1. Health Information Technology Standards Panel Ed Mikoski 19MAR09 TIA Healthcare ICT Section Teleconference

2. HITSP Background In the fall of 2005, the U.S. Department of Health and Human Services' Office of the National Coordinator for Health Information Technology (ONC) awarded multiple contracts to advance President Bush's vision for widespread adoption of interoperable electronic health records (EHRs) within ten (10) years. The contracts targeted the creation of processes to harmonize standards, certify EHR applications, develop nationwide health information network prototypes and recommend necessary changes to standardized diverse security and privacy policies.

3. AHIC The American Health Information Community (The Community) is a group of stakeholders who provided input and recommendations to the Department of Health and Human Services (HHS) on how to make health records digital and interoperable, and provide assurance that the privacy and security of those records are protected.

4. AHIC became NeHC The National eHealth Collaborative (formerly AHIC Successor, Inc.) is a public-private partnership driving the development of a secure, interoperable, nationwide health information system. The National eHealth Collaborative was founded in 2008 to build on the accomplishments of the American Health Information Community (AHIC), a federal advisory committee initiated by Secretary of Health and Human Services Mike Leavitt in 2005.

5. Partner Organizations The National eHealth Collaborative operates in close partnership with – the Office of the National Coordinator for Health Information Technology (ONC/HHS), – the Healthcare Information Technology Standards Panel (HITSP), – the Certification Commission for Healthcare Information Technology (CCHIT), and – the Nationwide Health Information Network (NHIN) Collaborative, to establish nationwide health information technology priorities.

6. www.HITSP.org Healthcare Information Technology Standards Panel (HITSP) – cooperative partnership between the public and private sectors – harmonizing and integrating standards that will meet clinical and business needs for sharing information among organizations and systems

7. HITSP Composition HITSP is chaired by Dr. John Halamka, Chief Information Officer of Harvard Medical School As of February 2009, over 600 organizations representing consumers, healthcare providers, public health agencies, government agencies, standards developing organizations, and other stakeholders now participate in the Panel and its committees. – Standards Developing Organizations (SDOs) 5% – Non-SDOs 82% – Government Bodies 7% – Consumer Groups 3% – Project Team Members (non-voting) 3% – Total 100%

8. Sponsors HITSP is administered by the American National Standards Institute (ANSI) in cooperation with strategic partners including: – the Healthcare Information and Management Systems Society (HIMSS), – the Advanced Technology Institute (ATI), and – Booz Allen Hamilton.

9. SDOs on HITSP Board Accredited Standards Committee X12 CDISC Integrating the Healthcare Enterprise (IHE) Health Level 7 National Council Prescription Drug Program (NCPDP) The Continua Health Alliance Organization for the Advancement of Structured Information Standards (OASIS) IEEE Standards Association

10. Program of Work The Panel's work is driven by a series of priorities (i.e., Use Cases) issued by the American Health Information Community (AHIC). HITSP produces recommendations and reports in Interoperability Specifications and related Constructs. These work products are intended to be equally applicable to the developing Nationwide Health Information Network for the United States (NHIN) and also to community and regional health information exchange networks.

11. HITSP Harmonization Framework a set of artifacts, known as "constructs", that: – specify how to integrate and constrain selected standards to meet the business needs of a Use Case Defines business and functional requirements – define a Roadmap to use emerging standards and to harmonize overlapping standards when resolved

12. HITSP construct types, in decreasing breadth of scope Interoperability Specifications Integration of all constructs used to meet the business needs of a Use Case Transaction packages Logical grouping of transactions Transactions Logical grouping of actions that use components and/or composite standards to realize the actions Components Logical grouping of base standards that work together, such as message and terminology

