1. 0 Healthcare Information Technology Standards Panel January 24, 2008 HITSP – NHIN Liaison Update

2. 1 Healthcare Information Technology Standards Panel NHIN Participants  Nine HIEs under contract to implement a Nationwide Health Information Network –Carespark - parts of Tennessee, Kentucky, Virginia, N. Carolina –Long Beach, Ca –Med Virginia –Delaware –Lovelace Foundation Clinic – New Mexico –NYeC - New York –NCHICA – North Carolina –West Virginia –Indiana –Plus the Federal Health Consortium

3. 2 Healthcare Information Technology Standards Panel NHIN Trial Implementations Year One Goals  Demonstrate in-situ, interoperable and secure health information exchange based on common specifications.  Build a foundation for production level services and initiatives to come.  Core Services Demonstrations –Deliver data across HIEs Including summary record, look-up and use case data –Look-up and retrieve data across HIEs From locations in EHRs and PHRs / Health Data Banks –Exchange consumer access permissions Decision to not participate in electronic exchange of their data Workable permissions for who can access what –Support the delivery of data for population uses  Use Case Demonstrations

4. 3 Healthcare Information Technology Standards Panel Organization  DURSA – Data Use and Reuse Services Agreement –Develop the model legal agreement under which the HIEs will operate as a member of the Nationwide Health Information Network  Testing –Develop the testing plans, tools and other needed components for testing the HIEs ability to fulfill the interactions of the NHIN  Core Services – Content –Defining the content, e.g., data elements, that is common to all use cases  Core Services Security and Infrastructure –Defining the infrastructure, e.g., common interfaces, on which the NHIN will operate, including security  Leadership and Communications Work Group

5. 4 Healthcare Information Technology Standards Panel Aggressive Schedule  March 31, 2008 - Draft Implementation Specifications (including legal agreement)  June, 2008 – First trial demo of exchanges  September – Full demo of exchanges

6. 5 Healthcare Information Technology Standards Panel Relationship to HITSP  Contractual requirement to implement HITSP specifications  All current HITSP Interoperability Specifications (IS01 through IS07)  Each NHIE will implement at least two of the ISs  All will demonstrate the exchange of the summary document within the IS04 context  This will be first real-world attempt to implement the HITSP specifications, presenting a golden learning opportunity for everyone including the SDOs on which HITSP relies for standards and solutions

7. 6 Healthcare Information Technology Standards Panel Interaction Goals  Work collaboratively with NHIN Working Group participants to: –Support interoperability among implementers Liaison to provide “first round” of support in use of HITSP constructs by NHIN participants, informal process for immediate support on understanding constructs Items not handled in the informal process will come back to HITSP for resolution via a more formal mechanism Internal Review Board –Improve the Interoperability Specifications (ISs) Capture issues related to the use of ISs by the NHIN implementers Readability Completeness Technical Viability –HITSP Comment on the Implementation Specifications

8. 7 Healthcare Information Technology Standards Panel Activities to Date  Liaison participation in all WG calls, providing “first line” of support in use of HITSP constructs  First round of “roadmap requests” received this week  Training – general sessions held covering –What is HITSP –Navigation of HITSP Interoperability Specifications –Walk through of IS03 –Walk through of IS04 –Ad-hoc/on demand sessions on specific constructs – C32  More to come… request for add’l sessions to focus on each IS

9. 8 Healthcare Information Technology Standards Panel Lessons so far…  HITSP constructs are –Complex and HARD to understand –Too many formats (although it gets better with each iteration) –Difficult to understand how all the ISs fit together –Too much fluff –Need additional information to speak to multiple audiences, e.g, consumers, executives, not just implementors –More examples!

10. 9 Healthcare Information Technology Standards Panel What’s next  First set of Roadmap Requests received yesterday –IRB has triaged and will distribute to TCs today  Request for additional in-depth training ASAP –2 hours on each IS by the co-chairs

11. 10 Healthcare Information Technology Standards Panel What’s Next  HITSP to review NHIN Implementation Specifications and provide feedback –Recognition that HITSP membership have valuable collective knowledge that can be tapped to comment on how the Interoperability Specifications are being implemented –Schedule TBD, but anticipate first week of March –Comment cycle TBD, expectation is 2-3 weeks