1. Purpose of HIPAA Administrative Simplification*
07/16/96
Purpose of HIPAA Administrative Simplification
“to improve ... the efficiency and effectiveness of the health care system, by encouraging the development of a health information system through the establishment of standards and requirements for the electronic transmission of certain health information.” –from the statute *

2. *
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3. *
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4. *
07/16/96 *

5. Security/Privacy Services*
07/16/96
Security/Privacy Services
A group of related services that, together, facilitate the integrity, confidentiality, interoperability and automation of healthcare information exchange in a SOA-based healthcare IT environment.
They address issues of entity authentication, authorization, access control and accountability.
Owned by Security TC, but…
Cross discipline, cross domain approach. *

6. *
07/16/96
Scope and Purpose
Security-as-a-Service within an SOA-oriented architecture implies the decomposition and decoupling of complex security processes that are typically integrated across infrastructure and applications into a set of encapsulated, loosely-coupled security/privacy services. *

7. *
07/16/96
Scope and Purpose
Security-as-a-Service within an SOA-oriented architecture implies the decomposition and decoupling of complex security processes that are typically integrated across infrastructure and applications into a set of encapsulated, loosely-coupled security/privacy services. *

8. *
07/16/96
Why do we care?
Encourages the deployment of interoperable services and applications
Reduces the cost of application development
Facilitates the automation of certain healthcare business processes *

9. Scenario: Clinician Needs Patient Data*
07/16/96
Scenario: Clinician Needs Patient Data
From viewpoint of Requestor/Recipient- Requesting
Where is the patient data? Who’s the custodian?
In what format can the data be sent?
What courier services are available?
How do I submit a request?
From viewpoint of Healthcare Information Custodian
Who is requesting the data?
Why should I let them see it?
Do the Requestor’s privileges match my Policy?
Courier Service
Deliver to intended recipient
Don’t allow tampering
Maintain confidentiality
From viewpoint of Requestor/Recipient- Receiving
Who sent it? Do I trust them?
Has it been tampered with?
Can I understand what the Author intended to say? *

10. Functional Capabilities*
07/16/96
Functional Capabilities
To include security/privacy functionality essential to enable or facilitate interoperability and automation including identity management, trust management, privilege and access management, auditing, etc. These would be as constrained as possible while still providing a complementary set of security services.
Identity and credentials of a resource requestor that can be authenticated must be transported to an resource access decision point where appropriate authorization policy is applied, an access control decision is enforced and all required audit events are recorded. Confidentiality of PHI is maintained at all times. *

11. Example – Open Source EHR-S Function*
07/16/96
Example – Open Source EHR-S Function
HL7 EHR-S Function I.1.6 Basic NHIN Access
Healthcare Applications/ Components
Trust Registry
Healthcare Framework
Directory Access
Trust Network
Authentication
Privacy
Communications
Cross Industry Framework
Identity Management
Security/ Encryption
Audit Services
Eclipse Base Framework
Execution Environment
Operating System
Computer Hardware *

12. Example – Vendor ePrescription Sub-Profile*
07/16/96
Example – Vendor ePrescription Sub-Profile
Vendors use the Healthcare Framework to build specialized profiles and applications like ePrescribing.
Installable Eclipse “plug-ins” encapsulate the functions required to support profiles and applications.
Operating System
Computer Hardware
Healthcare Applications/ Components
Execution Environment
Eclipse Base Framework
Cross Industry Framework
Healthcare Framework
HL7 EHR-S Function DC ePrescribe
Trust Registry
Identity Management
Trust Network
HL7 Messaging
UI - RCP
Directory Access
ePrescription
Practice Management
Components
EHR System Components
Payer Services
HL7 Vocabulary
Advanced XML Processing
Security/ Encryption
Privacy
Audit Services
Communications
Authentication *

13. Overview—Conceptual Healthcare Service Architecture
Healthcare Service Bus (HSB) *
07/16/96
Overview—Conceptual Healthcare Service Architecture
Health Information Network
Health Information Network Infrastructure Services
Interoperability Services  R  R
Patient Information Services
Public Health Information Services 
Provider Registry
Security Management
HL7 V3  R  R  R  R
Healthcare Information Exchange
Electronic Health Record (EHR)
Outbreak Management 
Patient Resolution
Privacy Management
Terminology  R  R
De-Identified Patient Data Warehouse
Personal Health Record (PHR)
Public Health Reporting
Service Registry
Community Management
Document Processing   R
Public Health Services
Pharmacy System
Radiology Center PACS/RIS
Lab System (LIS)
Hospital, LTC, CCC, EPR
Physician Office EMR
EHR Viewer
Public Health Provider
Pharmacist
Radiologist
Lab Clinician
Physician/ Provider
Physician/ Provider
Physician/ Provider
POINT OF SERVICE
HSB Access Node
HSB Support Services
Representative HIN Services
Representative Commercial Services 
Open HealthIT Core Initiative  R
Open HealthIT Reference Implementation *

14. Overview--Healthcare Service Architecture*
07/16/96
Overview--Healthcare Service Architecture
Health Information Network
Healthcare Information Exchange
Physician Office EMR
Physician/ Provider
POINT OF SERVICE
HSB Access Node
HSB Support Services
Representative HIN Services
Representative Commercial Services 
Open HealthIT Core Initiative  R
Open HealthIT Reference Implementation *

