1. 1 HIT STANDARDS COMMITTEE DRAFT: S&I Framework Principles and Processes 1

2. 2 KICK-OFF S&I Framework

3. 3 S&I Mission »Promote a sustainable ecosystem that drives increasing interoperability and standards adoption »Create a collaborative, coordinated, incremental standards process that is led by the industry in solving real world problems »Leverage “government as a platform” – provide tools, coordination, and harmonization that will support interested parties as they develop solutions to interoperability and standards adoption.

4. 4 ONC Standards and Interoperability Framework Tools and Services (Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository, Testing Scripts, etc) (Stanley) Tools and Services (Use Case Development, Harmonization Tools, Vocabulary Browser, Value Set Repository, Testing Scripts, etc) (Stanley) Use Case Development and Functional Requirements (Accenture) Use Case Development and Functional Requirements (Accenture) Standards Development (TBD) Standards Development (TBD) Certification and Testing (Stanley/Deloitte) Certification and Testing (Stanley/Deloitte) Harmonization of Core Concepts (Deloitte) Harmonization of Core Concepts (Deloitte) Implementation Specifications (Deloitte) Implementation Specifications (Deloitte) Pilot Demonstration Projects (Lockheed Martin) Pilot Demonstration Projects (Lockheed Martin) Reference Implementation (Lockheed Martin) Reference Implementation (Lockheed Martin)

5. 5 Standards and Interoperability Organizational Structure Standards and Interoperability Standards National Health Information Network Certification and Testing FHA Standards Teams NHIN Teams Certification Team FHA Teams Use Cases (Accenture) Use Cases (Accenture) Standards Development (TBD) Standards Development (TBD) Harmonization (Deloitte) Harmonization (Deloitte) Spec Factory (Deloitte) Spec Factory (Deloitte) Architecture Reference Implementations (Lockheed Martin) Reference Implementations (Lockheed Martin) Emergent Pilots (Lockheed Martin) Emergent Pilots (Lockheed Martin) Tools (Stanley) Tools (Stanley) Operations (Stanley) Operations (Stanley) Certification (Stanley/Deloitte) Certification (Stanley/Deloitte) Test Infrastructure (Stanley/Deloitte) Test Infrastructure (Stanley/Deloitte) CONNECT (TBD) CONNECT (TBD)

6. 6 What is an IEPD? »An Information Exchange Package Documentation (IEPD) is a collection of artifacts that describe the construction and content of an information exchange Developed to provide the business, functional, and technical details of the information exchange through predefined artifacts Created with a core set of artifacts in a prescribed format and organizational structure to allow for consistency Designed to be shared and reused in the development of new information exchanges through publication in IEPD repositories IEPDs contain design specifications for an information exchange but may not include supplementary information such as implementation decisions.

7. 7 The IEPD Artifacts IEPDs contain both required and recommended artifacts Required : Bold Recommended : Italic Note: Best practices for most organizations include many of the optional artifacts listed here Business Process Use Cases Sequence Diagrams Business RulesBusiness Requirements Exchange Content Model Mapping Document Subset Schema Exchange Schema XML Wantlist Constraint Schema Extension Schema Main Document IEPD Catalog IEPD Metadata Sample XML Instances XML Stylesheets Scenario Planning Analyze Requirements Map & Model Build & Validate Assemble & Document Publish & Implement No required artifacts. Publish the IEPD to a repository and implement the exchange

8. 8 S&I NIEM Harmonization Strategy »ONC’s Office of Interoperability and Standards is building a Health Information Exchange Model (NIEM Health) that is harmonized with NIEM »Health and Human Services petal to serve as bridge between NIEM and NIEM Health Human Services

9. 9 Capability Elaboration Capability Formulation Construction Release & Publication Use Case Development Spec Development Harmonization Reference Impl Cert &Testing S&I Development Phases S&I Governance Health Community Participants Scenario Planning Analyze Requirements Map & Model Build & Validate Assemble & Document Pub. & Impl. NIEM Lifecycle S&I NIEM Process Harmonized

10. 10 Addressing Challenges for the Health Information Exchange Model ChallengeApproach Existence of disparate health information exchange standards and specifications and implementation approaches Map exchange requirements to existing standards & specifications and address any gaps, duplications, or overlaps Harmonization and management of several well-established, large vocabularies for semantic interoperability Leverage existing vocabulary repositories (e.g. PHIN VADS), coordinate with Unified Medical Language System (UMLS), and collaborate with standards development organizations Usability of existing HIT exchange protocols and specifications Use NIEM processes and adapt supporting tools to create computable, useable implementation specifications NIEM only addresses data content, but transaction behavior and security provisions are necessary for health information exchange Adapt structure and content of S&I IEPD to incorporate transport and security aspects of exchange Compatibility of S&I IEPDs with existing NIEM infrastructure and tools, as well as existing health information exchange protocols Develop and adapt NIEM and health information technology tools and framework to support NHIN goals

