1. Client Registry An enterprise master patient index (EMPI), or Client Registry manages the unique identity of citizens receiving health services with the country – “For whom”

2. Considerations Challenge: – Health data generated in many locations with differing identifiers Approach(es): – Explore National ID / Healthcare Identifiers – Leverage sophisticated matching algorithms – Develop Policies/processes for reconciling identities Close coordination with SHR

3. Provider Registry A Provider Registry is the central authority for maintaining the unique identities of health providers within the country – “By whom”

4. Considerations Challenge: – Providers may have differing identifiers in differing contexts – Various use cases must be supported (e.g,,credentialing, provider quality of care reports) Approach(es): – Develop a standardized, shared source of canonical provider ID’s Close coordination with FR

5. Facility Registry A Health Facility Registry serves as a central authority to uniquely identify all places where health services are administered within the country – “Where?”

6. Considerations Challenge: – Complete and standardized facility data necessary for a variety of eHealth use cases is often lacking Approach(es): – Develop standardized Facility identifiers with a shared source of stakeholder-driven facility metadata. Close coordination with PR

7. Terminology Service A Terminology Service serves as a central authority to uniquely identify the clinical activities that occur within the care delivery process by maintaining a terminology set mapped to international standards such as ICD10, LOINC, SNOMED, and others – “What?”

8. Considerations Challenge: – Health data concepts and codes are non standard, which hinders a comprehensive view of patient-level and system wide outcomes. Approach(es): – Recognize need for distinct ‘interface’ and ‘reference’ terminologies – Develop stakeholder driven approach to adopting reference terminologies – Develop stakeholder driven approach to developing terminology metadata and term maintenance process Close coordination with SHR/HIL

9. Shared Health Record A Shared Health Record (SHR) is a repository containing the normalized version of content created within the community, after being validated against each of the previous registries. It is a collection of person- centric records for patients with information in the exchange.

10. Considerations Challenge: – eHealth data is often stored in differing formats among disparate systems, limiting availability and usability Approach(es): – Develop stakeholder driven approach to define data access requirements – Develop stakeholder driven approach to developing terminology metadata and term maintenance process Close coordination with SHR/HIL

11. Health Interoperability Layer A Health Interoperability Layer receives all communications from point of service applications and orchestrates message processing between the point of service application and the hosted infrastructure elements. Health Interoperability Layer

12. Considerations Challenge: – eHealth data is generated and transmitted often stored in differing formats among disparate systems, limiting availability and usability Approach(es): – Develop stakeholder driven approach to define/specify information exchange requirements and “bus behavior” Close coordination with all components