1. Welcome ONC/IWG/IHE USA/eHEX HPD Provider Directory Task Group
Call for Participation
April 2nd, 2014
Alex

2. Agenda Introductions Problem Statement and Objectives
ONC Modular Specification (Mod Spec) Process
Federated Provider Directory Technical Approach
Benefits of Participation
Roadmap/Timelines
Call for Participation
Q&A
References – For More Information
Alex

3. Introductions ONC Office of Science and Technology Matthew Rahn
Dragon (Nagesh) Bashyam (Drajer LLC – Subcontractor)
IHE
Eric Heflin (eHealth Exchange/ HIETexas/IHE)
John Donnelly (IntePro Soln / EHR|HIE Interoperability WG)
Alex Lippitt (HIMSS / IHE USA)
Sarah Willis-Garcia (HIMSS / IHE USA)
John

4. Problem Statement and Objectives
ONC has been gathering industry feedback on Provider Directories from sponsored pilots, environment scans, communities of practice and standards activities over the past couple of years.
These activities have identified the following areas where IHE HPD can be improved
Federation Facilitation
Absence of a centralized authoritative provider directory requires federation capability (within and across organizations) to use existing authoritative directories so that electronic addresses of providers and their systems can be discovered during workflows
Error Handling
Provide ability for a client to implement local policies and workflows based on complete/incomplete responses received
Objective is to develop a workable approach that is broadly supported and testable by the industry as soon as possible.
John

5. ONC Modular Specification (Mod Spec) Process
Mod Spec efforts are aimed at identifying existing specifications for a particular area of interest and improving/documenting/testing/promoting existing specifications.
Have successfully followed the process and improved Direct specifications and SOAP Transport specifications both of which are part of the MU2 certification rule.
Follows an Open process with regularly scheduled public calls to gather input and feedback as artifacts are developed.
Provider Directory Mod Spec was developed under this process where the IHE HPD specification was identified as the candidate specification for Provider Directories based on industry feedback.
Created an Advisory group consisting of real-world Provider Directory Implementers
Robert M. Cothren, Technical Director, California Health eQuality Institute for Population Health Improvement | UC Davis Health System
Walter Sujansky, Independent Consultant, Health Information Technology and Clinical Data Integration and Interoperability
Vince Lewis, Principal Architect at GSI Health
Gary Teichrow, Co-Founder, Chief Architect at Mirth Corporation
John Donnelly, President, IntePro Solutions Inc
Matt

6. ONC Modular Specification (Mod Spec) Process
Vendors participating in the Federated HPD HIMSS Interoperability Showcase
CareEvolution
Inpriva
NextGate
SureScripts
Verizon
….attracted interest
at the highest ONC level
Matt

7. Early Testing / Demonstration Vendors
IHE HPD profile needs some fixes/tweaks/enhancements
CPs are in process and more are on the way
Testing tools need some corresponding refinements
Gazelle and ONC tooling
Test data
Test LDAP schema
Federation aspects were developed just prior to HIMSS Interop Showcase
Federation can work(!) and was demonstrated to Dr. Karen DeSalvo
Fed HPD is based on DSML, which assumes LDAP and some vendors deployed using databases instead of LDAP resulting in some mismatches in query behaviors
John or Eric

8. Early Testing / Demonstration Vendors
Goal is to keep IHE HPD profile in sync as much as possible
Vendor neutral
Technology neutral
Seeking evidence that the technology is ready for implementation prior it to being a candidate for broad industry adoption
Should meet the requirements for the Direct Project, the eHealth Exchange, for state directories/IWG, and more
The Mod Spec Fed HPD is mentioned in the NPRM 2015 Certified EHR Technology for solicitation of comments (through April 28th, 2014)
John or Eric

9. Provider Directory Mod Spec Technical Approach
Enhance IHE HPD with a “wrapper” around the DSML payload to convey federation requests and error handling.
Allow Provider Information Consumers (requestors) to indicate to a Provider Information Directory that a request needs to be federated to other known directories.
Allow Provider Information Consumers (requestors) to receive responses that clearly identify the Provider Information Directory that produced the result and/or errors.
Allow Provider Information Consumers (requestors) to specifically target a Provider Information Directory for subsequent queries based on initial query results.
Allow for clear distinctions for errors that occur due to web service failures versus errors that occur due to data related issues at the Provider Information Directory. This improves the error handling and also debugging and implementation of the specification in the real world.
Provider Information Consumers will be able to detect partial versus complete responses based on the improved error handling and packaging of federated requests and responses.
Provider Information Consumers will be able to identify the authority of the source so that they can log the information for HIPAA and other compliance issues.
Dragon