11. 11 Requirements for a Model Centric Approach »The modeling approach used by the S&I Framework must Provide traceability from Use Case and Requirements through to one or more implementations Provide semantic and syntactic modeling constructs to support defining the information and behavior that are part of exchanges Support the need to harmonize with existing standards defined at different levels of abstraction Be adoptable by different organizations Be able to integrate into NIEM process

12. 12 Model-Centric Solution - MDA »Base S&I Framework modeling on the 3 OMG/MDA model abstractions. Computational Independent Model (CIM) Platform Independent Model (PIM) Platform Specific Model (PSM) »Define a mechanism to show traceability from Use Cases and Functional Requirements through to technical bindings defined in a PSM. »Define a flexible modeling foundation by which different types of specifications can be defined. »Provides ability for multiple technology bindings for the same set of logical specifications (multiple PSMs)

13. 13 Specification Models NIEM Processes and Artifacts S&I Activities Harmonization of Core Concepts Implementation Specifications Reference Implementation and Pilots Business Processes, Use Cases Business Rules, Business Requirements Exchange Content Model, Mapping Document Exchange Schema, Subset/Constraint Schema, Main Document, IEPD Catalog, IEPD Metadata, Sample XML Vision Document, Process Model Use Case Model, Interaction Model, Domain Model Behavior Model Domain Model Web Services Schema and WSDL Use Case Development and Functional Requirements Certification and Testing CIM PIM PSM Scenario Planning Analyze Requirements Map and Model Publish and Implement Build and Validate Assemble and Document Model Centric Solution - NIEM

14. 14 Prioritization and Backlog Lists Strategic Priorities Strategic Priorities Operational Priorities “Day to Day” Priorities within each functional team

15. 15 What’s Next »Create a NIEM Health standards harmonization process and governance framework »Establish roadmap for existing NHIN standards, MU harmonization, and non-MU health information exchange specifications »Establishes a repeatable, iterative process for developing widely reusable, computable implementation specifications »Establishing the tooling and repositories needed »Establishing the practices and guidelines for modeling »Enables semantic traceability so that useable code can be traced back to original requirements and definitions »Promotes transparency and collaboration from broad range of health stakeholders Scenario Planning Map & Model Analyze Requirements Build & Validate Assemble & Document Publish & Implement Use Case Development and Functional Requirements Standards Development Certification and Testing Harmonization of Core Concepts (NIEM framework) Implementation Specifications Pilot Demonstration Projects Reference Implementation NIEM IEPD Lifecycle

16. 16 CURRENT LESSONS S&I Framework

17. 17 Lessons Learned: NHIN Direct Focused Collaboration A Thousand Flowers Bloom Command and Control LowHigh Participation Classic Trade-Off Low High Focus »Consensus Driven Process »Open Collaboration »Established core guiding principles »Driven by business needs and elaborated use cases »Real world pilot implementation »Establish executive sponsorship and workgroup leads

18. 18 Lessons Learned: Eligibility and Enrollment Focused Collaboration A Thousand Flowers Bloom Command and Control LowHigh Participation Classic Trade-Off Low High Focus »Dedicated resource(s) to drive project and decision making »Clearly defined problem statement at project initiation »Define expectations for desired artifacts »Promote community enthusiasm »Leverage tools to increase efficiencies

19. 19 ISSUES TO DISCUSS S&I Framework

20. 20 Coordination Priority Setting Evaluating Artifacts S&I Framework Issues and Challenges (1) Issues and Challenges »How and when do we get input from other stakeholders including those outside of meaningful use? »VLER »Federal partners »Other stakeholders »How do we foster multiple working groups and create a unified view of priorities? HITSC HITPC Sustainable Operations Shared Infrastructure

21. 21 How do we create simple, easy to implement specifications that will drive adoption? S&I Framework Challenges (2) »How do we facilitate access to SDO standards for providers and support sustainable business models? Engaging the SDO community Developing a “one stop shop” for implementation specifications »How do we foster community and industrial participation to support balanced representation and diverse priorities? Identifying champions for S&I lifecycle initiatives Engage communities throughout S&I Framework Identifying demonstrable pilot programs Engaging and incentivizing volunteers from existing community

22. 22 S&I Framework Open Questions cont. »What are the appropriate interface points with HITSC through S&I Framework lifecycle? Establish priorities, approve implementation specifications, Identifying appropriate decision makers at S&I control points Identifying appropriate roles and participants in the governance of S&I Framework »How do we identify and select tools as shared resources that foster collaboration? Establishing and adhering to agreed upon modeling conventions Tools to support artifact lifecycle management and dissemination »How do we extend NIEM to accommodate needs of health care domain?

23. 23 S&I Framework Priorities »What should our priorities be for the next six months, twelve months, twenty-four months? From among… Meaningful Use Stage 1 Meaningful Use Stage 2 & 3 NHIN Exchange NHIN Direct Health Care Reform VLER New use cases (lab, pharmacy, content specifications) Prioritization needs to accommodate broad stakeholder needs, account for breadth and depth of available expertise, and support a long term growth strategy