of Record Levels 8 Level 1 – Current FocusLevel 2 - TBDLevel 3 - TBD Digital signature on aggregated documents (bundle) Digital signature to allow traceability of individual contributions to a document Digital signature on an individual document

Scope of Effort Spans 6 Areas 9 2. Identity Proofing Needed for all identity management requirements 3. Digital Identity Management Needed for all signing and AoR requirements 4. Encryption If limited scope, focus only on encryption of payload (eMDR) ? 5. Digital Signatures Required for all esMD transactions and AoR 6. Delegation of Rights Most likely needed, but limited industry solutions in the near term Eliminate from scope, but address in limited fashion if use case requires 1. Author of Record (Levels 1, 2, and 3)

esMD AoR – Framing the Scope AoR Level 1 * (Support Approved) AoR Level 2 (Support TBD) AoR Level 3 (Support TBD) Identity Proofing In Scope TBD Digital Identity Management In scope TBD Encryption Limited Scope TBD Digital Signatures In Scope TBD Delegation of Rights Out of Scope TBD 10 *All In Scope items will be necessary, at minimum, to address needs for esMD Use Case 1 and 2 Signature Artifact AoR Level 1 aggregate document bundle level digital signatures

Debbie Bucci (NSTIC) Debbie Bucci has extensive experience with identity management initiatives and is well acquainted with Identity management industry standards and practices. At NIH, she served as the principal program manager for both the NIH Federated Identity Service and the enterprise Service Oriented Architecture (SOA) efforts from Sept 2003 to Oct During that tenure she received the 2008 NIH Director's Award in recognition of her work with NIH Federated Authentication, 2009 InformationWeek 500 top 20 Innovators awards and the 2011 Kantara IDDY (Identity Deployment of the Year) Award for NIH iTrust. Debbie actively participates in the Federal CIO Council’s Identity Credentialing and Access Management subcommittee (ICAMSC) as a technical member of the Trust Framework Adoption Process Review Board, a participating member of the Access Control & Attribute Governance Working Group (ACAGWG) as well as the co-chair of the FICAM Federation Integration Working group (FIWG). She also is an active NSTIC agency partner and is involved in a number of NSTIC related activities. Debbie currently serves as an IT Architect on the Office of Science and Technology Policy (OSTP) sponsored SciENCV project and as a Technical Advisor to the Director, DECA, CIT NIH. Additionally, she will assist ONC with assessing the security concerns surrounding HIE, in particular as it relates to identity and access management 11

John Hall (DIRECT) John Hall serves as the Coordinator for the Direct Project. Direct Project is an ONC-guided initiative focused on the set of specifications and services enabling secure, directed exchange of health information over the Internet. John has been a participant in Direct Project since it began in early 2010, and has served as Coordinator since September

AoR Charter Review 13

Next Meeting - 6/13 Next week we will continue with the environmental scan and hear from experts on what they’ve done Reed Gelzer, HL7 RM-ES Other presentations in the coming weeks will include perspectives on AoR from Certificate Authorities, NwHIN, EHR Vendors, SSA, among others. 14