15. Open Health IT - HSB Messaging Stack*
07/16/96
Open Health IT - HSB Messaging Stack
Intranet Healthcare Services
Intranet Healthcare Services
Browser
Healthcare Applications
HSB Support Services
Healthcare Process Model & Execution Engine
Local Healthcare Services
xHIN Protocols
xHIN Protocols
xHIN Protocols
xHIN Protocols
SOAP
SOAP
SOAP
SOAP
HTTP
HTTP
HTTP
HTTP
HTTP-S/MIME
Healthcare Service Bus
TCP/IP
Network Hardware *

16. *
07/16/96 *

17. xHIN Identity Transport*
07/16/96
xHIN Identity Transport
Transport Envelope (http, smtp, file, …)
SOAP Envelope
SOAP Header
wss:Security
Sender ID + Structural Role
Policy-based (Tier 0) Web Service Access Decision
Digital Signature (transport)
SAML Assertion: Role
Sender Functional Role
Encrypted (transport)
SAML Assertion: Other
Sender Other
Other
Other
Policy-based (Tier 1) Target Object Access Decision
SOAP Body
Query
Encrypted (transport, optional)
Document
Other *

18. xHIN – extensible Health Information Network*
07/16/96
xHIN – extensible Health Information Network TM
The xHIN technology represents both an architecture and a set of functional specifications that exhibits two essential attributes:
the ability to facilitate automation of clinical and business processes, and
high extensibility—the ease with which xHIN-based health information networks can be deployed, expanded and enhanced.
xHIN
oneness
ACHI
EVE *

19. Security/Privacy Services*
07/16/96
Security/Privacy Services
May include:
Integrity
Confidentiality
Identity Management
Access Control/Privilege Management
Access Decision Service
Access Policy Provisioning Service
Audit
Privacy
Security
Entity Registry Service
Facilitates the location of an entity’s PKI information and other information required to accomplish the exchange of healthcare information.
Credential Authentication Service
Credential Binding Service
Credentials may be bound to an Identity
Trust Correlation Service
De-identification, Re-identification, Pseudnonymization *

20. Entity Registry Service*
07/16/96
Entity Registry Service
PKI identity services for entities are likely to be provided by many different parties- private, commercial and government. The Entity Registry Service facilitates the location of an entity’s PKI information and other information required to accomplish the exchange of healthcare information. The entity data may be maintained by an Identity Provider. This service may leverage the EIS. *

21. Access Control/Privilege Management*
07/16/96
Access Control/Privilege Management
Access Decision Service
Taking into account asserted identity/credentials, target resource and other factors, returns a decision allowing or denying access to the target resource.
May leverage Identity Authentication and Credential Authentication Services
Access Policy Provisioning *

22. Next Steps Reference/Resource Compilation Mailing List*
07/16/96
Next Steps
Reference/Resource Compilation
Mailing List
Telecon Schedule
Sub-service Prioritization
Initial Drafts *

23. Eclipse OHF Architecture Overview*
07/16/96
Internet
Display
Devices
Eclipse
Healthcare
Automotive
Telecom
Runtime UI
Workbench Services
Non-core Services and Plug-ins
Business Intelligence and Modeling
Resources
JFace
Data Tools
SWT
Basic XML Services
Development Tools
Help
Update
Text
Other Plug-ins as needed
Dynamic Code/Schema Management
Rules Processing
Smart Token Support
Security (OSGi)
Other Plug-ins as needed
Wireless Support
Metering
Eclipse Core
Windows or Linux OS
Computer Hardware
Class of Plug-ins
Plug-in
Communication Channel *

24. Eclipse OHF Architecture Overview*
07/16/96
Internet
Display
Devices
Eclipse
Healthcare
Applications
Runtime
Open Healthcare Framework UI
Workbench Services
Non-core Services and Plug-ins
Business Intelligence and Modeling
Resources
JFace
Data Tools
SWT
Basic XML Services
Development Tools
Voice Services Support
XML Processing
Other Plug-ins as needed
EHR Support
HIPAA Support
Trust-based Network Support
Help
Update
Text
Other Plug-ins as needed
Administrative Tools
Web Service Support
Dynamic Code/Schema Management
Rules Processing
Smart Token Support
Security (OSGi)
Other Plug-ins as needed
Wireless Support
Metering
Eclipse Core
Windows or Linux OS
Computer Hardware
Class of Plug-ins
Plug-in
Communication Channel *

25. Eclipse OHF Architecture Overview*
07/16/96
Internet
Display
Devices
ePrescription
Knowledge Services
Training
Clinical Testing
Practice Management
CCR Client
Clinical Data Capture Support
Telecom Services
Payer Services
Administrative Support
Dictation/ Transcription
Patient Services
Registry Services
Trust Services Support
Applications
Voice Services Support
XML Processing
Other Plug-ins as needed
EHR Support
HIPAA Support
Trust-based Network Support
Administrative Tools
Web Service Support
Open Healthcare Framework
Dynamic Code/Schema Management
Rules Processing
Wireless Support
Smart Token Support
Security (OSGi)
Metering
Other Plug-ins as needed
Eclipse Core
Windows or Linux OS
Computer Hardware
Class of Plug-ins
Plug-in
Communication Channel *