1. HIT Policy Committee NHIN Workgroup Introductory Remarks David Lansky, Chair Pacific Business Group on Health Danny Weitzner, Co-Chair Department of Commerce, NTIA December 15, 2009

2. 2 Workgroup Members Chair  David Lansky, Pacific Business Group on Health Co-Chair  Danny Weitzner, Department of Commerce, NTIA Members Christine Bechtel, National Partnership for Women & Families A. John Blair, III, Taconic IPA Neil Calman, Institute for Family Health James Borland, Social Security Administration Carol Diamond, Markle Foundation Colin Evans, Dossia Tim Cromwell, Department of Veterans Affairs Jonah Frohlich, Deputy Secretary, Health IT, California Leslie Harris, Center for Democracy and Technology Arien Malec, Relay Health Marc Overhage, Regenstrief Institute Marc Probst, Intermountain Healthcare Wes Rishel, Gartner Micky Tripathi, Massachusetts eHealth Collaborative ONC  Farzad Mostashari  Todd Park  Doug Fridsma

3. NHIN Workgroup Charge To create a set of recommendations for a policy and technical framework that allows the internet to be used for the secure and standards-based exchange of health information in a way that is both open to all and fosters innovation. The Workgroup will provide an initial set of recommendations to the HIT Policy Committee in January.

4. 4 Priority Focus Areas - Rationale Draft meaningful use criteria for 2011 implicates health information exchange among providers and with patients. A foundational element to achieve several of the criteria will be “push” of patient data from one provider to another, or from one organization to another (e.g., doctor to consultant, or lab to doctor, or doctor to pharmacy), where the sender may not have a prior relationship with the recipient.

5. Foundational NHIN Components Vocabulary Standards Document / Message Standards Directories and certificates Delivery protocols Authentication Security and trust relationship

6. 6 Priority Focus Area - Directories In examining the “push” function, the workgroup focused on the need for standardized, accessible directories that allow the sender to reliably locate the recipient – even the off-line recipient. The workgroup will host a public hearing on current approaches to directories on December 16. A second hearing, on authentication issues, is planned for January 7.

7. HIT Policy Committee NHIN Workgroup The Context Remarks by Dr. Farzad Mostashari

8. Outline Context NHIN today NHIN tomorrow Use cases Key Considerations

9. Section 3001(b) ONC is to foster “a nationwide health information technology infrastructure that allows for the electronic use and exchange of information and that…promotes a more effective marketplace, greater competition…[and] increased consumer choice” among other goals.

10. Exchanging Patient Data Vocabulary/ Document/ Message Standards Directories Authentication Delivery Protocols Security Trust Relationships

11. Vocabulary Standards Document/Message Standards Delivery Protocols Security and Trust relationships Directories and Certificates Exchanging Patient Data

12. NHIN: supporting meaningful use in 2011 & 2012 Provider ProviderPharmacy LabProvider

13. Meet the needs of today and tomorrow 2011 - ePrescribing - Lab results into EHRs - Exchange key clinical information - Public health reporting 2013 - Patient PHR access - ePrescribing refills - Summary record - transition of care - Receive health alerts - Immunization information 2015 - Access comprehensive patient data - Automated real-time surveillance Goal: This is part of an evolutionary path There will be incremental growth All journeys start with a few steps

14. Key Considerations Reinforce a solid trust fabric How to achieve authentication (January 7, 2010 hearings) Identify what can be done today to accelerate use of information exchange Clarify role of government Enable broad participation across broad spectrum of organizations, large and small

15. Agenda for December 16 hearing 10:05 a.m.Level Setting & Review of Objectives 10:20 a.m.Summary of Approaches for NHIN Meaningful Use in 2011 & Components of the NHIN 10:40 a.m.Testimony - SureScripts 11:00 a.m.Testimony - Council for Affordable Quality Healthcare 11.20 p.m.Testimony - Emdeon 11.40 p.m.Testimony - Social Security Administration 12:00 p.m.Testimony - Federation of State Medical Boards 12:20 p.m.Public Comments 12:50 p.m.Summary and Closing 1:00 p.m.PUBLIC MEETING ADJOURNS