1. © 2005 IBM Corporation Laying the Foundation for the Nationwide Health Information Network (NHIN) IBM Consortium - Prototype Architecture Infrastructure February 15, 2006

2. 2 NHIN Architecture Prototype: Key Facts  Announcement of Awardees on November 11, 2005 –Work will help create the foundation of the Nationwide Health Information Network. –RFI November 15, 2004 followed by RFP June 6, 2005 –Design and implement a standards-based network prototype over the coming year –Develop and evaluate prototypes of a NHIN architecture that maximize use of existing resources to achieve interoperability among Healthcare Applications – particularly EHRs. –Demonstrate the solution in 3 marketplaces / communities –12 month duration with option period to increase participation and for further demonstration. The NHIN Prototype – Key Facts

3. 3 NHIN Architecture Prototype : Key Facts –Four Major Consortia were Awarded Contracts – Led by : –IBM –Accenture –CSC –Northrop Grumman –Cooperative and Collaborative Approach –Between Four Awarded Consortia –With Other HHS Partners –Health Information Technology Standards Panel (established by ANSI) –Certification Commission for Health Information Technology (CCHIT) –Health Information Security and Privacy Collaboration (established by RTI and National Governor’s Association) The NHIN Prototype – Key Facts

4. 4 Team IBM  Core Team –Project Executive:Ginny Wagner, PMP –Business Lead:Richard Steen –Project Manager:Russell Scott –Chief Architect:Casey Webster –Consulting Architect:Kevin Julier  Small Business Partners Argosy OmnimediaBusiness Innovation HMS TechnologiesIDL Solutions IngeniumVICCS

5. 5 NHIN Context The NHIN Prototype – Context

6. 6 Community Partners  Fishkill, NY –Taconic Health Information Network & Community (THINC) –Dr. John Blair –2,300 physicians supporting 700,000 patients –Shared data using Healthvision  Research Triangle, NC –North Carolina Healthcare Information and Communications Alliance (NCHICA) –Holt Anderson –Competitive, high-tech urban environment  Rockingham County, NC –Also members of NCHICA –Rural environment with NC and VA patients –Small, competitive practices and hospitals The NHIN Prototype – Communities

7. 7 Architectural Principles  Drive and conform to standards –Instantiation of IHE interoperability framework (XDS, PIX, PDQ, ATNA & CT profiles) –IHE-compliant cross-domain data search & retrieval –PIX inter-community patient identification cross-referencing –Hardware & software vendor agnostic (J2EE, JDBC, JMS, EJB) –XML, CDA, SAML, …  Community-Centric –XDS Document Repositories aggregate and normalize clinical data across a community and can be distributed within that community –Each community has an XDS Document Registry that indexes and tags community data and supports the inter-community NHIN interface  Comply with security & privacy w/o sacrificing usability or research value –Anonymous/pseudonymous data that can be re-identified as needed –Other data aggregates (registries, biosurveillance, outcomes analysis, quality of care)  Practical –Scalable and cost-effective at every level of practice –Point-of-care performance is critical to adoption The NHIN Prototype – Architectural Principles

8. 8 High-Level Community Architecture NHIN Interface Security and Privacy Clinicians XDS Registry* Portal HCN Adapters Auditing PIX/PDQ MPI*Data Transforms Terminology Document Search/Retrieve Patient ConsentBiosurveillance Between Communities Request Response QoS Security Auditing Logging Critical Data* PIX/PDQ Data* Patients Other Components IBM IHE Components * 1 per community KEY Community XDS Documents The NHIN Prototype – Community Architecture

9. 9 Conceptual Architecture for the NHIN Prototype The NHIN Prototype – Conceptual Architecture

10. 10 Initial “Community” Use Case Areas  Domain: Biosurveillance –Use Case Area: emergency room and lab data reporting  Domain: Consumer empowerment –Use Case Area: registration summary and medication history  Domain: Electronic Health Record –Use Case Area: accessing lab results and interpretations The NHIN Prototype – Use Cases

11. 11 DRAFT ONC NHIN High Level Deliverables Schedule 2006 NHIN DeliverableOtherTargetDate Initial Submission of three use cases by consortia ONC -> CommunityJanuary Proposed high-level standards ONC -> HITSPFebruary Community Endorsed Use cases NHIN Consortia and othersMarch Proposed functional requirements HarmonizationApril NHIN Stakeholder Forum #1 CCHIT, HITSP, othersMay Implementation guide / integration profile needs HarmonizationJune NHIN Stakeholder Forum #2 HITSP, CCHIT, othersJuly Security and privacy models HarmonizationSeptember NHIN Stakeholder Forum #3 HISPC, HITSP, CCHITOctober Proposed revenue & cost models HarmonizationOctober NHIN Stakeholder Forum #4 November Documentation of architecture ONCNovember Prototype ONCDecember The NHIN Prototype – Schedule

12. 12 Next Steps …  I encourage you to visit the IHE Interoperability Showcase Peds … –See what has been done in terms of making this stuff real  Contact me (Kevin Julier) or Casey Webster with any questions –KJulier@us.ibm.com or –CaseyWeb@us.ibm.com