13. 13 Interoperability Specifications IS01 Electronic Health Record Laboratory Results Reporting IS02 HITSP Biosurveillance Interoperability Specification IS03 HITSP Consumer Empowerment and Access to Clinical Information via Networks Interoperability Specification IS04 HITSP Emergency Responder Electronic Health Record Interoperability Specification IS05 HITSP Consumer Empowerment and Access to Clinical Information via Media Interoperability Specification IS06 HITSP Quality Interoperability Specification IS07 HITSP Medication Management Interoperability Specification IS08 Personalized Healthcare Interoperability Specification IS09 Consultations and Transfers of Care Interoperability Specification IS10 Immunizations and Response Management Interoperability Specification IS11 Public Health Case Reporting Interoperability Specification IS12 Patient-Provider Secure Messaging Interoperability Specification IS77 Remote Monitoring (RMON) Interoperability Specification

14. 11 Transaction Packages TP13 HITSP Manage Sharing of Documents Transaction Package TP14 HITSP Send Laboratory Result Message to Ordering Clinician and Providers of Care Transaction Package TP20 HITSP Access Control Transaction Package TP21 HITSP Query for Existing Data Transaction Package TP22 HITSP Patient ID Cross-Referencing Transaction Package TP30 HITSP Manage Consent Directives Transaction Package TP43 HITSP Medication Orders Transaction Package TP46 HITSP Medication Formulary and Benefits Information Transaction Package TP49 HITSP Sharing Radiology Results Transaction Package TP50 HITSP Retrieve Form for Data Capture Transaction Package TP89 Sharing Imaging Results Transaction Package

15. 20 Transactions T14 HITSP Send Laboratory Result Message Transaction T15 HITSP Collect and Communicate Security Audit Trail Transaction T16 HITSP Consistent Time Transaction T17 HITSP Secured Communication Channel Transaction T18 HITSP View Laboratory Results from a Web Application Transaction T23 HITSP Patient Demographics Query Transaction T24 HITSP Pseudonymize Transaction T29 HITSP Notification of Document Availability Transaction T31 Document Reliable Interchange T33 HITSP Transfer of Documents on Media Transaction T40 HITSP Patient Generic Health Plan Eligibility Verification Transaction T42 HITSP Medication Dispensing Status Transaction T63 Emergency Message Distribution Element Transaction T64 Identify Communication Recipients Transaction T66 Retrieve Value Set Transaction T67 Clinical Referral Request Transport Transaction T68 Patient Health Plan Authorization Request and Response Transaction T79 Pharmacy to Health Plan Authorization Request and Response Transaction T81 Retrieval of Medical Knowledge Transaction T85 Administrative Transport to Health Plan

16. 29 Components C19 HITSP Entity Identity Assertion Component C25 HITSP Anonymize Component C26 HITSP Nonrepudiation of Origin Component C28 HITSP Emergency Care Summary Document Using IHE Emergency Department Encounter Summary (EDES) Component C32 HITSP Summary Documents Using HL7 Continuity of Care Document (CCD) Component C34 HITSP Patient Level Quality Data Message Component C35 HITSP EHR Lab Result Terminology Component C36 HITSP Lab Result Message Component C37 HITSP Lab Report Document Component C38 HITSP Patient Level Quality Data Document Using IHE Medical Summary (XDS- MS) Component C39 HITSP Encounter Message Component C41 HITSP Radiology Result Message Component

17. Components (continued) C44 HITSP Secure Web Connection Component C47 HITSP Resource Utilization Message Component C48 HITSP Encounter Document Using IHE Medical Summary (XDS-MS) Component C62 Unstructured Document Component C70 Immunization Query and Response C72 Immunization Message Component C74 Remote Monitoring Observation Document Component C75 Healthcare Associated Infection (HAI) Report Component C76 Case Report Pre-Populate Component C78 Immunization Document Component C80 Clinical Document and Message Terminology Component C82 Emergency Common Alerting Protocol Component C83 CDA Content Modules Component C84 Consult and History & Physical Note Component C87 Anonymize Public Health Case Reporting Data Component C88 Anonymize Immunizations and Response Management Data Component C90 Clinical Genomic Decision Support Component

18. Defining the Gaps HITSP has defined current duplications and gaps in their work as of NOV 2008. They will be updating this at a near-term upcoming meeting Spreadsheets defining these are available