Healthcare Information Standards Panel 2007,2008, and Beyond John D. Halamka MD Chair, HITSP

Agenda  HITSP Interoperability Specifications 2006, 2007, and 2008  Personal Health Records and the role of HITSP in defining them  HITSP's alignment with CCHIT  The HITSP process for repurposing interoperability specifications  The Future of HITSP

3 HITSP: Harmonizing standards to support the Nationwide Health Information Network 2006 – the First “Turn of the Crank”  Consumer Empowerment – Medications – Allergies – Demographics – Advance Directives  Electronic Health Records – Laboratory including blood banking and microbiology – Ordering and results exchange  Biosurveillance – Deidentified registrations – Labs – Radiology text results

4 HITSP: Harmonizing standards to support the Nationwide Health Information Network 2006 – the Second “Turn of the Crank”  Privacy and Security standards  Emergency Responder  Personal Health Records  Medication Management  Quality

5 HITSP: Harmonizing standards to support the Nationwide Health Information Network Consumer Access to Clinical Information

6 HITSP: Harmonizing standards to support the Nationwide Health Information Network Medications Management

7 HITSP: Harmonizing standards to support the Nationwide Health Information Network Quality

8 HITSP: Harmonizing standards to support the Nationwide Health Information Network Security Standards  Collect and Communicate Security Audit Trails  Consistent Time  Document Integrity  Manage and Control Data Access  Manage and Control Privacy Consents  Manage Entity Identity Credentials  Non-Repudiation  Secure Communications Channel  User Authentication

9 HITSP: Harmonizing standards to support the Nationwide Health Information Network JANFEBMARAPRMAYJUNJULAUGSEPOCTNOVDEC HITSP 2007 Timeline 02/05/07 HITSP Board 04/23/07 HITSP Board 07/09/07 HITSP Board 10/09/07 HITSP Board 03/19/07 HITSP Panel 05/11/07 HITSP Panel 09/07/07 HITSP Panel 03/06 – 03/08 TC Face to Face Chicago IL 5/08 – 5/10 TC Face to Face Arlington VA 6/18 – 6/20 TC Face to Face San Diego CA 09/04 – 09/06 TC Face to Face Arlington VA Requirements, Standards Selection, and Design Public Input Inspect Test and Public Comment Implementation Support and Testing (with annual updates as required)‏ Comment Resolution and Panel Approval 01/19 – 04/12 04/13 – 05/03 IS Construct Development 04/13 – 07/19 07/20 – 08/1608/17 – 10/15 Implementation Support and Testing (includes minor document updates)‏ EHR, CE and BIO v 2.0 Activity 1 – Version 2.0 of Existing EHR, CE, BIO ISs Activity 2 – On-going Work for Existing EHR, CE, BIO ISs (e.g. Security and Privacy) Activity 3 – New Emergency Responder EHR Use Case On-going Support 10/15/07 HITSP Panel 07/16/07 HITSP Panel 02/12/07 HITSP Panel Activity 4 –New Use Cases from AHIC Detail Schedule to be Established Upon Review of the Use Cases Work Plan and Schedule Overview S&P and EHR-ER v 1.0, EHR, CE, and BIO v M.m

10 HITSP: Harmonizing standards to support the Nationwide Health Information Network Overall Timeline

11 HITSP: Harmonizing standards to support the Nationwide Health Information Network Personal Health Records  Numerous commercial, payer/employer and hospital-based products will become available in 2008 that will enable the patient to become stewards of their own data.  We should expect and look forward to recognition of PHR systems in the future, similar to CCHIT certification of EHR systems, based on the HL7 PHR system function model.  HITSP and HL7 should continue their close alignment and good working relationship on the development of standards related to consumer privacy and interoperability for the use of these systems.  The HITSP standard for medical summary exchange, CCD, will be a major factor in enabling patients to retrieve their data from hospitals and ambulatory care sites. The HITSP security standards will be important in enabling the patient to control and exchange this data among caregivers

12 HITSP: Harmonizing standards to support the Nationwide Health Information Network HITSP and CCHIT  Recent HITSP/CCHIT MOU regarding interoperability standards  CCHIT Interoperability Expert Panel will look first to HITSP-approved standards  If HITSP-approved standard not available/ready for a market need, CCHIT will request HITSP opinion on candidate standard as a “Roadmap standard” and level of readiness  If HITSP can not deliver timely response to above, CCHIT may look to directly to SDOs  Recognition and Certification timelines have been aligned

13 HITSP: Harmonizing standards to support the Nationwide Health Information Network Repurpose of HITSP Interoperability Specs and Constructs  Repurposing – New actor – New information interchange – New information content  A Technical Review Board, a proposed new appointed subgroup of the TC Leadership including project team, analyzes all new use cases and change requests and assigns to these to TCs for preliminary analysis and planning.

14 HITSP: Harmonizing standards to support the Nationwide Health Information Network The Future of HITSP  HITSP will be tightly aligned with the AHIC successor and is likely to obtain consistent funding from it.  HITSP has successfully brought together different camps of standards volunteers and has expanded the overall population of standards volunteers with each use case. We expect this expansion of the volunteer base to continue with the 2008 use cases The next set of use cases are proposed to harmonize standards in new territory such as remote medical device interoperability with EHRs, and remote clinical consultation.

15 HITSP: Harmonizing standards to support the Nationwide Health Information Network Summary  HITSP has become an established, trusted organization with a multi- stakeholder, open, transparent process for standards harmonization  In 2007, we will complete 4 additional use cases plus security/privacy  In 2008, we expect an additional 3-4 use cases  In 2009, we will align with the AHIC Successor and continue to serve stakeholders nationwide