10. Provider Directory Mod Spec Technical Approach – Architecture Diagram
Provider Information Directory 1
Provider Information Consumer 4
Provider Information Directory A 1 2a 2c 3b
Provider Information Directory 2 5 2b
e.g. Health IT system (EHR)
(Acting as an aggregator) 3c
Provider Information Directory 3
Provider Information Directory B
Workflow
1b. Healthcare provider uses their HealthIT system to locate a provider
2a. The Provider Information Consumer (the HealthIT system) sends the request to a Provider Information Directory A which federates multiple directory sources as shown in the diagram
2b. The Provider Information Consumer (the HealthIT system) can also send a request to a Provider Information Directory B that does not federate the request to any other directory sources.
2c. The Provider Information Directory A federates the request to a set of known additional Provider Information Directories (1, 2, and 3).
3# Provider Information Directories provide a complete response, an error, or an incomplete response.
4. Provider Information Provider A aggregates responses (including complete responses, errors, and incomplete responses) back to the Provider Information Consumer.
5. The Provider Information Consumer (the HealthIT system) receives the responses, including incomplete and error responses, and presents the data to the user. 3d
Dragon
Requests
Aggregate or regular responses
Incomplete or error responses

11. Benefits of Participation - IWG
Addresses industry need as emphasized by recent ONC/IWG PD Federation Pilots
Pilot Deliverables
Pilot Feedback on Business & Operations Aspects
Pilot Feedback on Technical & Standards Aspects
Share lessons learned during bi-weekly check-ins and monthly calls
Provide metrics
Provide written policies, procedures and legal agreements, if possible
If applicable, share barriers to moving pilots to production environment
Respond to pilot feedback form to gather information on pilot experiences and findings
Review and provide feedback to documentation of pilot findings
Seeking feedback on questions such as:
Live data or test data?
Business use cases?
Providers taking part?
Level of training?
Policies & legal agreements?
Standards considered and piloted by each organization?
IHE HPD
IHE HPD with CP-601
IWG HPD+ 1.0
IWG HPD+ 1.1
ONC ModSpec 1.0
EHR Integration?
Conformance testing?
Interoperability issues?
What should IWG capture in Implementation Guide appendix?
How was federation accomplished?
John

12. Benefits of Participation - IWG
IWG HPD Guidance Updated to Highlight New Collaborative PD Federation Activities
IWG informed by PD federation feedback from Exemplar Governance Grantee PD Update project
PD federation complicated by multiplicative, non-compatible implementation guidance
Currently IWG HPD+ Appendix v1.1 nor the IHE HPD profile (post CP601) provide any guidance re federation
Published IWG HPD+ with updated appendix for “interim” PD federation guidance
IWG HPD+ Appendix v1.1.1 available at:
John

13. Benefits of Participation - eHEX
eHealth Exchange Benefits
Federated HPD would likely be the replacement for the current directory
UDDI is in use today for the eHEX
UDDI has limits
Waning technology
Limited vendor support
Unable to meet all current or identified future requirements
eHealth Exchange is seeking to deploy the same directory technology as the Direct Project, the IWG, states (Texas),
Eric/John

14. Roadmap / Timeline Event Dates
ModSpec specifications, data, and test tool development
April July 2013
IHE proposal and work initiation
July 2013 –
IHE NA Connectathon
Jan 2014
HIMSS Interop Showcase Demo
Feb 2014
Broad Vendor Outreach Call/Virtual Connectathon Start
April 2014 (today!)
IHE Profiles Complete for Trial Implementation
May 2014
FedHPD Vendors Bring Products to Market?
Jun 2014
Organizations Begin Procurement?
July 2014
Matt or Eric

15. Call for Participation – Benefits
In parallel with IHE Profile creation, and test tooling changes, we’ll hold a “Virtual Federated HPD Project Connectathon”
Virtual Connectathon testing is a tried-and-proven accelerator for focused projects
It helps ensure proper staff is engaged
It provides an early indicator of likely interop problems
It helps ensure basic IT issues, such as firewalls, are addressed
It confirms basic functionality of your actors
It helps familiarize your team, in advance, with peers for testing
And, it helps finalize any development that may still be occurring
Ability to influence and impact an emerging national standard
Jump start to providing this functionality to clients and prospects
Avoids surprises!
Eric or John

16. Call for Participation – How to Join
Join the workgroup!
We’ll publish a sign-up survey immediately after this webinar to all registered attendees
Respond to the survey and we’ll add you or your designated staff to the workgroup
Start participating in the weekly/bi-weekly working meetings
Review the resources & begin testing using the existing test tooling (includes test harness, test data, specs, and more)
Test with your peers
This is likely the final call for participation and your final chance to influence this standard before it is published by IHE USA for Trial Implementation
Eric or John Alex

17. Q+A
Alex/all

18. ONC Modular Specification (Mod Spec) Resources
Significant Artifacts Were Created to Assist Fed HPD Vendors and Users:
Implementable, Testable, Certifiable Requirements Traceability Matrix
Test Implementation (TI) based on RTM
Platform independent test cases
Basic conformance test tool, based on the RTM
Test Data for Download
LDAP Schema for the test data
Leveraging the IHE HPD Implementers Google Group
Plus and Implementation Guide, WSDLs, install guide, wiki, and more
Matt